Gout on the legs has vivid manifestations that serve as a reason for seeking help. Symptoms are observed not only on the lower extremities – the clinical picture of the disease is diverse and affects different organs and tissues. Timely initiation of treatment and preventive actions can stop the development of the process and improve the patient’s condition.
More About Gout
The disease has been known since ancient times – even the structure of the word indicates this. If you literally parse the term gout, you can get two words – a foot and a trap. Many centuries ago, people learned how to identify the symptoms of a disease and displayed it in the name.
Indeed, gout on the legs is the most common and striking type of the disease. The joint is affected mainly near the first, big toe.
The disease is heterogeneous, that is, it has different causes. However, all of them lead to one pathological mechanism – a violation of protein metabolism and the deposition of uric acid salts. These mineral complexes are called urates. They can form deposits in tissues and organs, thereby irritating their structure and function.
Urate disrupts the structure of joints and provokes the occurrence of recurrent arthritis. With an increased amount of salts in the blood, their deposits in the tissues arise – tofus. This disrupts metabolic processes, complicates the work of the affected structures. The more neglected the condition, the wider the scope of uric acid and the more tissues are involved in the process.
Even in antiquity, gout was called the “ailment of kings.” If there is a disease from reduced nutrition, then this vice versa – occurs with increased consumption of meat products, wine, and legumes. In the modern world this can be seen in statistics – in more developed countries, pathology is more common and accompanies an increased quality of life. Men get sick much more often than women.
The disease develops gradually and is chronic. At first, acute attacks rarely develop, but, over time, they become protracted and frequent. You can reduce the number of exacerbations with the help of proper treatment, and in some cases you can completely forget about them. For this, it is necessary to adhere to preventive measures and act on the pathology, starting from the early stages.
What is the manifestation of the disease
The first thing the patient responds to is an increase in the joint near the first toe and its pain. A deformed bone makes it difficult to wear familiar shoes, hurts when walking, stretches the skin. There are signs of inflammation – the skin becomes warm to the touch, reddens, surrounding soft tissues swell and the joint is broken.
All this is accompanied by pain. Most often, it is with these symptoms that the disease begins. Symptoms appear sharply, the patient can name the exact day and time of occurrence, which does not occur with other types of arthritis. Sometimes, an attack of gout occurs at night and the patient wakes up from pain. The debut of the disease may be different – some patients note a gradual increase in pain and deformation of the joint.
In addition to the symptoms of the first toe, general manifestations of the disease can occur. Patients note weakness, fatigue of the lower extremities, the impossibility of long walking or active pastime. There is a slight pain in the feet, which is easily confused with the usual result of overloads.
Therefore, a visit to the doctor is postponed, and the disease gradually starts. But when exacerbations occur in the form of intense soreness, then a person seeks help. The treachery of gout on its feet is what it bothers most often at night. Sleep disorders also affect overall well-being and complement the clinical picture with headache, fatigue, and a feeling of weakness.
In the middle of the night, the patient tries to relieve pain with analgesics, but few of them help during an attack of gouty arthritis. Gradually, the deformation of the joint becomes persistent and disrupts the usual motor activity. The skin above it also changes – it becomes thinner and drier, turns red and can become covered with cracks.
In the later stages, in addition to changes from the finger, the patient is also concerned about tofus. Morphologically, they are an accumulation of urates – salts of uric acid. These deposits are surrounded by connective tissue, like a capsule, and are located in soft tissues, on the surfaces of joints. A characteristic localization is the cartilaginous part of the auricle.
Starting with small joints, over time, gout affects larger formations – elbows, knees. Cartilage tissue changes persistently and is difficult to treat, so it is much easier to prevent these changes.
The neglected forms of the disease are accompanied by frequent exacerbations. Body temperature may increase, it is difficult for the patient to get out of bed, a general deterioration is observed.
Risk factors that lead to the development of gout on the legs
The disease does not have one specific reason. The single mechanism is the occurrence of gout on the legs – impaired metabolism of purines and uric acid salts. This is the basic principle of the pathogenesis of this condition.
An increased concentration of these substances in blood plasma leads to internal intoxication. There are structures, tissues and organs that are most sensitive to these conditions, they suffer in the first place. This is the synovial membrane of the joints, cartilage. Acid crystals violate their integrity and are deposited by small accumulations.
Constant damage to the joints leads to chronic inflammation – arthritis. Gout most often occurs precisely on this principle. This is a specific type of inflammation that differs from other types of arthritis in the nature of its occurrence and course.
Consider the main risk factors that lead to metabolic disorders and provoke the appearance of gout on the legs.
- chronic inflammatory process in the tissues and organs of the body;
- metabolic disorders in which uric acid metabolism suffers;
- increased uric acid synthesis;
- violation of the diet associated with a high amount in the diet of meat, sausages, legumes, smoked meats;
- overweight also provokes metabolic failures and impaired urate metabolism;
- drinking alcohol, especially wines;
- experiences and stressful conditions can provoke a metabolic failure. They worsen the course of the disease or provoke its onset;
- hereditary characteristics of the body. The defeat of some parts of the chromosomes and genes can lead to the development of gout in adulthood. Therefore, in families where there are cases of the disease, we can expect those in the next generations;
- disruption of the internal organs, especially the liver. Against the background of a long illness, gout can occur as a complication;
- chronic diseases and intoxications.
