Gout on the hands: treatment methods. One of the characteristic signs of the disease is tophi in gout: photo of the nodules, area of ​​localization and how dangerous the formations are. How to get rid of gout on the hands

Gout is a chronic metabolic (metabolic) disease characterized by impaired purine metabolism (excessive breakdown of proteins) and the inability of the kidneys to excrete uric acid. The disease usually appears after 40 years in men and after menopause in women. Gout affects any joints: fingers, hands, elbows, knees, feet.

What kind of disease this is - gout - the causes and first signs in women and men, as well as what symptoms and treatment methods are used in the acute phase of gout in adults - we will consider further in the article.

Gout: what kind of disease is it?

Gout is one of the types of joint diseases in which uric acid salts are deposited in them. It is called the “disease of kings” because... The disease was previously widespread in high circles, and most often arose as a result of excess in food and alcoholic beverages.

Signs of gout is the appearance of peculiar growths on the arms or legs, while the level of uric acid is significantly increased.

When the growths, otherwise known as tophi, burst, a person may see whitish crystals of uric acid. The patient may feel quite intense pain in the affected areas. Such salt deposits in the joints make it difficult to lead a full life.

Gout is an age-related disease. It is rarely diagnosed in children and adolescents. Typically, the first attacks in men occur by the age of 40, in women after the age of fifty.

In people over 60 years of age, the disease occurs in 97% of cases. In representatives of the stronger sex, the disease is more common because their blood initially has a higher level of uric acid.

Classification

The clinical classification identifies seven forms of gout:

• typical (classic) attack of acute gouty arthritis,
• polyarthritis of the infectious-allergic type,
• subacute,
• rheumatoid-like,
• pseudophlegmonous,
• periarthritic and low-symptomatic variants.

There are 4 stages of gout formation:

1. The accumulation of uric acid in the body, which is recorded by an increased level of its content in the blood.
2. Formation of salt crystals in joints.
3. Aggression of immune cells against urate formations and inflammation of the damaged joint.
4. Long-term manifestations of gout, kidney damage, joint deformities.

The main manifestations of the disease at the time of exacerbation are severe excruciating pain in the area of ​​the inflamed joint, its swelling and redness. Any movement increases pain, which leads to temporary loss of joint function

So, what is gout, if you look at an x-ray of the patient? These are foreign substances - microcrystals of urates (uric acid salts), which settle where there is no blood flow: in joints, tendons. Inflammation occurs in them.

The first signs of gout

The signs of gout cannot be confused with another disease, its manifestations are so specific. The first symptoms appear in the area of ​​the joint of the big toes (one or both). It is this joint of the thumb that gout chooses as its first target.

Signs of inflammation (in 97% of cases, the joint of the big toe is the first to be affected):

• severe excruciating pain;
• skin redness and swelling;
• the presence of whitish nodules in the joint area (tophi), which were previously inflamed;
• increased body temperature;
• signs of formation (pain in the kidney area, blood in the urine, etc.).

More specifically, the signs of gout differ by gender of patients:

• Men experience sharp, almost unbearable pain in the affected joint, swelling and redness of the skin. The disease progresses faster and more often affects the joints of the hands.
• in women, only one joint is often affected, and neighboring ones are affected by gout only in case of untimely treatment. In addition to the typical symptoms, women experience general malaise, nervousness, peeling of the skin at the site of the diseased joint, and immobility of the affected limb.

Causes

The cause of the development of the disease is the deposition of uric acid crystals (urates) in the cartilage tissue of the joint. Their accumulation leads to inflammation, accompanied by severe pain.

One of the main reasons for the development of the disease is the accumulation of uric acid in the body. Its chemical structure is similar to caffeine. As a result, patients are prohibited from drinking coffee and strong tea to avoid exacerbations.

In normal amounts, urate breaks down and is excreted by the kidneys in the urine. But with increased production of uric acid, the work of the kidneys is not enough to completely evacuate metabolic products, and some of them remain in the body in the form of dense, sharp crystals surrounding and damaging the cartilage tissue.

Uric acid can accumulate in the body due to two main factors:

1. Due to genetic disorders or hormonal factors, which are aggravated by alcohol abuse and poor diet.
2. Due to metabolic disorders or as a result of incorrect medication use.

The acute form manifests itself when a persistently increased concentration of uric acid is observed in the blood - more than 60 mg/l. Deviations from this norm can provoke:

• systematic overeating;
• addiction to fatty meat foods;
• obesity;
• physical passivity, immobility;
• hereditary predisposition.

Gout - strictly age-related disease. Almost all older people over 65 years old show signs of this disease. And in children and young people, gouty changes are recorded in exceptional cases.

The main risk factors for exacerbation of gout are:

• male gender;
• age over 50 years;
• skeletal muscle weakness;
• obesity;
• alcohol intoxication;
• fluctuations in blood pH levels;
• reducing the excretion of uric acid by the kidneys.

Gout symptoms and photos

The clinical picture of the disease depends on the degree of progression of the pathology. The following classification of gout is accepted:

• Stage 1 of the disease - in 80% of cases it is asymptomatic, detected only by urine analysis when the level of uric acid is elevated;
• Stage 2 – salts in the joints cause acute pain;
• 3rd, chronic stage - crystallizing urates deform joints and form stones in internal organs.

Symptoms of gout include:

• Sudden and severe pain in the joint;
• Stiffness and swelling;
• Redness;
• Tissue compaction around the lesion;
• In more than half of patients, the primary site of the disease is the big toe.

The pain arises not so much from “mechanical trauma” by the crystals of the surrounding tissues, but from penetration into the joint and the production directly in it of a huge amount of “inflammatory substances”. That is, the cause of pain during a gout attack is not mechanical (sharp crystals), but chemical (irritants).

A characteristic symptom is the appearance of gouty tophi. This is the deposition of uric acid crystals in soft tissues, as indicated in the photo

Gout on the finger

How does an attack begin?

Before an attack, patients usually feel completely healthy, but many note a tingling feeling in the affected joint. Many noted increased fatigue and irritability.

1. As a rule, the disease begins with an attack of the so-called. gouty arthritis. Initially, the inflammatory process affects only one joint.
2. Usually the big toe (less often the ankle or knee joint) is affected first.
3. The attack most often begins at night or in the morning.
4. The pain appears suddenly; it has a pressing character and is characterized by high intensity.
5. The affected joint quickly swells, and its projection shows hyperemia of the skin and a local increase in temperature.

A second attack of gout develops in most patients 6-24 months after the first, but in some patients this period of time is much longer (sometimes reaching 10-20 years). Over time, the frequency of acute gout attacks increases in the absence of treatment.

The occurrence of gout on the legs

Clinical picture of the acute phase of gout:

• The appearance of severe pain in the joint;
• Pain occurs most often at night or in the early morning;
• The occurrence of swelling in and around the joint;
• Increased body temperature;
• Loss of appetite, chills, general deterioration.

Most often, at first, pain manifests itself in only one joint - usually the big toe is the first to suffer (gout of the big toe), less often - the knee or ankle.

Complications

Hyperuricemia and accumulation of urate salts in gout leads to their deposition in the kidneys with the development of:

• nephropathy;
• gouty nephritis, characterized by proteinuria, microhematuria, cylindruria;
• arterial hypertension with subsequent transition to chronic renal failure.

In 40% of patients, urolithiasis develops with renal colic at the height of an attack of gout, complications in the form of pyelonephritis.

What diseases can be mistaken for gout?

What other diseases follow a scenario similar to gout? This information will be especially useful for those who are accustomed to diagnosing themselves using reference books or information from the Internet.

• septic (purulent) arthritis.
• pyrophosphate arthropathy;
• reactive arthritis;
• osteoarthritis (often combined with gout);
• psoriatic arthritis (inflammation of the joints in combination with skin disease –).

Diagnostics

If your joints have ever made themselves felt, you must see a doctor. And it doesn’t matter how quickly the attack passed or how severe the pain was. Otherwise, you can lead to disability.

Which doctor treats gout? Rheumatologist. At the first appointment, he will conduct an external examination of the joints and diagnose the patient’s condition.

The diagnosis is made directly on the basis of clinical and paraclinical (laboratory and instrumental) examinations. For some patients, the diagnosis does not take much time, while others have to undergo a series of tests and examinations.

The following stages can be distinguished in the diagnosis of gout:

• anamnesis (patient survey);
• assessment of the clinical picture of the disease;
• instrumental studies;
• laboratory research.

The following methods are used to diagnose gout:

• biochemical blood test (an increased level of uric acid is noted; by examining creatinine in the blood, the relevance of renal failure is determined);
• X-ray (examines current changes in the joints as part of the examination of the chronic form of gouty arthritis);
• examination of synovial fluid taken from the affected joint for absent bacterial flora and the presence of uric acid crystals;
• Ultrasound (the study examines the kidneys for the presence of stones in them).

The diagnosis of gout is based on the presence of two of the following criteria:

• the level of uric acid in the blood is higher than 416.4 µmol/l in men and higher than 356.9 µmol/l in women;
• presence of tophi;
• detection of uric acid crystals in synovial fluid or tissues;
• acute transient arthritis.

Treatment of gout

How to treat gout? Complex therapy for gout should be step-by-step. It consists of three stages:

1. relief of an acute attack (gouty arthritis);
2. drug correction of excess uric acid;
3. diet and prevention of recurrent exacerbations.

For gout, treatment is carried out at home. An acute attack is an indication for strict bed rest. It is advisable to keep the limb, the joints of which are affected by the inflammatory process, in an elevated position, placing something soft under them (a rolled up blanket or pillow).

Principles of drug treatment:

• Therapy with special drugs, the action of which is aimed at reducing hyperuricemia, cannot be started during an exacerbation of the disease.
• Such drugs are taken for a long time, for years, with short breaks (no more than 4 weeks) while the level of uric acid in the blood normalizes.
• When selecting drugs, it is extremely important to take into account the type of purine metabolism disorder (mixed, metabolic, renal).

Drug therapy for gout is aimed at solving two main problems:

• Reducing the level of uric acid in the patient’s body;
• Relief of acute inflammatory process and pain relief.

The sooner the patient undergoes examination, reconsiders his habits and begins treatment, the greater the likelihood of achieving stable remission.

1. Allopurinol. The use of Allopurinol can reduce the number of exacerbations of gouty arthritis, simultaneously eliminating the risk of formation of urate stones in the urinary tract. The minimum effective dose of the drug is selected individually for each patient to reduce possible side effects.
2. Febuxostat - acts similarly to allopurinol. Recommended for use by patients with moderate to mild kidney and liver damage.
3. Pegloticase is a solution for intravenous use containing enzymes that dissolve uric acid crystals. It is used for progressive, difficult-to-control gout.
4. Probenecid - taken orally, promotes accelerated excretion of uric acid by the kidneys.

