Gout. If you have experienced gout, you
know how painful it is. You may also know how tough
it was to diagnose, especially if it
was in the spine. Back pain or leg pain might have been your first
symptom. Your La Grande chiropractor at Paulette Hugulet, DC, LLC is aware of
spinal gout, its similarities with other conditions’ symptoms,
and the latest advised assessments to diagnose it
early to help you get the (appropriate!)
care you need.
PREVALENCE OF SPINAL GOUT
Arthritis is an inflammatory condition impacting
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% showed neurological symptoms, 72% had a
history of gout, 80% tested for high levels of serum
uric acid, and 76% went through a 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, suitable
diagnosis of spinal gout can better direct treatment and enhance
clinical outcomes.
DIAGNOSIS OF SPINAL GOUT
Researchers have explored various ways to safely and accurately identify gout in
people who have never experienced gout. They have analyzed
studies going back as far 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 cloud the diagnostic process for spinal
gout. Luckily, dual energy computed tomography (DECT)
shows the crystals. However, healthcare providers must be
aware of the possibility of gout to request
the right test. (4) A narrative review of published studies on
spinal gout that was done by two chiropractors agreed.
To improve the quality of life of spinal gout
sufferers as well as the diagnosis, treatment planning and prevention of
surgery, a mix of clinical symptoms, lab tests, and DECT may hold
the key. (2) Paulette Hugulet, DC, LLC
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 wound
up with a diagnosis of spinal gout after an MRI showed a mass in
his right erector spinae muscles which lead to a pathological exam showed spinal gout. 29% of
patients with gout experience spinal gout, too,
which didn’t 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 came for help with
severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was
diagnosed negating an initial diagnosis of vertebral
osteomyelitis. Initial treatment often involves
symptom management with colchicine, steroids, urate decreasing
therapy, and NSAIDS. (6) If spinal gout is supposed,
Paulette Hugulet, DC, LLC will get the right tests ordered.
CONTACT Paulette Hugulet, DC, LLC
Listen to this PODCAST
with Dr. Joseph Beissel on The
Back Doctors Podcast with Dr. Michael Johnson as he
illustrates the relief with The Cox® Technic System of Spinal
Pain Management for chronic back pain.
Schedule your La Grande chiropractic
appointment now. Your La Grande chiropractor will do
a thorough examination to determine the best course
to appropriately diagnose, treat, and attain the best relief of
spinal gout.