Gout is a type of arthritis that occurs when uric acid, a substance created when the body breaks down the elements of some food and drinks, builds up in the blood and causes joint inflammation. Gout can be an acute or chronic condition.
- Acute gout occurs suddenly and typically affects a single joint
- Chronic gout occurs over time and may involve more than one joint
Causes
Gout is caused by higher than normal levels of uric acid in the body. If uric acid builds up in the synovial fluid surrounding a joint, it can start to form crystals that result in swelling and inflammation in the joint. The exact cause of gout is unknown, but it may have a genetic or familiar component. Gout can also develop as a result of other conditions such as:
- Diabetes
- Kidney Disease
- Obesity
- Anemia
- Leukemia or other cancers affecting the blood
Symptoms
- Symptoms usually affect only one or a few joints
- Pain that starts suddenly
- A joint that is warm or red
- Tenderness in the affected joint
- Fever
- Joint swelling
Physical Therapy Interventions
Physical Therapists are professionals, educated and trained to administer interventions. As defined by The Guide to Physical Therapist Practice, interventions are the skilled and purposeful use of physical therapy methods and techniques to produce changes consistent with the diagnosis, prognosis and the patient or client’s goals.
If gout becomes chronic it may benefit from treatment from a physical therapist, who will perform a thorough evaluation to assess and determine the following:
- Joint: a series of measurements will be performed to determine which joint is involved and the extent to which the inflammation is acute
- Strength: resisted testing is performed to determine if there is associated weakness or strength imbalances
- Flexibility: range of motion measurements will be taken to determine if there is reduced joint movement
- Gait, Balance and Alignment: the therapist will assess your gait and balance on even and uneven surfaces. An assistive device such as a cane or walker may be indicated to improve safety, gait and reduce stress on the effected joint.
Physical therapy for gout must remain conservative at the onset to avoid aggravating the condition. Emphasis will be placed on rest, reducing the inflammation, protecting the joint and increasing the blood circulation for healing. Once the initial inflammation has reduced, a program of stretching and strengthening will be initiated to restore flexibility and improve function of the joint.
Treatments
- Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, stretching and joint mobilization by a physical therapist to improve alignment, mobility and range of motion of the affected joint. The use of mobilization techniques also helps to modulate pain.
- Therapeutic Exercises (TE) including stretching and strengthening exercises to regain range of motion and strengthen muscles of the joint and affected extremity to support, stabilize and decrease the stresses place on joint cartilage.
- Neuromuscular Reeducation (NMR) to restore stability, retrain the affected extremity and improve movement techniques and mechanics (for example, running, kneeling, squatting and jumping) of the involved extremity to reduce stress on the joint surfaces in daily activities. Taping, strapping or bracing may be indicated for joint protection and promote healing.
- Modalities including the use of ultrasound, electrical stimulation, ice, cold, laser and others to decrease pain and inflammation of the involved joint.
