Gout, a specific type of arthritis, inflames the joints due to an excess of uric acid. It can be acute or chronic and has a number of predisposing factors including lifestyle, conditions such as diabetes, and familial tendency. Uric acid accumulates when the body either produces too much or cannot get rid of it quickly enough. Thumb gout, where the joints of the thumb have become affected, produces a number of symptoms including pain, swelling, and inflammation.
Gout in the thumb is very painful, and attacks in this part of the body often last longer than in other joints. The pain starts suddenly and is localized to the thumb. Pain varies among individuals but is usually very sharp and throbbing, and the joint becomes very tender. Although this pain commonly recedes within 12 hours, it can last for weeks. The pain for this form of gout is normally treated with painkillers such as codeine.
Swelling is also localized, occurring around the joints or the top of the thumb. The skin of the thumb becomes taut and shiny. Swelling is due to the formation of tophi under the skin. Tophi consist of urate crystals that have been deposited around the joint, often taking a number of years to accumulate. The buildup of these crystals also causes the joint to become stiff.
Inflammation is another symptom of thumb gout. The joint becomes red and warm, and the patient may develop a slight fever. This inflammation is generally alleviated with corticosteroid injections into the joint and nonsteroidal anti-inflammatories such as ibuprofen. To reduce fever, patients take medications such as paracetamol.
These symptoms of thumb gout typically only occur once the patient has had gout for a significant amount of time, sometimes years. The thumb is often one of the last joints to be affected. Due to gout of the thumb occurring as part of a chronic condition, it can take longer to control the number and intensity of the attacks. Generally speaking, the longer the patient has had gout, the longer the attacks last. Some patients, however, find that they only have a single attack.
Doctors treat thumb gout in the same way as gout in other areas of the body. Medications that may be prescribed by a doctor include allopurinol, which prevents the formation of the urate crystals, and probenecid, which helps the body to increase the rate of urate removal. Lifestyle changes are also recommended for the patient, including a diet that is low in alcohol and high-fat foods. Certain foods that increase the formation of urate and should be avoided include asparagus, spinach, and oily fish.
Gout in the Thumb Causes
There is only one cause of thumb gout, and that is a buildup of urate crystals in your joint. These crystals, which can accumulate over time as described above, are sharp and needle-like, making the joint becomes painful. Urate crystals are formed when there is an excess of uric acid in your blood. Uric acid is a substance your body produces and can process in normal amounts. Following are some of the reasons why it can get out of hand.
Foods and Beverages
Some foods are high in purines, including some seafood, red meats, and organ meats like liver. Among the seafood that can be particularly high in purines are scallops, trout, tuna, anchovies, sardines, and mussels. As the body breaks down the purines, uric acid is formed. In addition, alcohol, particularly beer, as well as sweet drinks that are flavored with fructose, lead to high amounts of uric acid in the blood.
Some medical conditions make gout more likely, including diabetes; some diseases related to the kidneys or heart; obesity; and hypertension that is left untreated. With high blood pressure, some of the medications prescribed for it can also lead to high uric acid levels.
Although men tend to be more likely to have gout than women, the incidence of high uric acid in females does increase after menopause. Being overweight leads to your body producing more uric acid, as well as to your kidneys having a harder time getting rid of it. It's also been found that gout is something that can run in the family.
Gout in the Thumb Treatment
While doctors typically diagnose simply based on symptoms and appearance of the thumb, they may also order other tests such as a blood test or an x-ray to rule out other possibilities. Once the diagnosis is confirmed, there are two main reasons that medications may be prescribed.
For Current Symptoms
Your doctor will likely prescribe something to help deal with the current pain and inflammation that you are experiencing. These can include over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs); colchicine, which is also a type of anti-inflammatory; or corticosteroids.
To Prevent of Future Flare-ups
Preventive medications will fall into two types. One type is those drugs that block the body from producing uric acids, such as allopurinol or febuxostat. Other medications, such as probenecid, help your body to get rid of uric acid more effectively.
Home Remedies for Gout in the Thumb
When it comes to home remedies, you can try putting a cold pack on your thumb when you're having a flare-up to see if that will reduce at least some of the pain and inflammation. Drinking plenty of water can also help to decrease uric acid levels. If possible, rest the joint as well. Other remedies fall under the category of making lifestyle changes to prevent future attacks. Good habits to include in your day-to-day life are:
- Avoiding foods high in purines
- Limiting alcoholic intake, especially beers
- Staying away from fructose-sweetened beverages
- Keeping well hydrated with fresh filtered water
- Losing weight if applicable
- Exercising regularly