Most often, for the occurrence of the disease requires the combined effect of several factors and their long-term effect on the body.
In the early stages, compensation processes are included, but when pathological factors are stronger and longer, decompensation occurs and the disease begins.
Diagnosis of gout
The diagnosis of gout is based on the compliance of the clinical picture with certain diagnostic criteria that were formed during the meeting of the international symposium on the treatment and study of rheumatic pathology.
The undeniable, “golden” diagnostic standard is the detection of urate crystals in tissues or in intraarticular fluid – synovia. For this, appropriate laboratory tests are carried out.
A diagnosis requires at least two of the following criteria:
- the characteristic onset of the disease, which is accompanied by an acute attack of pain and inflammation of the joint near the big toe.
- a clear history and two or more similar attacks that are independently eliminated and are replaced by complete relief of the condition.
- a positive response to colchicine, which consists in reducing the clinical signs of the disease within 2 days after administration of the drug.
- clinically confirmed formation of tofus – deposits of uric acid salts in cartilage and soft tissues.
Radiography for gout can show inflammatory changes in the joints and can even detect tofus, but this is not a specific study. A more indicative diagnostic method are laboratory procedures that clearly indicate the pathogenesis of the disease. X-ray can be used for dynamic examination and assessment of the impact of pathology on the joints.
At the same time, fixing the fact of increasing the concentration of uric acid and its products is also not enough to confirm the diagnosis. Increased plasma urate – hyperuricemia. This condition can be observed without gouty changes, and leads to the disease only after a long period of time. Therefore, in 2000, criteria were adopted on the basis of which a diagnosis is made.
In addition to laboratory confirmation of the presence of tofus and uric acid crystals in the synovial fluid, at least 6 of the following symptoms must be confirmed:
- 1 or more acute attack of gouty arthritis;
- an increase in the inflammatory process near the joint in the first day after the onset of the disease;
- damage to one joint, not a multiple process;
- redness of the skin over the articular surface;
- swelling and pain in the joint of 1 toe;
- numerous tofus on the surface of the body;
- increased concentration of uric acid salts in plasma;
- unilateral localization of gout on the legs;
- lack of a bacterial component of the inflammatory process.
In addition to the survey and examination, the doctor uses methods such as a general analysis of blood and urine, biochemical studies, radiography. Diagnostic measures allow us to differentiate the condition with diseases that have similar manifestations. Also, diagnostic methods are used in the future to monitor treatment, assess the severity of the condition, and correct therapy.
Modern aspects of the treatment of gout on the legs
Effective treatment of gout leads to the following results:
- decrease in pain;
- slowing down the deformation of articular structures;
- reduction in the number of exacerbations and their duration;
- restoration of motor mode;
- increased performance.
There are medication, physiotherapy, home remedies. The attending physician should monitor the process in order to adjust these or other methods of exposure in time. A persistent decrease in uric acid synthesis products and elimination of clinical manifestations are the main criteria for successful treatment.
Of the physiotherapeutic techniques, magnetotherapy, electrotherapy, balneotherapy, the use of therapeutic showers and healing mud, and UHF are used. Using physiotherapy, you need to be sure that there are no contraindications, of which there are a lot. In general, the choice of treatment method depends on the phase of the disease, its stage, as well as the accompanying characteristics of the body.
Drug treatment includes drugs that reduce the amount of uric acid, as well as anti-inflammatory substances. The choice of agent depends on the stage of the process – metabolic drugs are used without exacerbations, and symptom therapy is needed if the condition worsens.
Between attacks of gout, it is recommended to take medications such as Allopurinol or Adenuric – they reduce the level of uric acid in the tissues of the body. They are taken even if the symptoms of the disease receded and the clinical picture seems better. The result of long-term use is increased excretion of uric acid from the body and reduced production of salts. The course of treatment should be complete, otherwise the effectiveness decreases. It is important to understand that taking medications does not depend on whether you feel worse or better – this group should consistently affect the body to ensure a lasting result.
If the disease worsens, pain and inflammatory changes bother, anti-inflammatory drugs must be added to therapy. The most effective in an acute attack of gout are colchicine, hexacetonide, indomethacin. They effectively reduce swelling, normalize joint function and eliminate pain. In special cases, the drug is injected into the joint cavity to alleviate the condition.
Treatment is carried out on an outpatient basis if there is no progression of the disease and taking medication brings relief. If the disease is accompanied by frequent exacerbations, poor health, hospitalization is desirable in order to fully examine the body and conduct more intensive treatment than at home.
Methods of prevention
The first and most effective method of prevention is the correct diet for gout. Patients with gout should limit their intake of meat, smoked meats, sausages, and sausages. Canned meat and poor quality products are especially dangerous. The use of alcohol is completely excluded. Legumes are not recommended: beans, peas, soybeans, beans, chickpeas. It makes no sense to start treatment if a diet is not applied – medications simply will not bring results.
It is advisable for patients to spare their body: normalize the load on the legs, avoid stress and anxiety, sleep normally, observe a proper drinking regimen. The last point is especially important, since a normal amount of fluid improves all metabolic processes in the body. It is necessary to give up smoking, drinking strong tea and coffee.
Normalizing body weight is another important step towards recovery. In general, these rules not only improve the clinical picture of the disease, but are generally beneficial for health. Early initiation of therapy and following the rules of prevention – the right methods to defeat the disease.
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