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Gout, also referred to as metabolic arthritis, is caused by the buildup of uric acid in the joints. Although it typically only affects one joint such as the big toe, it tends to be very painful. Indeed, gout pain can seem unbearable, and is accompanied by swelling, red, inflexible joints and in some cases a fever. Just simple movement or touching of the problem area can instigate the pain, and the surrounding skin may swell.
Although the big toe is the most usual location for gout to occur, other joints can also be affected. For instance it is possible to experience gout pain in your ankle, heel, knee, wrist, elbow, fingers, and spine. Diagnosis may consist of blood tests for electrolytes, renal function, and erythrocyte sedimentation rate.
Gout comes in four stages. First comes asymptomatic hyperuricemia. At this point, all that can be seen are heightened levels of uric acid in the blood.
Next comes acute gout, sometimes referred to as acute gouty arthritis. At this point uric acid crystals begin to appear in the joints. This is when the pain and swollen joints start to show up. The pain is typically worse at night and can be made worse by stress, alcohol, drugs, or a weakened immune system due to an accompanying illness. Painful gout episodes can last up to ten days, but then it can be a long time before another episode occurs, you may even go several years before experiencing it again. As time goes on however, the episodes can begin to last longer and occur more frequently.
The next stage is called intercritical gout and refers to the periods of calm in between the intensely painful gout episodes. The patient's symptoms seem to go away and the joint works normally.
Last comes chronic tophaceous gout. At this point the joint damage is permanent, although it takes a long time to get to this point, and you may never get there. With good treatment and care you may be able to avoid it.
When it comes to treatment your doctor is likely to focus on relieving your pain by prescribing drugs like indometacin or other nonsteroidal anti-inflammatory drugs (or NSAIDs) and may even inject intra-articular glucocorticoids into the painful area. Although it is always a good idea to keep up on what others are doing to relieve their gout pain, the starting point should always be a visit to your doctor.
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