During a gouty attack, its manifestations are first stopped:

• peace;
• cold on the joint;
• NSAIDs (Naproxen, Diclofenac) in tablets or injections;
• in severe cases, intra-articular administration of glucocorticosteroids or intra-articular colchicine.

Course treatment to prevent relapses:

• NSAIDs (neutralize inflammation, affect the gastrointestinal tract);
• corticosteroids (long-term use reduces immunity and thins bone tissue);
• Colchicine (affects the blood and gastrointestinal tract);
• vitamins C, P (promote the elimination of urates);
• uricodepressants (Allopurinol, Orotic acid) reduce the concentration of uric acid and are prescribed for hyperuricoemia;
• uricosuric agents (Ketasone, salicylates) improve the evacuation of uric acid from the body when its excretion rate is less than 3.56 mmol/day.

Physiotherapy

Physiotherapeutic procedures help to finally stop inflammation in the joints due to gout. They are prescribed exclusively after drug reduction of symptoms. In the acute period of the disease, any methods of physiotherapy are strictly contraindicated.

What methods are used:

• applications of paraffin and ozokerite,
• healing mud,
• magnetotherapy,
• electrophoresis,
• phonophoresis of drugs.

Surgery for gout

The last resort in treatment is surgery to remove tophi. They rarely resort to it, only in cases where:

• Urate deposits are very large;
• The treatment carried out is not effective - tophi do not resolve;
• Tophi have grown into soft tissue;
• The deformation of the joint is so great that its destruction is expected.

Timely recognition and initiation of rational treatment gives prognostically favorable results. Factors that aggravate the prognosis of gout are young age (up to 30 years), a combination of urolithiasis and urinary tract infections, a burdened somatic history (,), and progression of nephropathy.

How to relieve a gout attack?

1. In case of an acute attack, rest is recommended, especially for the affected limb.
2. The foot is provided with a slightly elevated position; ice can be applied to the sore joint, replacing it with a warm compress after the attack has subsided.
3. Anti-inflammatory non-steroidal drugs (NSAIDs) are used in the treatment of an attack; the specific drug, as well as its dosage, frequency of use and duration are determined by the attending physician.

Reduce inflammation and relieve pain on the arms and legs you can use compresses. Combine 5 tablets of aspirin with 10 ml of iodine. The product should be applied to the feet and placed in a warm place. Manipulation is recommended to be carried out 2 times a day.

After relieving an acute attack of gout, you need to engage in comprehensive treatment. Comprehensive treatment of gout includes:

• Medication method;
• Physiotherapy;
• Massage.

In order to control the health status of gout and prevent the occurrence of detailed attacks, you need to:

• constantly undergo biochemical blood tests to determine the content of uric acid salts;
• if necessary, perform punctures of intra-articular fluid;
• Fully comply with the doctor’s instructions and the gouty diet.

Nutrition

To create a daily diet, you should contact a specialist who, taking into account the stage of development of the disease and the presence of chronic pathologies, will develop a table of acceptable and prohibited foods.

Nutrition:

• Don't: eat a lot of meat, offal, fish, mushrooms, legumes. Rich broths, caviar, smoked and canned foods, and jellied meat are prohibited. Coffee, tea, cocoa, chocolate are not recommended. Alcohol, especially beer, is excluded.
• You can: milk and dairy products, eggs, chicken, vegetables, cereals, pasta, nuts.
• You need to drink as much fluid as possible, preferably 2.5-3 liters per day. It can be just water, mineral waters, preferably alkaline ones, such as Slavyanovskaya and Smirnovskaya, berry and citrus juices,

Diet for gout, as I hope you already understand, is the most important part of treatment. Complex therapy for this disease also includes medications and physiotherapeutic procedures. They are prescribed by the doctor individually to each patient, taking into account the severity of gout and the presence of concomitant diseases.

Using folk remedies at home

Before using folk remedies for gout, be sure to consult your doctor.

1. 15-20 g (about 1 tablespoon) crushed celery root, brew 0.4 liters of boiling water, leave until the infusion cools, filter. Dosage: drink 0.5 cups 3 times a day before meals (20-30 minutes).
2. Chicory. 2 teaspoons of chicory are poured into 200 ml of boiling water and left for 4 – 5 hours. Drink half a glass of infusion 2-3 times a day before meals. Chicory is also effective in combating hyperuricemia.
3. Foot baths with iodine are also useful for gout.. Add 3 tsp to 3 liters of warm water. sodium bicarbonate (baking soda) and 9 drops of iodine. Regular procedures with this type of treatment help reduce the volume of salt deposits.
4. You can use the tincture for rubbing from chamomile and elderberry. Dry plants are poured with a glass of boiling water and left for 2 hours. The filtered product should be applied to the affected areas.
5. Red madder roots. You need to pour one teaspoon of these roots into a glass of boiling water and let it brew, or better yet, boil it in a water bath for about 10 minutes. The infusion should be taken in the morning and evening, half a glass.

Prevention

The main means of preventing gout remains following the diet mentioned above. However, in addition to dietary nutrition, avoiding other risk factors is of great importance. This will help lengthen periods of remission, avoid exacerbations or reduce them.

Prevention of gout includes:

• Watch your diet and do not overuse foods high in purines.
• Exercise. Do not expose the body to heavy stress. Walking, morning jogging and light exercise are plenty. The main thing is that the joints do not receive a lot of stress.
• Drink plenty of fluids, which contributes to the timely and complete removal of excess uric acid from the body.
• When working sedentarily, try to compensate for lack of activity with regular training. Additionally, this will help get rid of extra pounds that put stress on your joints.
• Avoid tight and uncomfortable shoes and clothing. Such items are harmful to joints.

Now, you know what kind of disease this is, what characteristic signs and treatment methods to use for gout. Be healthy and monitor your health constantly!

Gout on the hands is a pathological condition in which uric acid crystals collect in the joints. This disease can affect the joints of different parts of the body, but the hands are most often affected. Gout can affect all fingers of both hands, fingers of one hand, or just one finger (usually the thumb) on one hand. In some cases, there may be only gout of the hands.

Important! Patients of all ages can experience gout, but men over 40 are at greatest risk of the disease.

The pathology worsens the physical capabilities of the joints and in some cases leads to partial or complete disability in manual activities.

Causes of gout

reading information

The main cause of gout on the fingers or other joints is a metabolic disorder in the body, in which there is an excess of uric acid crystals and their deposition in the joints.

This leads to the fact that the residual product of protein metabolism - purine - cannot be eliminated from the body through the blood, and it also begins to accumulate on the joints.

This violation can be caused by the following:

1. Heavy heredity. Unfortunately, in some cases, gout in the hand joints can be transmitted genetically. Sometimes the disease affects the joints of all or almost all family members over several generations.
2. Kidney disorders.
3. Poor nutrition, which consists of excessive consumption of meat and fatty foods.
4. Drinking alcohol over a long period of time in large quantities.
5. Impaired glucose tolerance.
6. Hypertension.
7. Obesity.

Symptoms of the disease

The main symptoms of gout on the hands are as follows:

1. Severe pain in the joint of a paroxysmal nature, which occurs mainly at night. By morning the patient's condition improves significantly. The period during which pain occurs can last up to 10-14 days.
2. Joint swelling.
3. Inflammatory process in the joints and increased temperature in the affected area.
4. The formation of tubercles of uric acid under the skin on the fingers of the affected hand - tophi.
5. Redness of the skin in the affected part and its acquisition of an unnatural shine.

Important! During remission, the patient may have a false sense of absence of joint problems. Moreover, remission can last from several weeks to several months, but over time this interval decreases.

Diagnosis of the disease

It is very important not to treat and diagnose gout yourself at home, since in this case there is a high risk of confusing this pathology with other, no less dangerous diseases. Only a qualified doctor can make a diagnosis after a thorough examination, which usually includes:

• blood test to determine the level of uric acid in the body;
• urine test to determine the amount of uric acid secreted during the day;
• samples of synovial substance from joints to detect urate crystals.

Treatment of hand gout

Important! To achieve good results in the shortest possible time, experts recommend using an integrated approach to treating the disease.

Such treatment should include the elimination of unpleasant symptoms, as well as the elimination of the very cause of the disease - metabolic disorders.

At the moment, doctors use the following methods to treat pathology:

1. Diet. No treatment will help improve the patient's condition unless he adheres to a special diet, the purpose of which is to reduce uric acid levels. A healthy diet for gout involves avoiding fatty fish, large amounts of meat products, as well as tea, coffee and alcohol. Overweight patients should reduce their intake of high carbohydrate foods.
2. Drug therapy includes the use of anti-inflammatory drugs for intramuscular, intravenous and oral use. In the absence of effect or severe inflammation, medications based on glucocorticoids can be used (usually they are injected into the joints).
3. Remedies for gout on the hands for local action. These drugs are selected only by an experienced specialist based on the symptoms of the patients in each individual case. Compresses are applied to the joints, wraps are made, and ointments are used. They have a gentle effect on the body, but at the same time complement the action of other medications.
4. Physiotherapy- can very quickly relieve discomfort, prevent exacerbation and prolong the period of remission. Most often, acupuncture therapy is used for this purpose, which acts specifically on the lesion, improving blood circulation in it. Thanks to this, finger movements become more free. It is strongly recommended to visit resort and sanatorium establishments that provide treatment with mineral waters and therapeutic mud.

To improve the results of drug treatment, you can perform special massage and hand exercises.

Cases of gout are not uncommon for a rheumatologist: the vast majority of their patients, mostly middle-aged men, complain about this type of arthritis (inflammation of the joints).

Often Improper diet leads to illness, namely the abuse of foods rich in purine (meat, beer, legumes): when these substances are broken down during digestion, uric acid is released.

Normally, it is excreted by the kidneys, but when excess is formed, uric acid is transported to the joints and deposited in the form of small, sharp salt crystals that irritate the joint structures.

The person feels severe acute pain - even the slightest touch causes agony, the affected joint swells and turns red. If left untreated, these symptoms can last for weeks, mostly worsening at night.

But it is worth noting that gout does not always develop due to poor nutrition: an increase in uric acid levels can be caused by kidney disease or taking certain medications.

Before treating the disease at home

If you have gout, you should first consult a doctor before starting treatment at home.

Only a specialist will be able to assess the general condition, prescribe a course of medications, and give effective recommendations.

The next step is strict adherence to the diet. Since gout attacks most often occur due to neglect of the diet, you should normalize your diet.

