What Are The Causes And Triggers Of Gout In The Elbow
The buildup of uric acid in the body is known as hyperuricemia. Your body produces uric acid when it breaks down purines. These are compounds found in all your cells. You can also find purines in several types of food, especially red meat and some seafood, as well as alcohol and some sugar-sweetened drinks.
Usually, uric acid passes through your kidneys, which help to eliminate extra uric acid in your urine. But sometimes theres too much uric acid for your kidneys to handle. In other cases, the kidneys cant process a typical amount of uric acid due to an underlying condition.
As a result, more uric acid circulates throughout your body, ending up in your elbow as uric acid crystals.
4 percent of adults in the United States. It tends to be more common in men because women usually have lower levels of uric acid. But after menopause, women start to have higher uric acid levels. As a result, women tend to develop gout at an older age than men do.
Experts arent sure why some people produce more uric acid or have trouble processing it. But theres evidence that the condition is often genetic.
Other things that may increase your risk of developing gout include:
- consuming a lot of high-purine foods
- consuming foods and drinks, especially alcohol, that increase uric acid production
- being overweight
What Are The Symptoms Of Gout
If you think you are suffering from gout, how can you be sure? One of the tell-tale signs of gout is excruciating swelling and pain in the big toe, usually resultant of an injury. Gout may affect other joints intermittently, though, most often it affects the joints in the foot and knee. If left untreated, gout can become a chronic condition.
If you do not treat gout symptoms, your body may produce something called tophi which are little crystals that form disfiguring lumps near your joints and can also produce painful kidney stones.
Pain Relief Without Medicine
Use cold. If your pain isn’t too bad, try cold packs or compresses on the joint to lower inflammation and soothe the ache. Wrap ice in a thin towel and apply it to the joint for up to 20 minutes several times a day. Do not apply ice to your hands or feet if you have nerve problems from diabetes or other causes.
Rest the joint. It’s a good idea to rest it until the pain eases up. You probably won’t want to move it much anyway. If you can, raise the joint on a pillow or other soft object.
Drink water. When your body doesnât have enough water, your uric acid levels rise even higher. Stay hydrated to help keep those levels normal.
Watch what you eat and drink. Foods that are high in substances called purines, such as some seafood, organ meats like liver, and fatty foods, can raise the uric acid in your blood even more. So can fructose-sweetened drinks and alcohol — especially beer.
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Elbows Appearance And Other Symptoms
Another sign of gout is how your elbow looks during the attack. Gout will cause your elbow to become inflamed or swollen. This inflammation can start at your elbow and move to other areas of your body, such as your forearm or fingers. In addition, you may notice that the skin on your elbow appears shiny, constricted and red. After a few days, the skin on and around your elbow may start peeling.
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Can It Lead To Any Complications
If left unmanaged, gout-related inflammation can cause permanent damage to your elbow joint, especially if you have frequent flare-ups.
Over time, lumps of uric acid crystals, called tophi, can also form around your elbow. These lumps arent painful, but they can cause additional swelling and tenderness during a flare-up.
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How Common Is Elbow Gout
In terms of gout flare-ups, the elbows are not the most commonly affected joints the big toe, knees, hands, and even ankles are more likely to suffer from the condition. It is speculated that this may be due to the fact that the elbow joints are somewhat warmer than the joints found in the distal extremities. This makes sense as the parts of the body closest to the heart tend to be warmer due to increased blood circulation from the heart. Also, remember that uric acid crystal formation is promoted by colder temperatures.
Another explanation for the relative rarity of elbow gout is that the synovial fluid of the elbow joint is more alkaline, which means it has a higher pH level. Observations of previously documented cases of gout found that the higher pH levels of the synovial fluid of the elbow were associated with less virulent attacks.
Whats The Outlook For People With Gout
Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.
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How Elbow Bursitis Is Treated
Elbow bursitis is a common condition that causes pain and swelling in the back of the elbow. Also called olecranon bursitis, elbow bursitis typically responds to simple treatment steps, although infected bursae or chronic bursitis may require more invasive treatments.
