Physiotherapy and Gout: The Facts
Gout is a kind of arthritis caused by a buildup of uric acid crystals in the joints. Uric acid is a breakdown product of purines that are part of many foods we eat. An abnormality in handling uric acid and crystallization of these compounds in joints can cause attacks of painful arthritis, kidney stones, and blockage of the kidney filtering tubules with uric acid crystals, leading to kidney failure. Gout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history
Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness. The small joint at the base of the big toe is the most common site for an attack. Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows. In some people, the acute pain is so intense that even a bed sheet touching the toe causes severe pain. These painful attacks usually subside in hours to days, with or without medication. In rare instances, an attack can last for weeks. Most people with gout will experience repeated bouts over the years.
Who is affected?
Gout is more common in men than in women and more prevalent in black men than white men. The chances of having gout rises with age, with a peak age of 75. In women, gout attacks usually occur after menopause.
How can Physiotherapy help?
In some cases of gout when the joint flares up, treatment with a physiotherapist at PCA can be helpful in conjunction with medication. Your therapist may use modalities such as ice, ultrasound, or laser to calm your joint down. You can also apply ice or a cold compress at home to soothe a joint flare up with gout. In many cases, however, direct physiotherapy treatment to the joint is too painful during a flare-up so resting and elevating the joint is the recommended treatment during this time.
Often when a joint is in a flare-up of gout, walking on the joint can be extremely painful or nearly impossible. Your physiotherapist can advise you on when you should use a walking aid such as a cane/stick to assist your gait. Walking without the proper support or with a limp for even a short period of time due to the pain of gout can cause you to develop incorrect gait patterns and put excess strain on the other joints of your body, particularly those in the lower extremities. Your therapist will also ensure that once your gout flare-up subsides that you are walking well and that you haven’t developed any poor long-term walking habits.
Being that repeated flare-ups of gout can eventually damage the joints and change the way they move and function, it is important that you maintain good range of motion in the joints, as well as flexibility and strength of the muscles surrounding the joints. Your physiotherapist will assess the joints that are commonly affected by gout in your case, and will prescribe range of motion, stretching, and strengthening exercises to help maintain the maximum function of the joints. Proprioception exercises, which assist in maintaining the joint’s sense of position, will also be prescribed. All exercises should be done between flare-ups rather than during a flare-up. Exercising a joint inflamed by gout is generally too painful, and may be detrimental to the joint due to the uric acid crystals that can wear on the joint surface during extreme motions of the joint.
A sedentary lifestyle without exercise, obesity, as well as hypertension are all risk factors for developing gout. For this reason, at PCA we feel it is important for all patients with gout to take part in a cardiovascular exercise program in order to reduce these risk factors, which can assist in decreasing the number of flare-ups of gout that occur. Your therapist can advise you on an appropriate cardiovascular exercise for you to partake in and can devise a program of exercise for you to follow. Some clients will find that doing a cardiovascular exercise in the pool, along with their other stretching and strengthening exercises, is easier and less painful on their joints. As with the other exercises mentioned above, cardiovascular exercise are best done between bouts of gout rather than during a flare-up.
Treatment for gout is a matter of management rather than elimination of the problem. By working closely with your physiotherapist and other healthcare professionals you can successfully manage the disease with as little impact as possible on your everyday life and activities.
For more information on how to get gout and arthritis relief today, call PCA on 0812 028 0496!