Gout Pal Interactive

I find soaking my toes in a hot bath brings some relief.  A couple times I have massaged the toe joint and it felt like perhaps I was able to break up the crystals a bit.  Not sure if that can really happen or if I imagined it.  So, my questions are: 1) can you really break down the crystals by manually massaging the joint? 2) if so, should you? Would that help break it down and assist in the process or is it doing more harm than good?

Along these same lines, I saw links here or somewhere else on the internet about “gout exercise”, but never could find the actual info.  My toes have been swelled up and mostly unable to bend for 8 weeks now and sometimes I wonder if some of the stiffness is from atrophy of the muscles as much as it is from crystals.  I try to move them around some but the gout pain limits me.  Is there a point where you should be trying to move the joints or massage them or anything?  (Some days I can't put any weight on either big toe; some days, I can put some weight, but cannot bend the toe up – meaning, the very last part of the step when walking is too painful, so I use a cane and take short steps and walk with a stiff/straight back and most of my weight on my heels).

I'm on UA lowering meds as well as colchicine for the short term and know I need those meds to actually cure the gout, but wondering if this massaging can also add any benefit while I work to get the UA levels down and the crystals and trophi dissolving.  (I'm on high dose prednisone and low dose colchicine (can't tolerate more than .3 mg 2 x / day) and that seems to keep the edge off the extreme toe pain, but I haven't been able to get the pain and swelling down enough to walk even close to normal and this has been every day for 8 weeks now). (Just started on the UA  a week ago and seeing a rheumatologist in a week for the first time, so I am pretty hopeful it will get better over the coming weeks).

Massaging causes more problems than it helps.

The problems with massaging are:

1. Uric crystals are sharp pointy spear shapes. Massaging them means pushing those spears into the surrounding tissue causing inflamation and tiny but physical damage.
2. Uric crystals are sharp pointy spear shapes. Massaging the crystals will also cause them to break apart into smaller pieces and form a compacted mass of crystals that prevent bloodflow from getting to them. (i.e. slower to dissolve
3. Check out a picture of what uric acid crystals look like… http://www.hopkins-arthritis.o…..ystals.jpg

Heat therapy is a more debatable topic – though I fall on the “for” side of the debate. Sitting in a hot tub or soaking your feet in a hot foot bath can cause crystals to dissolve since you only have to raise the internal temperature a couple degrees to make them soluable.

Upside: Crystals dissolve. Increased bloodflow helps move the liquid uric acid out of the area. If your uric acid level is low then it can help flush it from your system.

Downside: Crystals reform when your temp returns to normal. Increased bloodflow can also help the uric acid delve deeper into joints and other areas. Can cause a flareup if your uric acid suddenly spikes higher.

If you are Allopurinol and your normal level is sub-5.0 then doing regular heat therapy might help eliminate the lingering crystals in your joints. My personal unexpert opinion is that 20-30 minutes in the jacuzzi every couple days is not only relaxing, but helps my gout.

It might be worth trying 1/2 cup of Soda bicarb &/or Epsom Salts in the soak water.

I've found this helpful and the water can be kept in the bowl for re-use in short spells- even if at room temp.

Yep,

I am definitely anti-icing as well. Heat is the gouty's friend.

thank you all for your excellent advice.  I really did not want to hear that I should not be using ice.  I'd been using it a couple times a day for weeks and getting good temporary relief.  In fact, I had my two ice packs in hand and was heading up to bed when I decided to check any new posts on gout-pal.  But you guys on gout pal have had nothing but good advice, so I put the ice back and put heat on my toes.  Nothing but heat for the last couple days.  I also recently started on Uloric and have dropped from 9.1 UA to 4.4 in just two weeks of Uloric 40mg.    Toes are feeling a little better today than they have in weeks and I'm very encouraged.  Thanks!

I often come out of a hot bath or hot shower with red and swelled up big toe joint (even if my toe felt completely fine and was skin color before hand).  Does this mean the crystals were dissolved and just waiting to be flushed out?  When the foot returns to normal temperature the color goes back to normal, I assume the crystals were not flushed out and just re-formed.

I'm also curious, if heat can make the uric acid crystals more soluable and dissolve, what would be the best way to get those crystals up your leg and out your body?