Diagnosis is key to Relief of Fernandina Beach Spinal Gout

Gout. If you have had gout, you know how unpleasant it is. You may also know how tough it was to identify as the issue, especially if it was in the spine. Back pain or leg pain may have been your first symptom. Your Fernandina Beach chiropractor at Amelia Chiropractic Clinic is aware of spinal gout, its similarities with other conditions’ symptoms, and the latest advised assessments to diagnose it sooner than later to direct you to the (appropriate!) 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 a challenge to diagnose and discrimainate from other inflammatory issues. (1) A new narrative review stated that 94% of spinal gout patients had 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 uncommon cause of spine pain, gout’s inflammatory arthritis results 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 improve clinical outcomes.

DIAGNOSIS OF SPINAL GOUT

Researchers have investigated a variety of ways to safely and accurately identify gout in people who have never had gout. They have analyzed studies from as far back as 1945! They found that synovial fluid monosodium urate crystal analysis and imaging were superior to a clinical algorithm of signs and symptoms only for diagnosis and treatment planning. (3) Facet joint disorders, osteoarthritis, synovial cysts, etc., can confuse 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 order the proper test. (4) A narrative review of published studies on spinal gout that was done by two chiropractors concurred. 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 answer. (2) Amelia Chiropractic Clinic 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 limited 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 pathological exam revealed spinal gout. 29% of patients with gout are affected by 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 reducing therapy, and NSAIDS. (6) If spinal gout is speculated, Amelia Chiropractic Clinic will get the right tests ordered.

CONTACT Amelia Chiropractic Clinic

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 Fernandina Beach chiropractic appointment soon. Your Fernandina Beach chiropractor will do a thorough examination to determine the best course to appropriately diagnose, treat, and attain the best relief of spinal gout. 

 
Amelia Chiropractic Clinic is aware that inflammatory spinal gout is a differential diagnosis to consider for patients who present with back pain and other spine related symptoms. 
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"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."