Q: I’ve had attacks of gout in my big toe. Now, I’m getting joint pain and swelling in my hands. Can you get gout in your hands?
A: Gout is a painful form of arthritis that usually affects joints in the lower body, primarily the big toe, but also the ankle or knee. But gout attacks have been documented in almost every joint, including the fingers, wrists and elbows.
Attacks of gout happen in people with high levels of uric acid in their blood. Uric acid is a byproduct of natural processes in the body. Normally, it passes through the kidneys and leaves the body in urine. Some people have an inefficient system for getting rid of uric acid and it builds up in the blood. When the level goes above 6.8 milligrams per deciliter (mg/dL), it can leave the bloodstream and settle in joints. From there it can break down and release crystals into the joint space.
These crystals are the cause of the red, hot and swollen joint of a gout attack. Short-term treatment is aimed at reducing the symptoms, often with nonsteroidal anti-inflammatory drugs (NSAIDs) or the drug colchicine. The long-term goal is to prevent subsequent attacks by lowering the level of uric acid in the blood and keeping it consistently below 6 mg/dL. This is done with medication, such as allopurinol (Zyloprim®) or febuxostat (Uloric®)
Once a gout attack is over and you feel better, it’s easy to forget to take uric-acid lowering medication. But you need to continue. Anyone who’s had more than one gout attack should see their doctor to get their uric acid levels tested and make sure they’re are on the correct dose of a uric-acid lowering medication.
If you take the medication faithfully, future gout attacks can be prevented.
— Rheumatologist Chad Deal, MD