Diagnosis is key to Relief of Manahawkin Spinal Gout
Gout. If you have had gout, you know how uncomfortable it is. You may also know how tough it was to diagnose, especially if it was in the spine. Back pain or leg pain may have been your first symptom. Your Manahawkin chiropractor at Manahawkin Chiropractic Center is aware of spinal gout, its resemblance to other conditions’ symptoms, and the latest recommended tests to diagnose it early to help you get 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 difficult to diagnose and differentiate from other inflammatory issues. (1) A recent narrative review stated that 94% of spinal gout patients had back or neck pain, 86% displayed 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 uncommon 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 guide 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 analyzed 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 of the possibility of gout to order the right test. (4) A narrative review of published studies on spinal gout that was undertaken by two chiropractors concurred. To enhanced 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 answer. (2) Manahawkin Chiropractic Center documents that cases of spinal gout are emerging 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 revealedspinal 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 presented with severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was diagnosed negating an initial diagnosis of vertebral osteomyelitis. Primary treatment often involves symptom management with colchicine, steroids, urate reducing therapy, and NSAIDS. (6) If spinal gout is speculated, Manahawkin Chiropractic Center will get the right tests ordered.
CONTACT Manahawkin Chiropractic Center
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.
Make your Manahawkin chiropractic appointment soon. Your Manahawkin chiropractor will do a thorough examination to determine the best course to appropriately diagnose, treat, and attain the best relief of spinal gout.
