I’m going to move this question about gout and knee replacement to the gout forum for further discussion.

I’ll also close the comments here, as it is quite an old post.

If anyone else has any comments or questions, please start a discussion about signs and symptoms of gout in the gout forum.

One is that when tophi grow, they can attract infection. I’m not sure if this is because they break the skin and allow infection into the body, or if they can cause infection within the body simply from the tissue damage that they cause.

The other point that I know about refers to diagnosing gout. It can be confused with (and sometimes coexist with) septic arthritis. I wrote about this earlier today in Swollen Toes Diagnosis.

I will read your article “About Allopurnol.” When these attacks happen, I go just about anywhere looking for help.

Ice is really helping the wrist thankfully, and I’ve put the arm in a sling, which he says is very helpful. Lots of rest.

I’ve been very concerned since a horrid attack last summer lasted for several weeks. I found information on some websites that mentioned that when a diagnsis of gout is given one should always be suspicious of infection, especially in Stage 4 which is where my partner is now. So, he is on an antibiotic too, but no one is quite sure why, so he’s going to stop taking them. There are few doctors in our neck of the woods who have ever seen anything other than the first round or two of gout, and they have no idea how to help.

He’s be really good though, and this is the first severe attack in a year. But it’s a doozy. Gout can mimic so many things, that I thought he was having a stroke this time. It was some time before I believed it was a gout attack… because nearly his entire body was involved,

I hope I never see an attack like this one again.

We pull through somehow, with kindnesses from people like you. Thank you so much.

JP

Thank you for the comment, and my deepest sympathies for your partner.

You don’t say how long your partner has been on allopurinol, but it could well be this that has triggered the gout flare.

Don’t use this as a reason to stop the allopurinol. It is vital that your partner continues to take it. As long as the dose is keeping uric acid below 6mg/dL then the gout will eventually go, and the 20 years of pain will be over.

I’ve just written another post about allopurinol that has more information.

JP

I’m sorry, but I have no medical training - I just know about gout from suffering with it.

For the doctors to test for gout, they must draw fluid from inside the joint, not around it. This is not as painful as it sounds - nothing compared to the pain of gout.

You’ve set me thinking about this, so I’ve done a short article about stubborn gout pain.

Thank you for the inspiration.

Second and subsequent gout attacks did not respond to NSAIDS and I tried fresh cherries, dried cherries and cherry juice concentrate. The Cherries worked at first and then failed to give relief.

Next, I tried Colchicine and that worked - with gastric upset side-effects.

I am currently (6/25/07) having another gout attack (Big Toe Joint and Knee Joint). I took 0.6mg of Colchicine this morning and am drinking a lot of water - I’ll see how it goes!

Cherries for gout: Eat six to 10 cherries daily as a preventive or 10 to 15 at the start of and during of the gout attack. Reduces the length and pain of the attack.

DEAR DR. GOTT: My husband has had recurring gout for several years. There were times he could not walk for days or even sleep because of the pain and swelling. The doctor would give him shots, which would cure the attack. Then a friend told me about cherries, so I bought a can, and the next time he felt an attack coming on, he ate about half the can. That attack never materialized. The next time he felt an attack coming, he decided to wait until the next day before trying the cherries. The next day he could not walk and his foot was hot, red and swollen. He ate the cherries and by afternoon the gout subsided. I always keep a can of cherries in the pantry, and he never hesitates to consume them when the gout is approaching. We have told a friend of his who gets gout, and he also has had good results.

DEAR READER: I was quite astonished when, after printing a reader’s letter endorsing “cherry therapy” for gout, I received dozens of replies from people who have had astoundingly positive results. Once again, this is a cheap and safe remedy and certainly worth a try.

DEAR DR. GOTT: Regarding eating cherries for treating gout, they definitely do the trick — fresh cherries, apple-pie cherries, even maraschinos in a pinch. My husband used to have bad attacks of gout, and I don’t know where I read or heard about the “cherry cure,” but it works every time. No costly trips to the doctor or expensive drugs. He couldn’t even stand a sheet over his legs, much less dress.

DEAR READER: I keep getting mail about the wonders of cherries in curing acute gout attacks. I have no proof of their supposed benefits, but it certainly wouldn’t hurt to try them; they’re inexpensive and safe.

