One patient came to me saying…. "Doctor I was fine till yesterday, today suddenly I am having pain in my great toe, it is red and swollen, I don’t remember I got hurt or hit, but the pain started suddenly." These kind of picture or somewhere similar presentations are given by most of the patients. These presentation in most of the time are gout. In some cases it can be an insect bite or infection.
What is GOUT?
It is a form of arthritis -- an inflammation of the joints -- that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling in some joints. It usually affects one joint at a time, although it can be in several joints at once.
The large toe is most often affected, it’s called Podagra, but gout can also affect other joints in the leg-- such as the knee, ankle, and foot -- and less often, the hand, wrist, fingers,and elbow. The spine is almost never affected.
If someone has gout on and off for years, eventually uric acid crystals may accumulate in the body to form gritty nodules called "tophi." These nodules can appear as lumps under the skin near joints such as the elbows and fingers, at the rim of the ears, or in the kidneys.
Gouty arthritis is caused by the deposition of crystals of uric acid in a joint. Uric acid comes from purines, which are the natural breakdown products of the genetic material in cells, RNA (ribonucleic acid) and DNA (deoxyribonucleic acid). Some foods contain large amounts of purines, especially red meats and organ meats (such as liver and kidneys), as well as some shellfish, anchovies, and alcohol. Purines are broken down to uric acid in the body.
Uric acid in normal amounts remains dissolved in the blood and easily passes through the kidneys, leaving the body through the urine as waste.However, uric acid in high amounts makes a person more likely to develop gout. But not all cases develop gout.
How Frequent Are GOUT Attacks?
Gout attacks can recur from time to time in the same joint. The initial attack may last several days to two weeks unless treated.
Over time, gout attacks may occur more often, involve more joints, have more severe symptoms and last longer. Repeated attacks can damage the joint.
Some people will have only a single attack. However, most people who have one gout attack will have at least a second attack, although it may not occur for several years after the initial onset.Others may have attacks every few weeks.
It can affect anyone. Men are more likely to get gout, but women become increasingly susceptible to gout after menopause.
Triggers for gout attacks include surgery, dehydration, beverages sweetened with sugar or high fructose corn syrup, beer, liquor, red meat, and seafood. Anything that raises or lowers the uric acid level can cause a gout flare by causing uric acid crystals to deposit in a joint certain drugs like diuretics, allopurinol (lowers uric acid), treatment used for cancer. Any drug that raises or decrease the uric acid level of blood can trigger a gout attack, as it deposits uric acid crystals in joints.
When to see a doctor?
- If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage.
- Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be assign of infection.
Medications are the most proven, effective way to treat gout symptoms. However, making certain lifestyle changes also may help, such as:
- Limiting alcoholic beverages and drinks sweetened with fruit sugar (fructose). Instead, drink plenty of nonalcoholic beverages, especially water.
- Limit intake of foods high in purines, such as red meat, organ meats and seafood.
- Exercising regularly and losing weight. Keeping your body at a healthy weight reduces your risk of gout.
- Cherries may help prevent gout attacks
WHAT ARE THE TESTS?
- A joint fluid analysis (arthrocentesis) to see whether uric acid crystals are present. This is the only certain way to diagnose gout.
- A medical history and physical exam.
- A test to measure levels of uric acid in blood. This may be done if your doctor cannot safely get fluid from the affected joint.
- A test to measure levels of uric acid in urine.
- While X-rays of extremities (hands and feet)
In homeopathy, the approach to illness is to treat the whole person and not only the presenting symptoms of the disease. Thus, rather than treating the disease therapeutically, knowing a person’s constitutional type helps the homeopath choose the most appropriate remedy. In conjunction with taking the appropriate homeopathic remedy, it is necessary to maintain a diet low in purines, as mentioned above, to manage this condition.
Homeopathic practitioners select remedies according to the total picture of the patient, not only based on the physical symptoms, but lifestyle, character, mental and emotional state, stress levels, diet, family history and other general factors in order to prescribe the best remedy. Homeopathic treatments are highly individualized. Two people with gout are treated as distinct individuals, each uniquely influenced by the many factors as mentioned above, with each patient being prescribed a remedy that matches their symptom.
The below are the few important remedies for the treatment of gout.
Colchicum: inflammation of the great toe, gout in the heel, cannot bear to have touched or moved. Oedematous swelling and coldness of legs and feet. Joint stiff and feverish. Shifting rheumatism. Worse from warm weather, evening, night.
Urtica urens: this remedy helps in elimination of uric acid from the body. Uric acid diathesis and gout. The joints are associated with hive like eruptions. Pain in acute gout deltoid, ankles and wrists.
Benzoic acid : it produces and cures the sy. Of uric acid diathesis. The sy are associated with high colored urine and offensive.Rheumatic gout nodes very painful. Pain in great toe, cracking sounds. Worse in open air and uncovering of affected parts.
Ledum pal: gouty pains shoot all through the foot and limb and in joints, but esp. small joints. Ball of great toe swollen, hot, pale. Ascending rheumatism. Amel. Cold water. Cold
Antimonium crud: pain in fingers and heel. Associated with gastric complaints. Thick white coating of tongue. Worse heat and cold bathing.
Sabina: gout worse in heated room. Red shiny swelling, gouty nodosities. Esp. in females with uterine trouble.
Ammonium phos: chronic gouty patients with uric acid diathesis. Indicated in bronchitis and nodosities of the fingers and back of the hands. Coldness from least draft of air.
Arnica: Sore bruised feeling, hurts to walk. The person is afraid to be touched or approached because of pain.
Berberis vulgaris: old gouty constitution. Sudden twinges of pain. Stitching pain in gouty joints. Worse from motion. Stitching between metatarsal bones as from nail when standing. Pain in balls of feet on stepping. Pains change in regard to place and character. Thirst alternates with thirstlessness, hunger with loss of appetite. etc.
Lycopodium: chronic gout with chalky deposits in joints. Pain in the heel on treading as from a pebble. Painful callosities on soles, toes and fingers contracted. Rt. Foot hot and lt. cold. Urine is slow to produce a heavy red sediment. Backache relieved by passing urine. Worse 4pm and 8pm.
Rhododendron: gouty swelling of big toe joint, that flares up before a storm. Other joints may ache or swell esp. on rt. Sides of body. Pain usually worse toward early morning and after staying long. Better warmth and eating.