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Diagnosis is key to Relief of San Jose Spinal Gout

Gout. If you’ve experienced gout, you know how painful it is. You may also know how tough it was to diagnose, particularly if it was in the spine. Back pain or leg pain may have been your first symptom. Your San Jose chiropractor at Chiropractic Solutions understands spinal gout, its resemblance to other conditions’ symptoms, and the latest advised tests to diagnose it early to direct you to the (appropriate!) care you need.

PREVALENCE OF SPINAL GOUT

Arthritis is an inflammatory condition impacting 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 experienced back or neck pain, 86% showed neurological symptoms, 72% had a history of gout, 80% had elevated levels of serum uric acid, and 76% underwent surgery. Though an infrequent 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 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 reviewed studies going back as far 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. Fortunately, dual energy computed tomography (DECT) illustrates 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 undertaken 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 key. (2) Chiropractic Solutions 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 limited his mobility and with no history of gout wound 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 confirmed spinal gout. 29% of patients with gout are affected by spinal gout, too, which did not 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 lowering therapy, and NSAIDS. (6) If spinal gout is speculated, Chiropractic Solutions will get the right tests ordered.

CONTACT Chiropractic Solutions

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 San Jose chiropractic appointment now. Your San Jose chiropractor will do a thorough examination to determine the best course to properly diagnose, treat, and attain the best relief of spinal gout. 

 
Chiropractic Solutions 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."