Uric Acid Is The Cause
When there is an overabundance of uric acid in the blood it is called gout. Usually, having too much uric acid in the blood is not harmful. In fact many people with high levels in their blood never know about it. When uric acid levels in the blood become extremely high, the uric acid may start to form crystals. These crystals most commonly form in the joints, especially the joints in the big toe. Your odds of experiencing the pain of gout are higher if you are overweight, drink excessive amounts of alcohol, or have a diet that is comprised of meat and fish that are high in chemicals called purines.
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Treating Gout With Medications
Certain medications reduce the pain and inflammation of gout attacks, such as anti-inflammatory drugs , colchicine, and corticosteroids. Other medications decrease the level of uric acid in the blood and prevent the deposit of uric acid in joints , the kidneys , and in tissue , helping to prevent further attacks and complications. These drugs include allopurinol, febuxostat, lesinurad, and probenicid.
What Does A Gout Attack Look And Feel Like What Would A Foot Or Toe With Gout Look Like
When gout occurs, the joint tends to be extremely painful and is warm, red and swollen . The inflammation that is part of a gout attack is systemic, so that fever and chills, fatigue and malaise are not uncommonly part of the picture of a gout attack.
Figure 6: Toe with Acute Attack of Gout
Gout attacks can occur in joints that look normal, or in joints that have easily visible deposits of uric acid. These deposits are called tophi and can be in numerous locations, but especially on the feet and elbows. In Figure 9, the little finger of the right hand is bandaged since fluid was just removed from it, which demonstrated innumerable uric acid crystals.
Figure 7a: Tophi on Foot
Figure 7b: Tophus Over Achilles’ Tendon
Figure 8: Tophus on Elbow
Figure 9: Tophi on Hands
Figure 10: Large Tophus of Finger
While some gout attacks will solve quickly by themselves, the majority will go on for a week, several weeks, or even longer if not treated. Since gout attacks are usually quite painful and often make walking difficult, most gout sufferers will request specific treatment for their painful condition.
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What Is Gout Symptoms Treatments And More
Gout causes sudden and intensely painful inflammation in a joint, and itâs the result of the accumulation of a waste product called uric acid. This may happen for a few different reasons.
The body can make too much uric acid, or the kidneys may not get rid of enough uric acid. Most commonly, this is due to genetics. Some people are just more sensitive to foods and drinks high in purines, which the body turns into uric acid.
Foods and drinks especially high in purines include red meats, certain seafood, high-sugar food and beverages, and all types of alcohol.
As uric acid breaks down, it forms tiny needle-like, painful crystals which settle into joints just about anywherein the knee, foot, ankle, hand, wrist, elbow, or fingers, but it often targets the big toe.
You may feel absolutely fine during the day, but like a bad nightmare, gout typically strikes at night, causing pain so intense you canât go back to sleep. The pain may be so severe it incapacitates you.
A gout attack may last a few days to a week or even longer. Some medication works to speed up relief and healing for a gout attack other medications work to lower uric acid in order to prevent future gout attacks.
What Causes Gout In Elbow
Normally, uric acid is produced in the body and is present within normal limits. It remains dissolved in the blood, which circulates in the body, is processed by the kidneys and excreted in the urine as a normal component of urine. Gout in elbow is mainly caused by excess uric acid in the blood. This could be a result of over production in the body or improper excretion from the body. In either cases, the excess uric acid remains present in the blood, which then begins to form crystals that get deposited in the elbow joints. This causes inflammation in the elbow joints and other tissues.
What causes gout in elbow is an important thing that needs to be understood. While it is possible that people with increased levels of uric acid in the blood may not always develop gout, it is possible that some people may be at an increased risk. Certain risk factors of gout in elbow have been identified.
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Treating A Gout Attack
Treating an attack of gout doesnt lower your urate levels or stop future attacks. The treatment helps you to manage your symptoms when an attack happens.
The most commonly used drug treatments for attacks of gout are:
Some people will be better suited to NSAIDS, while others will be suited to colchicine. But your preference is also taken into consideration many people with gout quickly learn what works best for them.
In cases where one drug doesnt seem to be working on its own, your doctor might suggest a combination of NSAIDs with either colchicine or steroids.