Don't forget about movement. Special sets of exercises will help not only restore and maintain joint mobility, but also destroy small crystals of uric acid salts. A combination of physical therapy and massage gives excellent results.

And, of course, there are many traditional medicine recipes for both external and internal use.

Diet for gout

The main goal of the diet is to eliminate the intake of purines, sources of uric acid, from food.

If you have gout, you should not eat meat and fish products, mushrooms, legumes, canned food, chocolate, smoked foods, strong coffee and tea.

It is allowed to eat poultry, eggs, dairy products, cereals, vegetables and fruits, berries, and nuts.

In order for uric acid to be removed from the body more actively, it is recommended to increase the intake of fluids - water, both drinking and mineral (preference is given to alkaline medicinal waters), juices, fruit drinks.

Traditional medicine

Treatment of gout with folk remedies in combination with medications selected by a specialist is intended to alleviate the patient’s condition during exacerbation conditions, remove excess uric acid from the body, and also prevent re-inflammation of the joints.

External means

Folk remedies for gout for external use:

Products for internal use

Traditional treatment of gout using means for internal use:

Changing our lifestyle

At the first symptoms of gout, treatment at home should begin with changes in lifestyle and diet.

Uric acid salts tend to be deposited in sedentary joints. A short exercise every morning will help protect you from this trouble.

If it is not possible to do exercises, then it is advisable to take walks every day - at least half an hour and, if possible, prefer walking to transport and elevators.

When gout occurs it is necessary to additionally check the functioning of the kidneys, because if their functioning is impaired, even the strictest adherence to the diet and taking all the necessary medications will not help remove all excess uric acid.

It is believed that gout is an incurable disease, but with timely consultation with a specialist and compliance with all treatment and prevention measures, you can completely get rid of the painful symptoms of the disease, maintain full joint mobility and continue to enjoy life!

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• What is gout
• Causes, symptoms and signs of gout
• What is a gout attack
• Drug treatment, diet
• Treatment of gout with folk remedies
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What kind of disease is gout?

Gout– a disease caused by a violation of purine metabolism in the body, which leads to an increase in uric acid in the blood. As a result of this, its crystals are deposited in tissues, most often near joints, with limited movement in them. The kidneys are often affected. The main symptoms are joint pain, but this is not so much a joint disease as a metabolic disease. The body either produces excess uric acid or does not remove the resulting acid well. Uric acid salts are breakdown products of proteins. Therefore, diet is very important in treatment.

Causes of gout

Most often, a congenital metabolic disorder or malnutrition, which also leads to metabolic disorders. Gout can be caused by lead poisoning, a side effect of certain medications that increase uric acid levels in the blood.
Mostly people aged 45-60 years get sick. Often the disease develops against the background of diabetes mellitus, hypertension, and atherosclerosis.

The symptoms and signs of gout are as follows:

1. Increased uric acid levels - in men over 420 mmol/l, in women over 360 mmol/l
2. Deposition of uric acid salts in tissues, detected by chemical or microscopic analysis
3. Gouty nodes (tophi) appear, that is, nodules that are dense to the touch, located near the joints, as well as near the ears, in advanced cases, even on the internal organs.
4. Urolithiasis develops
5. Gout attacks

What is a gout attack?

Attack- This is inflammation of the joint, accompanied by very severe pain.

Symptoms of a gout attack

• Sudden pain, usually in the area of ​​the big toe.
• The pain increases quickly.
• Accompanied by swelling and redness of the skin around the sore joint.
• The temperature of the whole body rises.

The attack lasts from several hours to several days, after which the pain
disappears, joint function is restored.
The pain during an attack can be so severe that it is not only impossible to put on shoes, but you cannot even cover the sore joint with a sheet - the slightest touch causes unbearable pain.
Some patients may confuse an attack of gout with an abscess, because there are similar symptoms - the skin quickly turns purple, heats up, and severe pain occurs.

Causes of a gout attack.
An attack can be triggered by:

1. Injury
2. Hypothermia is the most common cause of an attack
3. Drinking alcohol or fatty, fried foods

Often a sick person, after an evening feast, eating fatty meat food and drinking alcohol, wakes up in the morning with an attack of gout. The reason is that if you don’t diet, the level of uric acid in the blood increases sharply, and alcohol slows down the excretion of uric acid by the kidneys.
When hypothermia occurs, especially in the legs, uric acid, circulating in the blood as a solution, begins to crystallize, most of all in the place that is most chilled.
The attack begins with acute pain.
At first, attacks occur 2-3 times a year and do not last long, then they become more frequent. Each time the pain and duration increase. The number of joints affected by the disease increases. First of all, the joints of the toes are affected, then the inflammation can spread to the joints of the shins and knees.

Treatment of gout.
After the attack, the patient feels completely healthy, but treatment must begin after the first attack, without waiting for irreversible changes in the joints and kidneys. Because after the first attack, despite the patient’s good health, magnetic resonance imaging shows that tiny tophi fall out in the aorta, coronary vessels, and other organs and tissues, which increase over time. The disease becomes chronic and becomes a trigger for the development of atherosclerosis, diabetes, and other diseases that progress very quickly against the background of gout.
In the treatment of gout, drugs that prevent the formation of uric acid are used. or accelerating its release from the body. Also, for the treatment of this disease, a diet with reduced calorie content and limited purines is important. Alcohol, meat broths, and offal are excluded from the diet.
This disease is very serious, but it is never too late to start treating it, unlike other systemic chronic diseases. It responds well to treatment with folk remedies. If a person begins to strictly control himself in nutrition and adhere to a low-purine diet, the tophi will begin to disappear and the attacks will stop.
During treatment, it is necessary to constantly monitor uric acid levels and follow a diet.

Foods for gout

• Exclude from food:
  Fried meat, canned meat and fish, meat and fish broths, smoked meats, liver, kidneys, vinegar, spicy seasonings, cocoa, chocolate, alcoholic drinks, carbonated drinks.
• Limit the following foods in your diet:
  salt, sugar, sausages, pickles, boiled fish and meat, mushrooms, lard, legumes, sorrel, spinach, cauliflower, celery, radishes, strong tea and coffee.
• Most often you need to include in the diet for gout:
  Milk, dairy and lactic acid products, potatoes, bread, cereals, raw vegetables, berries and fruits, especially apples, carrots, strawberries, currants.
• Alkaline mineral waters, fasting days based on apples, oranges, cottage cheese and kefir are very useful.
• Drink liquids at least 1.5-2 liters per day

Depending on your diet, a new attack of gout may take several weeks, months or years to develop.

Effective treatment of gout with folk remedies - how to treat gout.

Since gout is associated with metabolic disorders (metabolism of purines, from which uric acid salts are released) and occurs with exacerbations in the form of attacks, then Treatment of the disease with folk remedies is divided into two stages:

1. Reducing the level of uric acid in the blood through diet and herbal remedies helps avoid new attacks and reverse the disease.
2. Relieving pain during a gout attack, reducing the duration of the attack.

If the disease is advanced and growths on the joints (tophi) have appeared, then there are many folk remedies that help in resolving the growths and relieving pain.

Home treatment for gout between attacks - diet, herbs and other folk remedies.

Recipes from the newspaper “Vestnik ZOZH”

These folk remedies help reduce the level of uric acid in the blood, avoid attacks, and remove growths on the joints.

Home treatment for gout with pine nut shells
Pour the dried pine nut shells into a dark glass bottle up to the hanger, and fill it with alcohol or vodka until the cork stops. Leave for 10 days, shaking daily. Take 1 tsp. before meals 3-4 times a day, and if severe pain occurs up to 5 times. Pine nut tincture helps with all joint diseases, osteochondrosis, stomach diseases, and hemorrhoids. (recipe from Healthy Lifestyle 2012, No. 6, p. 9)

If you are worried about gout pain in your big toe, then iodine will help.
Apply liberally to the sore spot in 2-3 doses, preferably at night. The woman even managed to avoid surgery. In addition, you need to walk a lot, at least 3-5 km a day. (HLS 2012, No. 2, p. 41)

Folk treatment with clay
The clay is kneaded like dough, rolled into a flat cake and applied to the sore spot overnight. 6-8 procedures are enough and the disease will not bother you. (recipe from the newspaper Bulletin of Healthy Lifestyle 2012, No. 2, p. 41)

How to treat gout with birch buds or leaves at home.
Birch in all its forms is often and successfully used.
Infusion: pour 10 g of birch buds with 2 glasses of water and boil for 15 minutes, wrap, leave for 1 hour. Take 1/4 cup 4 times a day 1 hour after meals.
Or 15 g of birch leaves pour 1 tbsp. boiling water, leave for 2-3 hours. Take 1/2 cup 3 times a day.

It is also useful to drink fresh birch sap 1 glass 3 times a day.
Birch bud ointment helps relieve joint pain and dissolve gouty nodes. To prepare the ointment, you need to grind 1 cup of birch buds into powder (if they are dry) or grind into pulp (if they are fresh) and grind with 0.5 kg of fresh interior fat. In a clay pot, this mixture is simmered in the oven for 3 hours every day. Only 7 days. If there is no oven, use a water bath. Rub into joints 2 times a day. This is a very wonderful ointment, it also helps with rheumatism and almost all skin diseases (dermatoses, bedsores, ulcers, lichen, eczema) (2002, No. 21, p. 23)

Burdock.
Burdock root infusion helps with metabolic disorders, gout, osteochondrosis, urolithiasis and cholelithiasis. To prepare the infusion at home, you need to take 2 tbsp. l. dry crushed burdock root and pour three glasses of water at room temperature, leave for 2-3 hours, then boil for 15 minutes. Drink 1/2 cup warm 3 times a day after meals. (2011, no. 6, p. 35)
Here is another folk remedy from burdock, which heals joints well, dissolves stones in the gall and bladder. Grind young burdock leaves in a meat grinder to make 0.5 liters. pulp, add 500 g of honey and 500 g of vodka, mix well, take 1 tbsp. l. 3 times a day on an empty stomach. Store in a dark cupboard, but not in the refrigerator. (recipe from Healthy Lifestyle 2009, No. 11, p. 32)
From the advice of the healer Ustinya. If you have gout on your leg, compresses made from burdock root decoction will help. 1 tbsp. l. dry crushed roots are boiled in 1 tbsp. water for 10 minutes, leave for 40 minutes. Several layers of cloth or gauze should be moistened in this decoction and applied to the sore joint. Wrap with cotton wool or a warm scarf overnight. After each procedure, the bandage must be washed with soap or replaced with a new one. 25-30 such procedures and the disease goes away. Burdock root infusion can also be used internally. (2001, no. 14, pp. 16-17)