Yes, this sounds exactly like gout to me. I was quite surprised when it first happened to me, but I know from discussing with other gout sufferers that this is one of the many common signs and symptoms of gout.

The only definite way to confirm diagnosis is to draw fluid from one of the affected joints and check for uric acid crystals. This is quite a simple process, and not as painful as it sounds - nowhere near as painful as gout. When I had mine done I asked the doctor when he was going to start after he had done it!

Anyway, it is always wise to see a rheumatologist if you have, or suspect gout. Not only can they give you a clear diagnosis, but they can give the best advice about treatment and ongoing care. You will notice from many of my other posts here and on my main Gout site, just how important I think it is to have good, professional gout support and regular uric acid level tests.

Does this sound like gout?

I’m not sure what “stingers” are. If this is something to do with neuroma paresthesia then there is no reason why you cannot have that condition at the same time as gout. Obviously, treatment will be different from that for gout. You must see a doctor to get confirmed diagnosis and appropriate treatment.

What really concerns me here is the advice that you have already been given about gout. There are a couple of quite serious issues.

1. You say “the soreness does not feel like gout.” Please note that gout reaction to uric acid crystals ranges from a mild tingling to acute painful swelling. In between you can get numbness and various degrees of aching. Often, but not always, the reaction includes redness and/or itching. This is your immune system reacting to uric acid crystals forming in and around joints.

The degree of reaction will depend on both the number of crystals forming, and the state of your immune system. The crystals themselves do not hurt. Pain comes from the inflammation arising when your immune system tries to kill the uric acid crystals. This is similar to the reaction to a virus, except that uric acid crystals do not die.

Uric acid crystals will continue to build up in the joints and/or tophi. This eventually causes physical damage which is painful in the joints. Tophi can grow and burst the skin, or impede mobility if near a joint.

The uric acid crystal build up can occur so slowly that you do not always notice it. After a few years there is enough uric acid deposited around your body to create a very serious situation.

I mentioned earlier, that uric acid crystals do not die like a virus. They are coated by proteins from your blood cells, where they remain hidden from your immune system.

When you take any treatment (medication, alternative or diet change) that lowers uric acid, the crystals start to dissolve, shedding the protein coating. When this happens, your immune system will attack the crystals again. Depending on the number of crystals and amount of reaction, you will experience a similar response as when the gout attacked in the first place. Unlike initial gout attacks caused by crystals forming, which only usually attack one or two joints at a time, crystals tend to dissolve all over the body, causing reactions in several joints.

This brings me to my second concern.

2. Allopurinol is not a drug to be messed with. Unlike painkillers that can be taken at will to ease symptoms of gout, allopurinol must be managed properly.

Dosage must be monitored to ensure it is adequate to bring uric acid levels below 6mg/dL. Any higher, and uric acid crystals are unlikely to dissolve, which continues your risk of joint damage.

Allopurinol must be accompanied by sufficient fluid to prevent a build up of toxins.

I’ve posted more information recently about allopurinol. Please read this and consider consulting a rheumatologist to get your uric acid problems managed properly. You can find one from the listing mentioned in last month’s posting about gout treatment

My research indicates the gout damaged a nerve and I am experineceing NEUROMA PARAESTHESIA.

I have been lingering for about 2 mo.s with the stingers and sore foot at the end of the day.

Can someone tell me what will remendy this problem..

dg

I went to an acupuncturist for gout, and this was not a good idea, since it delayed me in seeking regular medical care. What’s more embarrassing is that I had been suffering from gout for years, and did not know it. I had other symptoms, like swollen aching ankles and achilles tendon that were not the result of an injury. Both regular MDs and the acupuncturist and myself were unable to figure this out, even after the classic ‘red big toe’ symptom had occurred. I hope that this experience can help someone else!

Hello, I’m a new Gout sufferer and I’m wondering if any one else reports that they experience heavy localized itching at the site of their gout attack.

I’ve had a little itching around a sore joint. I’ve just put this down to skin irritation connected with the swelling. I don’t recall it being particularly heavy?

Have you had any itching related to a gout attack? (I’m not talking about the general itching that can occur as a side effect of some meds)

I have tried contact lenses in the past. No problem with them, except that after a few hours my vision seemed cloudy. My optician examined them and noticed a build up of protein that was depositing a film on the lenses.

Thinking about the gout-protein link makes me wonder if my cloudy lenses were gout related.

Have you had the same problem?