Diagnosis is key to Relief of St Peters Spinal Gout
Gout. If you’ve had gout, you know how unpleasant it is. You may also know how difficult it was to identify as the issue, especially if it was in the spine. Back pain or leg pain might have been your first symptom. Your St Peters chiropractor at Old Mill Chiropractic understands spinal gout, its similarities with other conditions’ symptoms, and the latest recommended tests to diagnose it early to direct you to the (proper!) care you need.
PREVALENCE OF SPINAL GOUT
Arthritis is an inflammatory condition affecting people around the world - 47.8 million US sufferers, 8 million UK sufferers, 108 million European sufferers - with osteoarthritis being the most common affecting joints in the knee, hands, etc. Gout is just such an inflammatory cause of pain in similar areas, making it difficult to diagnose and differentiate from other inflammatory issues. (1) A recent narrative review reported that 94% of spinal gout patients described back or neck pain, 86% displayed neurological symptoms, 72% noted a history of gout, 80% tested for high levels of serum uric acid, and 76% underwent surgery. Though an infrequent cause of spine pain, gout’s inflammatory arthritis stems from monosodium urate crystals in synovial fluid and other joint tissues (ankle, foot, hands, wrists, elbows, knees, hips, and spine). (2) An early, appropriate diagnosis of spinal gout can better direct treatment and enhance clinical outcomes.
DIAGNOSIS OF SPINAL GOUT
Researchers have investigated a variety of ways to safely and accurately diagnose gout in people who have never experienced gout. They have reviewed studies from as far back as 1945! They found that synovial fluid monosodium urate crystal analysis and imaging were better than a clinical algorithm of signs and symptoms only for diagnosis and treatment planning. (3) Facet joint disorders, osteoarthritis, synovial cysts, etc., can muddle the diagnostic process for spinal gout. Luckily, dual energy computed tomography (DECT) illustrates the crystals. However, healthcare providers must be aware that gout is a possible cause to order the proper test. (4) A narrative review of published studies on spinal gout that was done by two chiropractors concurred. To make better the quality of life of spinal gout sufferers as well as the diagnosis, treatment planning and prevention of surgery, a combination of clinical symptoms, lab tests, and DECT may be the key. (2) Old Mill Chiropractic notes that cases of spinal gout are appearing in the medical literature.
CASES OF SPINAL GOUT and TREATMENT
One case of a 48-year-old man with sudden, severe, sharp low back pain that reduced his mobility and with no history of gout ended up with a diagnosis of spinal gout after an MRI showed a mass in his right erector spinae muscles which lead to a biopsy that exposedspinal gout. 29% of patients with gout experience spinal gout, too, which did not help in this case of a patient without gout but is an interesting stat to consider in the next case. (5) A 41-year-old male who did have a 7-year history of gout presented with severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was diagnosed negating an initial diagnosis of vertebral osteomyelitis. Initial treatment often includes symptom management with colchicine, steroids, urate lowering therapy, and NSAIDS. (6) If spinal gout is supposed, Old Mill Chiropractic will get the right tests ordered.
CONTACT Old Mill Chiropractic
Listen to this PODCAST with Dr. Joseph Beissel on The Back Doctors Podcast with Dr. Michael Johnson as he describes the relief with The Cox® Technic System of Spinal Pain Management for chronic back pain.
Schedule your St Peters chiropractic appointment today. Your St Peters chiropractor will do a thorough examination to figure out the best course to appropriately diagnose, treat, and attain the best relief of spinal gout.