Currant.
At the age of 27, a woman’s fingers became swollen and deformed. There was unbearable pain, especially at night. After all the tests, the doctor said that it was gout, it was difficult to treat and I had to follow a diet and take allopurinol tablets for the rest of my life. The patient was not satisfied with this, and she began to look for folk remedies for treating gout. The magazine “Science and Life” wrote that black currant removes uric acid from the body. To do this, leaves and young twigs should be brewed and drunk instead of tea. The woman began to do this, brewed currant leaves and twigs in a thermos, sometimes added a leaf of mint or lemon balm, and drank a mug 3-4 times a day. Very soon all the bumps disappeared, and even earlier the pain and inflammation of the joints went away. (recipe from the newspaper Bulletin of Healthy Lifestyle 2011, No. 24, p. 10)
An infusion of black currant leaves reduces blood pressure and tones the cardiovascular system, treats kidney and bladder diseases. (2011, no. 24, p. 15)

How to treat gout with apple juice
The man had gout and urolithiasis; there were often exacerbations with severe pain. Freshly squeezed juice from green apples helped cure the disease. He drank it on an empty stomach, 1 glass in the morning. 30 minutes later I had breakfast. I drank apple juice every day. Six months later I felt better. Over the past three years, there has not been a single attack. In addition, the blood pressure returned to normal. (2010, no. 6, p. 31)

Traditional treatment with wheatgrass.
4 tbsp. l. wheatgrass root in 2 cups of boiling water, leave for 12 hours. Drink half a glass 4 times a day. This infusion dissolves kidney stones and deposits on joints (2009, No. 6, p. 17)

Compresses - salt + soda + potassium permanganate
The woman managed to get rid of the disease using the following folk remedy: 2 tbsp. l. salt, 2 tbsp. l. soda, mix a few crystals of potassium permanganate with 2-3 tbsp. l. water to make a paste. Place the mass on a bandage and tie it to the sore joint. Secure the compress with a bandage, do not change the bandage for 3 days, then make a new compress. (HLS 2009, No. 6, p. 28, 2004 No. 15, p. 25)

Treatment with elecampane baths at home
1 tbsp. l. Pour 1 cup of boiling water over elecampane roots and leave. Add the infusion to the foot bath. Soak your feet before bed for 12 days in a row. The attacks will subside. (HLS 2009, No. 12 p. 30-31)

Ceylon tea
You need to brew strong Ceylon tea and make a compress from this tea at night. And in the morning, after removing the compress, tap the bones with a wooden spoon. 3-4 procedures will be required. The woman was treated with this method - on the first day, when tapping her leg, there was severe pain, she simply reduced the force of the blow. On the second day I hit her harder - the pain was weaker. On the third day I no longer felt any pain. I did the procedure for the fourth time, and now I’ve been healthy for 4 years. (2007, No. 7 p. 30)

Fraction ASD-2.
Gout can be cured with ASD-2. This drug should be taken according to the general regimen. In addition, make compresses on the sore joint, just like for skin diseases, but also use the ASD-2 fraction (and not ASD-1 as for skin diseases). (2007, No. 9, p. 7, 2006, No. 14, p. 8,)

Ointment for resolving growths on joints
Pour 1 tbsp into a 100 gram jar. l.: camphor oil, ammonia, turpentine, vinegar 9%, fill the jar to the top with melted fat (pork, goose, etc.). When cooling, this mixture is divided into 2 fractions, so before use it must be heated in a water bath and shaken. Rub the resulting emulsion into the sore joint, then moisten a cloth with this mixture and make a compress on the sore joint, top with a film, cotton wool and a bandage. Within a month and a half of daily compresses, the growths on the joints dissolved (From the practice of Kyiv herbalist V. Kupchin. (Healthy Lifestyle 2007, No. 21 p. 14)

From a conversation with academician of the RA med. Sciences, Chief Researcher of the Institute of Rheumatology V. A. Nasonova
It is necessary to treat the disease with folk remedies in three ways: take baths, drink infusions of medicinal herbs, do exercises and rubbing. Only then will the disease reverse itself.
Of all the folk remedies, the most powerful and radical is the tincture of the root of the wrestler. You need to take 100 g of roots, pour a liter of vodka or 60% alcohol. Infuse in a warm place for three days, the tincture should become the color of strong tea. The patient can use no more than 1 tsp for rubbing. tinctures. When rubbing this remedy, blood circulation sharply increases, the patient immediately feels a strong heartbeat. If gout is on the legs and arms, then only one arm or leg should be treated with this tincture at a time, the next day - the other limb, etc. Rub the tincture dry overnight, then wrap the affected joint in flannel and woolen material. In the morning, remove the bandage and 2 hours later quickly wipe your leg with a rag soaked in cold water and well wrung out.
Rub the tincture in every day for 4-5 weeks before going to bed. The patient needs to drink 2-3 liters of fluid per day. (Bulletin of Healthy Lifestyle 2006, No. 22 p. 6-7)

Herbs in the treatment of gout with folk remedies.

From a conversation with Dr. Natalya Lyubimova

1. Very effective herbal collection: take 1 tsp. chamomile flowers, mint leaves, horsetail grass, St. John's wort, elecampane root, nettle leaves, birch buds, lingonberry leaves, flax seeds. Total 9 tsp. Stir and pour 1 liter of boiling water. Leave for 2 hours, strain. Drink 1 glass 3-4 times a day. Course 3 weeks. This herbal collection is aimed at preventing attacks and reducing the level of uric acid in the blood.
2. Strawberry tea Brew 50 g of wild strawberry leaves with 1 liter of water. Drink during the day instead of tea for a long time. This is a very effective folk remedy for treating gout. Scheme: Drink 2 tbsp of flaxseed oil 3 times a day. l., and drink strawberry tea throughout the day. The course of treatment is 7 days. Repeat the course every 2 months.
3. Lovage Pour 5 g of lovage root into 1 cup of boiling water, bring to a boil, and boil for 10 minutes. Leave for 3 hours, strain. Take 1 tbsp decoction. l. 3-4 times a day 30 minutes before meals. Course - 2 weeks. (2005, No. 21 p. 12)

Herbs to treat gout at home
Herbal infusions and vegetable juices can successfully treat the disease at home.
Alkalinizes urine: juice of pumpkin, zucchini, cucumber.
Increase the solubility of uric acid salts: infusions and decoctions of barberry roots, immortelle herbs, lingonberries, strawberries, bearberries
Inhibits the reabsorption of salts in the intestines: infusions of blueberries, astragalus, horsetail herb
Inhibits the formation of uric acid crystals: infusions of corn silk and Chinese lemongrass.
Here is an effective collection of herbs that acts in several directions at once: mix strawberry leaves, birch leaves, corn silk, nettle leaves, and agrimony grass. 1 tsp. collection, pour 1 cup of boiling water, leave for 30 minutes. Take 1/3 cup three times a day. If you take this collection for 1.5-2 months, the disease gout will begin to recede (2004, No. 6, pp. 8-9).

Recipe for gout and bumps on the leg - triple cologne + ammonia + iodine
A woman suffered from gouty pain in her foot for 7 years; a painful lump formed near her big toe. Friends advised her to use a folk recipe: 10 tbsp. l. “Triple” cologne, 10 tbsp. l. ammonia and 10 tbsp. l. Pour iodine into a bottle and mix. Infuse for a day. Lubricate the bump every day 2-3 times a day. She was treated with this remedy for six months. The pain went away, the lump on my leg disappeared. (Bulletin of Healthy Lifestyle 2005, No. 21 p. 12, 2004, No. 1, p. 27).

Adam's root
Rinse 100 g of Adam's root, grate it, pour in 200 g of vodka. Leave for 1 day and rub into the sore joint every other day. (Bulletin of Healthy Lifestyle 2004, No. 15 p. 16. From the recipes of the healer Golyuk).

Flax seed to reduce uric acid levels and against urolithiasis
2 tsp. seeds, pour 300 g of water and cook over low heat for 15 minutes. Leave for 10 minutes, pour into a glass bottle, close tightly and shake the broth for 5 minutes. Strain, take 1 tbsp. l. 4-5 times a day. (2004, no. 4 p. 23).

Baths
Outside of attacks, baths are good: radon, hydrogen sulfide, sodium chloride. Radon baths work best because they affect the metabolism of purines and promote the removal of uric acid salts. There are radon baths in the resorts of Pyatigorsk, Essentuki, and Tskhaltubo. The course includes 12-14 baths every other day. Hydrogen sulfide baths and therapeutic mud, which are available in Sochi, Zheleznovodsk, Saki, Staraya Russa, and Sestroretsk, are also effective.
Sodium chloride baths can be prepared at home: take 1.5-2 kg of salt per bath, dissolve it in water at 37-38 degrees. Stay time – 20 minutes, course – 10-15 procedures. These baths cannot be used for cardiovascular diseases. . (2004, no. 6 pp. 8-9).

Treatment with leeks and butter
Leeks are good at removing salts from joints and preventing their deposition. It is often called the “anti-gout onion.” The man began to grow this leek and constantly consumed it. Soon I forgot about the gouty pain in the joints and the crunching in the joints. (2002, No. 17 p. 20). Boletus mushrooms have the same effect (2002, No. 19, p. 19).

Sorrel
Sorrel, which contains oxalic acid and dissolves uric acid salts in the joints, helps cure the disease. Sorrel cannot be boiled, it must be eaten raw - chew several leaves a day, preferably more. At the very beginning of treatment, the diseased bones will itch and ache a little, and then the pain quickly passes, the salts dissolve, and the disease recedes. (2001, No. 6 p. 17).

Activated carbon
Activated carbon is of plant origin and is not soluble in any media. It is completely eliminated from the body in 24-28 hours along with feces. Coal absorbs carcinogenic and toxic substances from the body. It reduces cholesterol levels and promotes weight loss. Consumption of charcoal improves the general condition of gout, diabetes, psoriasis, atherosclerosis, stops the formation of stones in the gall bladder and kidneys.
Take activated carbon for two weeks, 3-5 tablets 3 times a day, an hour after meals. The course is conducted 2-3 times a year. (2001, No. 19 p. 11).

Kerosene ointment
The ointment is prepared from 50 g of kerosene, 50 g of sunflower oil, 30 g of laundry soap and less than a teaspoon of soda. Rub the sore spot on the leg dry. (2001, no. 23 p. 19).

