Gout Got You Down?
Physical Therapy for Gout
Are you suffering from gout? Physical Therapy Can Help
Gout–many people have heard of it but for the more than 8 million people in the U.S. suffering from gout, it is a painful reality they’d love to prevent. While medical care from a physician is an important part of managing gout, many people do not know that a physical therapist can help address the symptoms and risk factors associated with gout.
WHAT IS GOUT?
So what is gout? Gout is a complex form of arthritis characterized by sudden, severe bouts of joint swelling, pain, warmth, redness, and tenderness. Accumulation of needle-like urate crystals in the joint causes the inflammation and pain characteristic of gout.
Urate crystals form when either too much uric acid is produced by the body or too little is excreted by the kidneys. Uric acid is produced normally by the body when it breaks down what are called purines. Purines are substrates found commonly in food we eat such as red meat, organ meat and some seafood like tuna, anchovies, and mussels. Eating these foods in high amounts can cause elevated uric acid as can drinking certain alcohols such as beer or sugary cocktails.
Men tend to be at higher risk for developing gout than women, though post-menopausal women are at a higher risk than their pre-menopausal counterparts. Certain medications such as low dose aspirin, ACE inhibitors and anti-rejection medications for post-organ transplant patients may increase levels of uric acid in the body. Finally, a family history of gout and a personal history of certain medical conditions such as obesity, uncontrolled high blood pressure, diabetes, metabolic syndrome, or heart and kidney disease increase one’s risk of developing gout.
Gout attacks are most common in the joint at the base of the big toe but can actually occur in any joint. Ankles, knees, fingers, wrists and elbows may be affected by gout as well. An attack of gout typically occurs suddenly. You may awake in the middle of the night with pain, heat, and redness in a joint so severe that even the bedsheet touching the area is unbearable.
It is important to call your doctor if you develop these symptoms. Firstly it is important to rule out other causes of joint pain, redness and swelling such as an infection or acute injury. Secondly, untreated gout can lead to joint erosion and prolonged pain.
HOW IS GOUT TREATED?
During an acute gout attack your physician may prescribe medications to reduce inflammation and manage pain. They may also recommend medications to prevent the build-up of uric acid and improve its removal from the body to decrease your risk of future gout attacks.
While your physician is an important and necessary first point of contact for treating gout, a physical therapist should be another important member of your care team.
WHAT IS A PHYSICAL THERAPIST’S ROLE IN TREATING GOUT?
Once the gout attack is under control, physical therapy is a great option to help restore normal joint movement and function and also to address lifestyle modifications that will lower your risk for future gout attacks.
Lifestyle modifications: If you go back and review the list of risk factors for gout outlined above, you will notice that many of them can be addressed with modifications to one’s lifestyle. It should feel empowering to know that medication is not the only way you can decrease the likelihood of another gout attack and of developing long term joint damage.
Participation in a regular exercise program consisting of moderate to high intensity cardiovascular and strength training can improve risk factors for diabetes, heart disease, high blood pressure, and metabolic syndrome, all conditions associated with an elevated risk for gout.
For many people, lack of familiarity with exercise and concerns about injury or worsening pre-existing conditions such as joint pain or heart disease is a barrier to entry for exercise. Luckily, physical therapists are experts in prescribing exercises that are individualized to not only prevent worsening of your pre-existing medical concerns but to actually help improve them! When you work with a physical therapist they can advise you on how to safely begin an exercise program. Your physical therapist will take the time to get to know your medical history, your current abilities, your concerns, and your motivating factors and help tailor a program to meet your needs.
Physical therapy treatment: Physical therapy for gout will focus on managing pain symptoms and improving function. Modalities such as cryotherapy (cold/ice) have been shown to improve inflammation and pain during a gout attack. Your physical therapist may advise you on splinting, or bracing the involved joint or on assistive devices such as a cane or crutches when pain is severe enough to impair walking.
As the acute attack wanes or in the case of chronic joint damage from gout, restoring normal joint motion is an important part of restoring your function. Your PT may apply gentle hands-on techniques such as passive range of motion, soft tissue therapy or joint mobilization, myofascial release techniques, or taping to improve the mobility and health of the joint and soft tissues that are affected.
In the case of chronic gout, while the surfaces of the joint may no longer be pristine, how the joint moves and how much stress is applied across a joint can play a large role in how much pain you experience and how much you have to limit your activities. Proper strength and flexibility in the muscles surrounding the joint can optimize the movement of the joint and may reduce some of the rubbing that occurs between uneven joint surfaces. Your physical therapist will test your muscles to identify areas that need work and can guide you through a progressive program of exercises to address these issues.
As muscles get stronger and tissues regain their proper length and flexibility, learning to activate muscles at the right time and in the right order during a specific activity is essential. Even if your muscles are strong, the motor control of these muscles may not be adequate to properly perform a movement without putting excessive stress across a certain joint. As you learn to control and fire your muscles while performing motions such as going up stairs or running, you will experience less pain.
The ultimate goal of a physical therapy program is to help you get back to the activities you love and need to do throughout your life. While you may not be able to prevent every gout attack, you can help prevent long-term disability associated with joint injury and inactivity. Don’t let gout get in your way of a happier, healthier, and more active life. Schedule an appointment with a physical therapist at Evolve where they will empower you to make lifestyle changes to reduce your risk for another gout attack and help you get back to activities in the safest, most effective and quickest way possible.
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About EvolveNY-
Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!
First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.
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