What is Gout? And how can Physiotherapy help?
Gout is a form of arthritis characterized by sudden and severe attacks of pain, redness, and swelling in the joints. It occurs due to the buildup of uric acid crystals in the affected joints, leading to inflammation. Uric acid is a waste product that is normally filtered out by the kidneys and excreted in urine. However, in individuals with gout, there is an overproduction of uric acid or reduced excretion, resulting in elevated levels in the blood and the formation of crystals.
It usually occurs with painful intermittent attacks followed by long remission periods. Most patients with gout have other comorbidities. Gout is more common in individuals with chronic diseases such as diabetes, myocardial infarction, hypertension, congestive heart failure and chronic kidney disease.
The most commonly affected joint in gout is the base of the big toe, but it can also affect other joints such as the ankles, knees, elbows, wrists, and fingers. During an acute gout attack, the joint becomes red, extremely tender, swollen, and hot to the touch. The pain is often described as sharp and excruciating, and the affected area may appear red and shiny. Onset of pain often occur during sleep with the acute phase usually lasting 7-10 days.
Management:
Lifestyle changes, including dietary modifications and medication to manage uric acid levels prescribed by a healthcare professional, are typically recommended to prevent further gout attacks and help manage the condition. A healthcare professional can also provide guidance on weight management and trigger avoidance (e.g., alcohol, certain foods). With proper treatment and adherence to lifestyle modifications, gout attacks can be minimized or prevented, and long-term joint damage can be avoided.
Physiotherapy can play a supportive role in managing gout. While it cannot directly treat the underlying cause, it can help in various ways:
Pain management: Physiotherapists can employ techniques such as ice or heat therapy, ultrasound, and transcutaneous electrical nerve stimulation (TENS) to provide pain relief during acute gout attacks.
Joint mobilization: Gout can lead to joint stiffness and limited range of motion. Physiotherapists can use manual therapy techniques to improve joint mobility and reduce stiffness.
Exercise and strengthening: Regular exercise, under the guidance of a physiotherapist, can help maintain joint flexibility, strengthen the muscles around the affected joints, and improve overall mobility.