Ointment for gout pain - butter + alcohol
The woman suffered from gouty pain for many years. She was able to get rid of severe pain with the help of a folk remedy found in an old book. Take butter (preferably homemade) and alcohol, ratio 1:1. Heat the oil in a frying pan or saucepan until foam appears, remove from heat, pour in alcohol and set it on fire. The flame will be high, you need to be careful and protect your face. When the flame goes out, the ointment is ready. Keep refrigerated. It is necessary to rub the ointment into the sore joint in a warm place - in front of a stove, oven or heater. No need to wrap it up. After using this recipe, attacks of gout on her leg have not bothered her for 20 years. (HLS 2005, No. 2 p. 30). This same folk remedy is also recommended by Dr. Lyubimova in the “Bulletin of Healthy Lifestyle” for 2005, No. 21 p. 12

Traditional treatment during an attack.

These folk remedies will help quickly relieve pain. The main thing is to provide rest to the sore joint and “flush” uric acid from the body by drinking plenty of fluids.

During an attack of gout, willow bark is used to relieve joint pain.
1 tbsp. l. Pour a glass of boiling water over chopped white willow bark and leave for 1 hour. Take 1/4 cup 4 times a day (2012, No. 1, p. 30, 2001, No. 15, p. 21)

From a conversation with Dr. med. Sciences, Kadykov A.S.
When treating gout, you must strictly adhere to the diet. During attacks, you can apply a sheet to the sore joint burdock, cabbage.
Warm leaf baths relieve pain well. nettle, and even better from its roots. 8 tbsp. l. Bring 3 liters of water to a boil and leave. Keep your hands or feet in the warm solution for 15-20 minutes, without wiping, wrap in a warm diaper. A course of 20-25 procedures will help stop the progression of the disease and delay a new attack. It is useful to reinforce the baths by taking nettle decoction internally – 2 tbsp. l. 0.5 liters of boiling water is a daily dose, drink in 4-6 doses.

Ginger root is good for reducing uric acid levels in the blood: grate 2 tbsp. l. ginger, pour 1 liter of boiling water into a thermos, throw in 1 bag of green tea, leave for 30 minutes. Drink with honey instead of tea. Ginger root is part of the drug Urisan, prescribed to reduce uric acid levels. (2011, no. 14, pp. 6-7)

"Mushroom fat"
Fly agaric ointment relieves pain well. At the bottom of the pan you need to put 200 g of chopped interior fat, add 50 g of spruce or pine resin, simmer until all the fat is rendered, then remove the resulting cracklings with a slotted spoon. Add 100 g of fly agarics ground into powder and 30 g of rye flour to the slightly cooled fat. This folk remedy can be stored in the refrigerator for 2 years.
Mode of application: Warm up the sore joint with a massage with alcohol tincture of cinquefoil or fly agaric (infuse 100 g of fresh fly agaric per 100 g of vodka for less than 30 days). Then rub in the “mushroom fat” for 3-5 minutes, cover with a warm cloth and go to bed. Course - 10-15 nightly procedures. After a week's break, the course can be repeated to consolidate the result. The same folk remedy can cure arthritis, rheumatism, osteochondrosis and other diseases. The woman had nodules on her thyroid gland; after rubbing in fly agaric ointment, they resolved (2010, no. 20, pp. 39-40)

Traditional treatment with horseradish or radish
Place horseradish or radish gruel on the sore joint, wrap it with burdock or coltsfoot leaves, and secure with a bandage. Gout pain on the leg goes away quickly. Under such a compress, uric acid salts dissolve and tophi decrease. (2009, no. 6, p. 17)

How to relieve a gout attack with copper wire
The Healthy Lifestyle reader has been sick for 7 years. After a sleepless night during the attack, he re-read all the newspapers with folk recipes. I found an article that copper is good for relieving joint pain. The man wrapped his big toe and entire foot with copper wire, which he took from two-wire telephone wiring. After half an hour the pain subsided, and after an hour it completely disappeared. On the second day, the swelling subsided, the man was able to put on his boots and go to work without feeling pain in his leg. Previously, I couldn’t walk normally for months, although I took pills, gave injections, used ointments, and went to physical therapy. (2009, no. 6, p. 28,)

Comfrey is one of the best folk remedies for treating joints.
An ointment is made from comfrey: 2 parts of grated fresh root are mixed with 4 parts of pork fat and 1 part of dimexide (sold in a pharmacy). Gout on the leg is rubbed or lubricated with this ointment, covered with compress paper, and insulated with woolen cloth for 4-5 hours. This treatment is carried out every day until a noticeable result is obtained, but not less than 10 days (2008, No. 14 p. 28)

During an exacerbation of the disease, when the level of uric acid in the blood rises sharply, treatment with cranberry juice will help. You should drink 100 g of juice 3 times a day, diluted half with water. Make a compress from cranberry pomace on a joint affected by gout: mix the pomace with potato starch 1:1, grease with rich cream and apply the cranberry mixture, wrap with compress paper and put on socks (2003, No. 20 p. 20-21).

How to relieve a gout attack with lilac ointment
1 tbsp. l. Grind lilac flowers with 1 tbsp. l. butter. During an attack, apply a compress with this ointment. Between attacks, rub the sore joint with this ointment. (2005, no. 21 p. 12).

How to relieve pain during a gout attack

From a conversation with academician of the RA med. Sciences, chief researcher at the Institute of Rheumatology V. A. Nasonova.
The main medicine for the treatment of gout is allopurinol, but it should not be used during an attack - this drug can only increase the intensity and duration of the attack.
At home, to relieve pain, you need to provide rest to the sore joint and begin to “wash out” uric acid from the body - drink more water, 1.5-2 liters a day, but better herbal tea, rosehip infusion, lingonberry juice without sugar.
If the joint can be touched, then apply an ice pack to the sore spot for no more than 10 minutes. Then apply cabbage leaves or a cloth bag with hot salt.
If the pain does not calm down, then you should prepare an ointment: 100 g of yogurt or kefir. 100 g mashed rye bread. 0.5 tsp. soda. Place the ointment on a bandage and apply it to the sore joint. (2006, No. 22 pp. 6-7)

What to do during a gout attack

Compress of honey, aspirin and yogurt For acute pain, this folk remedy will help: apply a thin layer of honey to the joint, cover with 4 crushed aspirin tablets, and put a cloth soaked in cold yogurt or cottage cheese on top. When it warms up, change the compress. If you don’t have money for such a compress, then moisten the problem area on your leg with table vinegar diluted with water in a ratio of 1:3
Juniper drink. Prepare an infusion - 2 tsp. juniper berries in 1 glass of boiling water, leave and drink at the beginning of an attack. It's good to wrap yourself up for sweating. After sweating, change into dry clothes. After 6 hours, drink another glass of drink. Do this until the attack stops. In the future, simply take 10 juniper berries, simply chewing and swallowing, 2-5 times a day. Juniper berries are also good for treating kidney diseases.
Wormwood seed. To prevent the attack from recurring as long as possible, take the seed of cypress wormwood. Previously, it was always sold in pharmacies. 1 tsp. Boil the seeds in a glass of milk. Drink this drink: half a glass in the morning, half a glass in the evening. It will take a long time, two years. But this folk remedy will greatly ease suffering. If the gout on the leg ever moves, after many years, it will only timidly and immediately subside.
A decoction of oat stalks in milky ripeness or a decoction of oat grains (2 kg of grains per 6 liters of water, simmer for 5 hours) will help reduce the level of uric acid and maintain it in a normal state. It is also useful to use an infusion of cinquefoil grass, an infusion of meadowsweet flowers or roots, an infusion of wheatgrass roots, an infusion of knotweed herb (Bulletin of Healthy Lifestyle 2004, No. 15 pp. 22-23. From recipes of conversations with healer Clara Doronina).

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Causes of damage to the joints of the hands

Classic gout, affecting the joints of the hands, begins with damage to the first metatarsophalangeal joint (the finger suffers), and then, as the disease becomes chronic, it involves other joints in the pathological process. In rare cases, the disease can occur as an isolated monoarthritis with periodic inflammation of only the metatarsophalangeal joint. However, there is another variant of the course of gouty arthritis, in which the joints of the hands are primarily affected.

Gout begins to affect the joints of the hands only in two cases: if the disease proceeds atypically, or if the process has gone quite far and all joints have become involved in it. Gout is a systemic inflammatory disease associated with impaired metabolism of purine bases, which are part of the nucleotides that form DNA and RNA. They appear in the body in two ways: coming from food and being formed in some cells.

As a result of this metabolic disorder, increased formation of uric acid is observed in the blood. Normally, it is present in plasma in dissolved form. Getting into the joint cavity or nearby tissues, it is deposited in the form of crystals. These deposits are called “tophi.”

Normally, the amount of uric acid in the blood serum (determined by the calorimetric method) should not exceed 0.36 (360 µmol/l). Exceeding this value (according to the criteria developed by EULAR - the European Association of Rheumatology) allows a diagnosis of hyperuricemia to be made.

Depending on how much uric acid is in the blood, as well as the rate at which this indicator increases, the risk of developing gout is determined.

Metabolic disorders in this disease

Gout develops with certain changes in purine metabolism.

1. Excessive synthesis of purine bases (metabolic or exchange type of gout). Occurs as a result of hereditary pathology. Most often, this type of gout is caused by enzymopathies, a deficiency of the enzyme hypoxanthine-guanine-phosphoribosyltransferase, for example. In addition, some hematological diseases influence the increased production of purine bases: polycythemia vera, leukemia, lymphoma, pernicious anemia, tumors, psoriasis, Gaucher disease. Taking medications such as nicotinic acid, warfarin, and ethanol can also have a negative effect. Other factors are a diet rich in foods with purine bases: fatty meats, red wine, juices, fruits.
2. Impaired release of purines from plasma (renal gout). Most uric acid removal occurs through the kidneys, although a small proportion is excreted through the skin. Any disorders of the kidneys (nephropathies, chronic renal failure, dehydration), pathology of the endocrine system (hypothyroidism, hyperparathyroidism), taking certain drugs (diuretics, cyclosporines, anti-tuberculosis drugs) affect the filtration capacity of the kidneys and reduce the excretion of uric acid from the body.
3. The combination of the above symptoms (hybrid or mixed type of gout).

The development of gout can be provoked by bad habits (in particular, alcohol abuse), taking certain medications (aspirin, intravenous heparin, some antibiotics), diseases (chronic renal failure), as well as such a harmful factor as the effect of lead on the body.

What happens as the disease develops?

Urates (uric acid crystals) are carried through the bloodstream throughout the body, where they are deposited in various tissues and organs. The skin, cartilage tissue and synovial fluid, and kidneys are most sensitive to them. Urates are deposited preferentially in those places where there are a large number of proteoglycans. In this case, the cartilage tissue suffers the most. Through cartilage defects, urates penetrate deep into the joint and reach the bone.