Non-steroidal anti-inflammatory drugs
Attacks of gout are often treated with NSAID tablets, which can help with pain and reduce some of your inflammation. Ibuprofen, Naproxen and diclofenac are three NSAIDs you could be given.
If youve been prescribed NSAIDs to treat an attack, you should start taking them as soon as you notice signs of one coming on. Your doctor may let you keep a supply so you can start taking them at the first signs of an attack.
The earlier you start treatment, the better.
NSAIDs arent suitable for everyone, so talk to your doctor about them first if you have any other conditions. They can also interact with other drugs, so make sure you talk to a doctor before starting on any new medication.
Colchicine
Colchicine isnt a painkiller, but can be very effective at reducing the inflammation caused by urate crystals.
Colchicine tablets can cause diarrhoea or stomach aches.
Steroids
The Role Of Physical Activity In Prevention Of Gout
Along with diet, physical activity can help with weight loss, and gout has been associated with being overweight.7 in patients with well-established gout, especially if X-rays have demonstrated joint damage in the foot, a low-impact exercise program is reasonable. An exercise program combined with diet in gout can reduce risk for attacks.7 If an attack seems to be coming on in the lower extremity, patients are well-advised to try to get off their feet, since impact seems to worsen gout attacks. Clues to an attack of gout coming on include local swelling, heat, redness, and tenderness in a joint, especially in the foot, ankle, or knee. Some patients have fever and chills as the first warning that an attack of gout is coming on.
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How Is It Diagnosed
The only way to diagnose gout with certainty is by your doctor finding urate crystals in fluid taken from your joint. Uric acid levels can be measured by blood tests, however these are not always accurate. Uric acid levels may be normal or even lowered during an attack of gout. Blood tests are most useful in ruling out other causes for your symptoms, such as joint infections or other forms of arthritis. X-rays are often normal in the early stages so are not very useful in diagnosing gout.
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Gout In Elbow Symptoms
Gout in the elbow can cause sudden severe pain. This gout elbow pain may be so bad that it can wake you up at night. Gout episodes typically occur rapidly over a few hours, with the skin of the affected joint appearing shiny and small, firm lumps possibly developing underneath the skin. Symptoms of gout in elbow include:
- Swelling
- Pain
- Possible fever
After an acute attack of elbow gout, it may begin to spread down to other joints such as the wrist and fingers over the coming days. Gout in elbow symptoms tend to recur anywhere from six months to two years after the initial episode, with approximately 60 percent of gout patients having a recurrence within one year.
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Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
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What To Do During An Attack
You should:
- take any medication you’ve been prescribed as early as possible after you notice an attack this should start to have an effect within two or three days
- rest and raise the limb
- avoid knocking or damaging the affected joint
- keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
- ensure you’re well hydrated
Apply the ice pack to your joint for around 20 minutes. Don’t apply ice directly to your skin and don’t apply it for more than 20 minutes at a time because this could damage the skin.
If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.
How Is Gout Diagnosed
In a clear-cut case, a primary care physician can make the diagnosis of gout with a high level of confidence. However, often there are two or more possible causes for an inflamed toe or other joint, which mimics some of the symptoms of gout, so tests to identify the presence of uric acid is performed.
Since the treatment for gout is lifelong, its very important to make a definitive diagnosis. Ideally, the diagnosis is made by identifying uric acid crystals in joint fluid or in a mass of uric acid . These can be seen by putting a drop of fluid on a slide and examining it using a polarizing microscope, which takes advantage of the way uric acid crystals bend light. A non-rheumatologist, when possible, can remove fluid from the joint by aspirating it with a small needle and send it to a lab for analysis. A rheumatologist is likely to have a polarizing attachment on their microscope at their office. Gout crystals have a needle-like shape, and are either yellow or blue, depending on how they are arranged on the slide .
Figure 11: Uric Acid Crystals Under Polarizing Light Microscopy
There are many circumstances where, however ideal it would be, no fluid or other specimen is available to examine, but a diagnosis of gout needs to be made. A set of criteria has been established to help make the diagnosis of gout in this setting .2
Table 1: Diagnosing gout when no crystal identification is possible
Ideally, 6 of 10 features will be present of the following:
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