As a result of the accumulation of crystals, giant cells begin to migrate into this area. At the same time, a granuloma forms at the site of crystal deposition. When activated, macrophages begin to destroy subchondral bone tissue, which is why a so-called “piercing defect” is formed in this place - an x-ray symptom characterized by the formation of a rounded shadow caused by the zone of destruction.

The destruction of bone tissue activates the process of inflammation.

Leukocytes (in particular, neutrophils and eosinophils) and macrophages begin to migrate into this zone. They start the process of synthesis of anti-inflammatory cytokines, TNF - tumor necrosis factor. Their combined effect on the joint only intensifies the process of inflammation. Ultimately, a malfunction of the immune cells occurs: lysosome-containing cells (neutrophils and eosinophils) rupture, and the contents of their lysosomes (aggressive proteolytic enzymes) are released into the joint cavity, aggravating the already serious condition and triggering repeated migration of immune cells and the synthesis of inflammatory mediators.

Symptoms of gout on the hands

The course of gouty arthritis is practically no different from classic gout. There are several stages here. This is asymptomatic hyperuricemia, acute gouty arthritis, interictal period.

Asymptomatic, long-term hyperuricemia - the condition practically does not manifest itself in any way, and is detected only during medical examinations with a biochemical blood test. If it is not transient, then over time it develops into acute or chronic form of gout. To confirm the diagnosis of gout, it is recommended to do a repeat biochemical blood test for uric acid, along with determining it in the urine.

Acute gouty arthritis - its development with manifestations on the metacarpophalangeal joints is observed in approximately 40% of patients. An exacerbation is characterized by the presence of intense pain, swelling, and impaired range of motion (particularly due to pain). The affected joint is warmer to the touch, palpation reveals pain, in some cases the symptom of crepitus is positive - a feeling of crunching under the fingers as a result of movement. Active movements are practically not performed, passive ones are painful. As the disease progresses, there is a decrease in the range of active movements in the joint, its stiffness, and deformation.

Gradually, acute arthritis develops into a chronic tophi form. Tophi on the hands are localized in the area of ​​the tendons of the back of the hand, sometimes the elbow joint is affected. Tophi themselves are painless formations that rise above the skin.

The interictal period - in acute gout, is characterized by the subsidence of the symptoms of the acute phase and the restoration of movement in the affected joint. As the disease progresses, the period of remission becomes shorter and the symptoms begin to accumulate. As a result, arthritis becomes chronic.

Rarely, atypical gout on the joints of the hands can occur without severe pain, but with numerous formation of tophi and severe deformation of the joints. Because of this, it is sometimes confused with osteoarthritis, and neoplasms with osteophytes.

Over time, in almost 90% of cases, gout also affects the kidney tissue. Tubulointerstitial nephritis, nephrolithiasis and uric acid nephropathy develop.

Diagnosis criteria

The diagnosis of gout is made based on certain criteria. These include two main criteria (detection of uric acid in synovial fluid and detection of uric acid crystals on tophi) and at least six additional signs.

List of minor or additional signs of the disease:

• peak of the inflammatory process on the first day of exacerbation;
• a history of at least one similar attack on a joint;
• monoarthritis;
• joint hyperemia;
• pain and inflammation of the metacarpophalangeal joints, in the classic course - in the first metatarsophalangeal joint;
• asymmetrical damage to the joints of the hands;
• damage to the heel (tarsal) joints (on one side) - for classic gout;
• hyperuricemia;
• detection of a “punch”;
• negative result for synovial fluid culture;
• with the development of polyarthritis - asymmetrical damage to the joints;
• identification of tophi (or tophi-like formations).

The course of gouty arthritis can be divided into mild, moderate and severe.

A mild course is characterized by rare attacks of exacerbations, low intensity of inflammatory symptoms, and quick and easy relief of the attack. Moderate course is characterized by 3-5 attacks of arthritis per year, damage to several (usually up to 4) joints, moderate symptoms and the formation of tophi. A severe course is observed in the case of increased frequency of attacks, the formation of a large number of tophi, kidney damage and significant deformation of many joints.

Non-drug methods of combating the disease

Therapy for gout should be comprehensive and include not only drug treatment, but also the normalization of all metabolic processes. The complex of help for this disease also includes a diet for gout. First of all, the patient should be reasonably explained that treatment for gout, including diet, will now be lifelong. A complete cure will never occur; it will only be possible to relieve the symptoms.

Non-drug methods of treating the disease include lifestyle changes.

1. Complete abstinence from alcohol. Even with a carefully observed diet, drinking a small amount of alcohol can provoke an acute attack of arthritis, which will be quite difficult to stop. If the outcome is unfavorable, as a result of violation of the “dry regime”, an illness such as acute toxic kidney may develop with an outcome in acute renal failure.
2. Diet for gout on the hands. Fatty meats, artificial juices and nectars, a variety of baked goods, and sweets are excluded from the diet. It is allowed to eat low-carbohydrate foods supplemented with unsaturated fats: milk and dairy products (kefir, cottage cheese, curdled milk, cheeses), nuts (walnuts, hazelnuts), vegetables (cabbage, beets, cucumbers, carrots, onions), fruits (grapes, plums) , cherries, oranges).
3. Loss of body weight. This factor has virtually no effect on the damage to the joints of the hands in gouty arthritis, but manifests itself in the classical course.
4. For the most effective treatment of the acute form of the disease, it is recommended to provide the patient with complete rest and elevate the inflamed joints. It is recommended to apply cold to the area of ​​the affected joints. During an attack, the patient should be given more fluids.

How to treat gout with medications

Drug treatment of a gout attack should include relief of acute symptoms. Medicines used include nonsteroidal anti-inflammatory drugs, glucocorticoids, and colchicine. These drugs influence the links of pathogenesis.

Thus, nonsteroidal anti-inflammatory drugs (NSAIDs) block the formation of cyclooxygenase, an enzyme responsible for the synthesis of inflammatory prostaglandins. When used, the symptoms of inflammation are reduced, due to which the acute gout attack is stopped. Glucocorticoids are used when NSAIDs are ineffective. They are administered mainly into the joint cavity, since in this way glucocorticoids have less side effects on the body as a whole.

Colchicine is a plant alkaloid. It has an anti-inflammatory effect by stabilizing the membranes of cells involved in the development of inflammation in the joint. In addition, it stabilizes the pH of the synovial fluid, which prevents further deposition of salt crystals in the joints.

With prolonged attacks of gout, an increase in their frequency throughout the year, and a deterioration in the general condition, anti-gout therapy is started. For this purpose, allopurinol is used (for excessive formation of uric acid), probenecid, urisan (for reduced excretion through the kidneys). These medications, like any other, must be prescribed by your attending physician.

What to pay attention to during treatment and prevention

When using medications, they are guided by the following principles.

1. In case of acute gout attack, you should not start therapy with allopurinol.
2. Allopurinol is prescribed and used by dose titration: a starting dose of the drug (50 mg) is prescribed, after which the dose of the drug is increased until normal uric acid levels are achieved.
3. The first month of treatment is recommended to be guided by the principle of gradual treatment: the slower the better.
4. If renal parameters (clearance and glomerular filtration rate) decrease, it is better to use low doses of the drug.
5. To prevent exacerbation, you need to carefully adjust your daily diet.

The diet for gout should not include foods rich in purines. You should use a sufficient amount of water: at least 2-2.5 liters per day. The liquid is used to dilute blood plasma, as well as to improve the excretion of uric acid through the kidneys by increasing diuresis.

If kidney failure has developed, it is recommended to first get rid of it, and then prescribe fluid intake. Alkaline mineral waters can also be used, as they help dissolve urate crystals. You should not eat table salt. On the contrary, it is recommended to reduce the daily dose of salt to 3 g, as it helps retain fluid in the tissues and prevents the leaching of urates from joints and tissues.

Gout is called an ailment of people of high society, a disease of lords, as it develops against the background of consumption of red wine, fatty meat, and alcohol. However, simply normalizing your diet will not completely prevent the development of gout. It is worth undergoing preventive examinations annually for timely diagnosis of possible diseases.

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Which doctor treats gout?

It is strictly not recommended to take any medications for gout, use ointments, or make compresses without consulting a specialist. Assessing clinical symptoms, conducting diagnostic tests, formulating an appropriate diagnosis and prescribing specific treatment should be carried out either by a local physician or a rheumatologist.

How to treat gout at different stages at home?

At home, you need to cope not only with acute attacks of gout, but also learn to prevent relapses. And also achieve stable remission, having first consulted with your doctor. Treatment of gout with medications is aimed at the following factors:

1. Combating acute joint pain and getting rid of general symptoms of inflammation.
2. Reduce relapse rates as much as possible.
3. Preventing further accumulation of uric acid salts and eliminating existing foci of urate deposition.

How can you relieve an attack of gout if the joints of the legs are affected?

To relieve an attack of gout, relieve pain and eliminate signs of inflammation in the joints of the legs, medications are used, as well as local therapy (applications and compresses). Before using any of the listed therapeutic methods, be sure to obtain approval from a medical specialist.

Medications

According to generally accepted practice, only proven and effective medications should be used at home for gout attacks and joint pain, preferably in the form of tablets, capsules and soluble powders. With the permission of the supervising physician, you can take:

• Non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, naproxen, nimesulide).
• If NSAIDs are ineffective or there are contraindications, use colchicine.
• If the above medications for gout do not help, then proceed to taking glucocorticoids in tablets (prednisolone).

Despite the fact that aspirin is a non-steroidal anti-inflammatory drug, it and other salicylates are not recommended for use during exacerbation of gout and an increase in clinical symptoms of the disease. According to some studies, soluble aspirin tablets, when taken orally, can increase uric acid levels and provoke an increase in attack.

Local therapy

To treat any form of gout during its exacerbation, local therapeutic procedures are actively used. The following have an excellent effect:

• Applications to the affected joints (metatarsophalangeal big toe, knee, ankle, elbow, wrist) of dimexide solution. The effectiveness of the procedure increases significantly when combined with a glucocorticoid drug.
• Warm compresses, which usually need to be done after the pain subsides.

Having carried out drug treatment for gouty arthritis at home, and not having achieved the disappearance of the clinical symptoms of inflammation of the joints in the legs, it is necessary to consult your doctor again.

What ointments are used for gout when the joints in the legs are inflamed?

Clinical experience shows that when any joint on the legs is inflamed (knee, ankle or metatarsophalangeal joint of the big toe), treatment of gout with anti-inflammatory ointments is practically ineffective.

It is also usually not possible to quickly relieve joint pain when diagnosed with gout using various ointments or gels.

Folk remedies for an acute attack of gout when treated at home

Non-traditional methods of treating gouty arthritis that can cope with both joint pain and normalize uric acid levels include:

• phytotherapy;
• apitherapy (bee stings);
• rubbing honey;
• various baths;
• compresses, etc.

As practice shows, folk remedies for gout are very effective in affecting various types of joints on the legs and arms (knee, ankle, elbow, wrist, fingers and toes).

Phytotherapy

Today, there are quite a lot of recipes for decoctions, tinctures and herbal infusions for gout. The following folk recipes are considered not only very popular, but also effective:

1. Brew 20 grams of lingonberry leaves in a glass of hot water. Leave for at least half an hour. Take 2-3 times a day, a tablespoon.
2. Drink one teaspoon of stinging nettle juice several times a day.
3. Take an infusion of black currant leaves 3-4 times a day.
4. An infusion of St. John's wort, chamomile and linden blossom helps remove uric acid.
5. Fresh birch leaves applied to the affected joints reduce inflammation and relieve pain.

It is not only possible, but also necessary to use ginger for gout. It is beneficial to drink ginger tea every day.

Water treatments for gout

“Can I steam my feet or take a hot bath if I have gout?” - this question can often be heard from patients. Yes, you can, but not in the acute stage of inflammation. There are countless folk methods and techniques regarding how to properly steam your feet or take a bath for gouty arthritis, but it would be appropriate to dwell on the most effective and accessible ones:

1. Do foot baths with chamomile. For 10 liters of water add 100 grams of chamomile and 200 grams of regular baking soda.
2. It relieves pain perfectly if you steam your feet in a hot sage decoction.
3. You can also steam sore joints before bed in a decoction of oat straw.
4. For rubbing, fly agaric tincture is used, which effectively copes with joint pain.

Although an NSAID drug such as aspirin is not recommended to be taken orally during an exacerbation of gouty arthritis, it can be used to prepare a solution. Add 5 soluble aspirin tablets to 10 ml of iodine tincture. Make the solution discolored and lubricate the affected joints with it at night.

It has been repeatedly proven that regular consumption of fresh apples helps normalize uric acid levels.

Prevention of attacks and relapses

Anyone who has ever felt joint pain due to gouty arthritis is unlikely to want to experience similar sensations again and again. Once diagnosed with gout, patients must strictly adhere to a diet, eliminating all foods rich in purines from their diet, exercise regularly, and follow all prescriptions prescribed by their doctor.

In addition, constant monitoring of uric acid levels, which is the main factor in the development of pathological changes in the body, will help achieve stable remission.

Metabolic diseases have recently begun to occur more and more often. The reason for this is poor nutrition, physical inactivity, and bad habits. As a result, disturbances occur in one or another branch of metabolic reactions, which lead to the involvement of other substances in metabolism, which further worsens the situation. One of these common diseases is gout. It is also classified as a rheumatological disease, since it affects the joints.

Causes of damage to the joints of the hands

Classic gout, affecting the joints of the hands, begins with damage to the first metatarsophalangeal joint (the finger suffers), and then, as the disease becomes chronic, it involves other joints in the pathological process. In rare cases, the disease can occur as an isolated monoarthritis with periodic inflammation of only the metatarsophalangeal joint. However, there is another variant of the course of gouty arthritis, in which the joints of the hands are primarily affected.

Gout begins to affect the joints of the hands only in two cases: if the disease proceeds atypically, or if the process has gone quite far and all joints have become involved in it. Gout is a systemic inflammatory disease associated with impaired metabolism of purine bases, which are part of the nucleotides that form DNA and RNA. They appear in the body in two ways: coming from food and being formed in some cells.

As a result of this metabolic disorder, increased formation of uric acid is observed in the blood. Normally, it is present in plasma in dissolved form. Getting into the joint cavity or nearby tissues, it is deposited in the form of crystals. These deposits are called “tophi.”

Normally, the amount of uric acid in the blood serum (determined by the calorimetric method) should not exceed 0.36 (360 µmol/l). Exceeding this value (according to the criteria developed by EULAR - European Association of Rheumatology) allows a diagnosis of hyperuricemia to be made.

Depending on how much uric acid is in the blood, as well as the rate at which this indicator increases, the risk of developing gout is determined.

Metabolic disorders in this disease

X-ray of the hand of a patient with gout

Gout develops with certain changes in purine metabolism.

1. Excessive synthesis of purine bases (metabolic or exchange type of gout). Occurs as a result of hereditary pathology. Most often, this type of gout is caused by enzymopathies, a deficiency of the enzyme hypoxanthine-guanine-phosphoribosyltransferase, for example. In addition, some hematological diseases influence the increased production of purine bases: polycythemia vera, leukemia, lymphoma, pernicious anemia, tumors, psoriasis, Gaucher disease. Taking medications such as nicotinic acid, warfarin, and ethanol can also have a negative effect. Other factors are a diet rich in foods with purine bases: fatty meats, red wine, juices, fruits.
2. Impaired release of purines from plasma (renal gout). Most uric acid removal occurs through the kidneys, although a small proportion is excreted through the skin. Any disorders of the kidneys (nephropathies, chronic renal failure, dehydration), pathology of the endocrine system (hypothyroidism, hyperparathyroidism), taking certain drugs (diuretics, cyclosporines, anti-tuberculosis drugs) affect the filtration capacity of the kidneys and reduce the excretion of uric acid from the body.
3. The combination of the above symptoms (hybrid or mixed type of gout).

The development of gout can be provoked by bad habits (in particular, alcohol abuse), taking certain medications (aspirin, intravenous heparin, some antibiotics), diseases (chronic renal failure), as well as such a harmful factor as the effect of lead on the body.

What happens as the disease develops?

Urates (uric acid crystals) contribute to gout

Urates (uric acid crystals) are carried through the bloodstream throughout the body, where they are deposited in various tissues and organs. The skin, cartilage tissue and synovial fluid, and kidneys are most sensitive to them. Urates are deposited preferentially in those places where there are a large number of proteoglycans. In this case, the cartilage tissue suffers the most. Through cartilage defects, urates penetrate deep into the joint and reach the bone.

As a result of the accumulation of crystals, giant cells begin to migrate into this area. At the same time, a granuloma forms at the site of crystal deposition. When activated, macrophages begin to destroy subchondral bone tissue, which is why a so-called “piercing defect” is formed in this place - an x-ray symptom characterized by the formation of a round shadow caused by the zone of destruction.

The destruction of bone tissue activates the process of inflammation.

Leukocytes (in particular, neutrophils and eosinophils) and macrophages begin to migrate into this zone. They start the process of synthesis of anti-inflammatory cytokines, TNF - tumor necrosis factor. Their combined effect on the joint only intensifies the process of inflammation. Ultimately, a malfunction of the immune cells occurs: lysosome-containing cells (neutrophils and eosinophils) rupture, and the contents of their lysosomes (aggressive proteolytic enzymes) are released into the joint cavity, aggravating the already serious condition and triggering repeated migration of immune cells and the synthesis of inflammatory mediators.

Symptoms of gout on the hands

The course of gouty arthritis is practically no different from classic gout. There are several stages here. This is asymptomatic hyperuricemia, acute gouty arthritis, interictal period.

Deposition of uric acid crystals in soft tissues

Asymptomatic, long-term hyperuricemia - the condition practically does not manifest itself in any way, and is detected only during medical examinations with a biochemical blood test. If it is not transient, then over time it develops into acute or chronic form of gout. To confirm the diagnosis of gout, it is recommended to do a repeat biochemical blood test for uric acid, along with determining it in the urine.

– its development with manifestations on the metacarpophalangeal joints is observed in approximately 40% of patients. An exacerbation is characterized by the presence of intense pain, swelling, and impaired range of motion (particularly due to pain). The affected joint is warmer to the touch, palpation reveals pain, in some cases the symptom of crepitus is positive - a feeling of crunching under the fingers as a result of movement. Active movements are practically not performed, passive ones are painful. As the disease progresses, there is a decrease in the range of active movements in the joint, its stiffness, and deformation.

Gradually, acute arthritis develops into a chronic tophi form. Tophi on the hands are localized in the area of ​​the tendons of the back of the hand, sometimes the elbow joint is affected. Tophi themselves are painless formations that rise above the skin.

The interictal period - in acute gout, is characterized by the subsidence of the symptoms of the acute phase and the restoration of movement in the affected joint. As the disease progresses, the period of remission becomes shorter and the symptoms begin to accumulate. As a result, arthritis becomes chronic.

Rarely, atypical gout on the joints of the hands can occur without severe pain, but with numerous formation of tophi and severe deformation of the joints. Because of this, it is sometimes confused with osteoarthritis, and neoplasms with osteophytes.

Over time, in almost 90% of cases, gout also affects the kidney tissue. Tubulointerstitial nephritis, nephrolithiasis and uric acid nephropathy develop.

Diagnosis criteria

The diagnosis of gout is made based on certain criteria. These include two main criteria (detection of uric acid in synovial fluid and detection of uric acid crystals on tophi) and at least six additional signs.

List of minor or additional signs of the disease:

• peak of the inflammatory process on the first day of exacerbation;
• a history of at least one similar attack on a joint;
• monoarthritis;
• joint hyperemia;
• pain and inflammation of the metacarpophalangeal joints, in the classic course - in the first metatarsophalangeal joint;
• asymmetrical damage to the joints of the hands;
• damage to the heel (tarsal) joints (on one side) - for classic gout;
• hyperuricemia;
• detection of a “punch”;
• negative result for synovial fluid culture;
• with the development of polyarthritis - asymmetrical damage to the joints;
• identification of tophi (or tophi-like formations).

The course of gouty arthritis can be divided into mild, moderate and severe.

A mild course is characterized by rare attacks of exacerbations, low intensity of inflammatory symptoms, and quick and easy relief of the attack. Moderate course is characterized by 3-5 attacks of arthritis per year, damage to several (usually up to 4) joints, moderate symptoms and the formation of tophi. A severe course is observed in the case of increased frequency of attacks, the formation of a large number of tophi, kidney damage and significant deformation of many joints.

Non-drug methods of combating the disease

Therapy for gout should be comprehensive and include not only drug treatment, but also the normalization of all metabolic processes. The complex of help for this disease also includes a diet for gout. First of all, it should be reasonably explained to the patient that, including diet, will now be lifelong. A complete cure will never occur; it will only be possible to relieve the symptoms.

Non-drug methods of treating the disease include lifestyle changes.

1. Complete abstinence from alcohol. Even with a carefully observed diet, drinking a small amount of alcohol can provoke an acute attack of arthritis, which will be quite difficult to stop. If the outcome is unfavorable, as a result of violation of the “dry regime”, an illness such as acute toxic kidney may develop with an outcome in acute renal failure.
2. Diet for gout on the hands. Fatty meats, artificial juices and nectars, a variety of baked goods, and sweets are excluded from the diet. It is allowed to eat low-carbohydrate foods supplemented with unsaturated fats: milk and dairy products (kefir, cottage cheese, curdled milk, cheeses), nuts (walnuts, hazelnuts), vegetables (cabbage, beets, cucumbers, carrots, onions), fruits (grapes, plums) , cherries, oranges).
3. Loss of body weight. This factor has virtually no effect on the damage to the joints of the hands in gouty arthritis, but manifests itself in the classical course.
4. For the most effective treatment of the acute form of the disease, it is recommended to provide the patient with complete rest and elevate the inflamed joints. It is recommended to apply cold to the area of ​​the affected joints. During an attack, the patient should be given more fluids.

How to treat gout with medications

Drug treatment of a gout attack should include relief of acute symptoms. Medicines used include nonsteroidal anti-inflammatory drugs, glucocorticoids, and colchicine. These drugs influence the links of pathogenesis.

Thus, nonsteroidal anti-inflammatory drugs (NSAIDs) block the formation of cyclooxygenase, an enzyme responsible for the synthesis of inflammatory prostaglandins. When used, the symptoms of inflammation are reduced, due to which the acute gout attack is stopped. Glucocorticoids are used when NSAIDs are ineffective. They are administered mainly into the joint cavity, since in this way glucocorticoids have less side effects on the body as a whole.

Colchicine is a plant alkaloid. It has an anti-inflammatory effect by stabilizing the membranes of cells involved in the development of inflammation in the joint. In addition, it stabilizes the pH of the synovial fluid, which prevents further deposition of salt crystals in the joints.

With prolonged periods, an increase in their frequency throughout the year, and a deterioration in the general condition, anti-gout therapy is started. For this purpose, allopurinol is used (for excessive formation of uric acid), probenecid, urisan (for reduced excretion through the kidneys). These medications, like any other, must be prescribed by your attending physician.

What to pay attention to during treatment and prevention

When using medications, they are guided by the following principles.

1. In case of acute gout attack, you should not start therapy with allopurinol.
2. Allopurinol is prescribed and used by dose titration: a starting dose of the drug (50 mg) is prescribed, after which the dose of the drug is increased until normal uric acid levels are achieved.
3. The first month of treatment is recommended to be guided by the principle of gradual treatment: the slower the better.
4. If renal parameters (clearance and glomerular filtration rate) decrease, it is better to use low doses of the drug.
5. To prevent exacerbation, you need to carefully adjust your daily diet.

The diet for gout should not include foods rich in purines. You should use a sufficient amount of water: at least 2-2.5 liters per day. The liquid is used to dilute blood plasma, as well as to improve the excretion of uric acid through the kidneys by increasing diuresis.

If kidney failure has developed, it is recommended to first get rid of it, and then prescribe fluid intake. Alkaline mineral waters can also be used, as they help dissolve urate crystals. You should not eat table salt. On the contrary, it is recommended to reduce the daily dose of salt to 3 g, as it helps retain fluid in the tissues and prevents the leaching of urates from joints and tissues.

Gout is called an ailment of people of high society, a disease of lords, as it develops against the background of consumption of red wine, fatty meat, and alcohol. However, simply normalizing your diet will not completely prevent the development of gout. It is worth undergoing preventive examinations annually for timely diagnosis of possible diseases.

How gout manifests itself in the hands of someone affected by the disease will be shown to the patient in the clinic by the attending physician, who will also tell about methods of treating the disease. Gout is a disease that causes not only pain, but also stiffness of movement.

The causes of its occurrence are metabolic disorders. This means that uric acid substances - purines, which should be excreted in a timely manner, for some reason begin to linger in the body, gradually accumulating.

Causes of gout

Gout can occur for various reasons:

• hereditary factor;
• lack of certain enzymes in the body;
• presence of hematological disease;
• taking certain medications, for example, ethanol, nicotinic acid, as a result, the filtration work of the kidneys decreases;
• consumption of foods with purine base, for example, fatty meats, red wine;
• impaired release of purines from plasma;
• pathologies in the kidneys or endocrine system;
• drinking large amounts of alcohol;
• long-term exposure to lead.

How does gout manifest?

Uric acid contains salts called urates. They begin to deposit, creating crystal-like formations that can subsequently cause inflammation in the joints and kidneys.

These crystals are somewhat reminiscent of needles, and when the body's defenses are activated, the neutrophils and eosinophils found in the blood cells try to absorb them. Leukocytes and macrophages are sent to this zone, in which the process of synthesis of anti-inflammatory cytokines has already been launched, but this causes new inflammation.

Neutro- and eosinophils rupture, the aggressive proteolytic enzymes contained in their lysosomes, getting out, penetrate into the joint cavity. This results in severe pain, the disease begins to progress, and as a result, nodules appear, i.e., salt deposits. They most often form on small joints in the area of ​​the foot or hand, and can also occur on the ears.

The blood carries uric acid crystals to all parts of the body, and the urates have time to settle in tissues and organs. The following are particularly sensitive to them:

• leather;
• cartilage tissue;
• kidneys;
• synovial fluid.

Urates are formed in those areas where there is a large accumulation of proteoglycans, which means the cartilage tissue is most vulnerable. Having detected cartilage defects, urates reach the bone through the joint. Due to the accumulation of crystals, giant cells begin to move here, destroying the subchondral bone tissue, and a granuloma forms in the same place.

If treatment is not started on time, the disease can deform the joint, and its functions are significantly impaired.

Recently, metabolic diseases are becoming more common. This is due to poor nutrition, bad habits, and a sedentary lifestyle. As long as the body is able to fight, it does not affect health. But when the strength of the immune system runs out, metabolic reactions are disrupted, and gradually more and more organs begin to participate in the failure. This is why gout is so dangerous, which is often classified as a rheumatological disease, based on the fact that the joints suffer.

How does the disease develop?

When gout begins on the hands, the lesion process primarily affects the first metatarsophalangeal joint, that is, the initial blow falls on the finger. And only then, the more rapidly the disease develops, the more joints experience the full severity of the disease.

There are cases when the disease does not spread beyond the metatarsophalangeal joint, but there is also an option when the joints of the hands are first affected.

Gout affects the joints of the hands if the disease:

• takes on an atypical form;
• progresses so much that all joints suffer.

Gout can be caused by many reasons, but the most basic ones are caused by disorders at the genetic level in the enzyme system, if the problem is in the kidneys, or if the food contains more uric acid. This systemic disease disrupts the metabolism of those purine bases that are contained in the nucleotides that form RNA and DNA. Their appearance is caused by the formation in some cells, and can also come from food.

When metabolism is disrupted, increased formation of uric acid occurs in the blood. It is usually present in plasma in dissolved form at an acceptable level of 360 µmol/l. Having discovered the joint cavity or tissues located very close, uric acid leaves its crystals there; these phenomena are called tophi.

Gout is characterized by an increased level of uric acid in the blood and the rate at which it increases, although much depends on metabolism.

Often the onset of the disease is preceded by a form of gouty arthritis. But inflammation of the joints can be determined by an attack of illness, when pathological changes have already begun due to the large amount of urates in the blood.

Usually the load falls on the metatarsal joints of the legs, but the arms suffer no less. Most attacks begin at night with sharp pain, swelling appears, and redness can be observed in the area of ​​the affected joint. This period can last from several hours to several days, but at this time joint deformation is not yet observed.

When the acute period has passed, the disease may not appear for several months, even a year.

Gout can cause kidney damage, since increased formation of uric acid leads to the deposition of salts in the vessels of the kidneys, which causes a disease such as nephritis.

Gout has several stages:

1. Hyperuraturia is asymptomatic. The level of uric acid in both the blood and urine increases. Clinical signs do not appear, salts have begun to be deposited in the joints, and the kidneys are already affected.
2. At stage 2, acute gouty arthritis began. The big toe is usually attacked. If left untreated, it can spread to the joints of the arms, legs, and knees.
3. Stage 3 is considered the remission phase. If at first the attacks are not so long and the pain is quite tolerable, then with each new exacerbation the attacks are more protracted, the pain intensifies, and the time between the old and new attack is increasingly reduced.
4. This stage leads to chronic tophi gout. It usually begins 4 years after the onset of the disease. It has clear external signs - specific nodules on the skin, and the attacks are increasingly intensifying. If there is no treatment, then remission is impossible.

The disease can deform the fingers so much that physical activity is sharply reduced and finger mobility becomes impossible.

You can find out that this is gouty arthritis of the joints of the hands by the following phenomena:

• pain in the fingers prevents you from falling asleep at night;
• remission lasts several months or years, but a time comes when periods of pain are reduced to a minimum;
• the sore finger seems to be engulfed in heat, warmer to the touch than all the others;
• the diseased joint swells greatly;
• nodules begin to appear under the skin, containing uric acid salts inside - these are tophi;
• general malaise is felt.

In most cases, the thumb is damaged. If the disease is severe, other fingers may also be affected. But before you start treating gout, you need to undergo laboratory tests for a correct diagnosis. When is it time to reduce pain and relieve inflammation?

How to treat the disease?

Only doctors know how to treat gout on the hands in the acute period.
The most important thing is to relieve pain and try to eliminate inflammation. For such cases, there are drugs that reduce inflammation, ointments, tablets and non-steroidal injections.

During the remission stage, medications are not required unless the disease is severe. You need to know how to treat gout at home. A purine-free diet, drinking plenty of fluids to cleanse the body of salts, and moderate physical activity are required. Drugs are required that stabilize metabolic processes and reduce the level of uric acid in the blood. For treatment, special procedures are used: baths, mud and mineral water. Based on the form of the disease, therapy is prescribed. Only the attending physician can determine the form of the disease.

In the mild form, attacks are quite rare, there are no intense manifestations of inflammation, and the pain can be quickly relieved. The disease is of moderate severity, can be accompanied by attacks 3 to 5 times a year, and affects several joints with the formation of tophi. If the form of gout is severe, it means that attacks occur frequently, a lot of tophi have formed, the joints are significantly damaged, and significant abnormalities have appeared in the kidneys.

Treatment should be comprehensive, including medications and diet.

But the main thing is to cure the disease, you need to forget about alcoholic drinks. After all, they can cause an attack, which in this case is extremely difficult to stop, since a so-called toxic kidney may appear.