Those who suffer from gout may be twice as likely to also get a diagnosis of chronic pain, according to a new study published in Clinical Rheumatology. The study shows the most frequently diagnosed type of inflammatory arthritis is gout, and it may also represent a correlate of non-flare chronic pain.
Gout is a form of inflammatory arthritis that develops because of high levels of uric acid in the blood. The acid can form needle-like crystals in a joint and cause severe pain, tenderness, and swelling. The big toe is the most common target, but gout can attack the feet, knees, ankles, and hands as well. A “flare” can last for days or even months.
For the study, a five percent random sample was taken from United States Medicare claims data filed between 2006 and 2012. In this study, the presence of gout at baseline was the independent variable. Chronic pain was the dependent variable and the primary outcome. The outcomes were calculated through the analysis, adjusting for demographics, cardiovascular disease, and gout medication use.
Of the 1,321,521 eligible participants, 54.7 percent were women, 85.5 percent were men, and they had a median age of 75.2 years old. The study showed that 424,518 individuals were diagnosed with chronic pain at follow-up, leading to incidence rates of 158.1 and 64.5 per 1,000 person-years in patients with and without gout.
There were two models to the study. The first showed the risk for new chronic pain in patients with gout was twice as high as in patients without gout. The second model showed sensitivity analyses, where the risk for chronic pain was slightly lower but still elevated with versus without gout.
The subgroup analysis showed no significant differences associated with race or gender. However, there was a minor reduction in chronic pain risk in the oldest participants compared with younger individuals with gout.
“Efforts must be made to optimize gout control, so that chronic pain can be avoided as a long-term sequela of gout and when present, treated early and appropriately,” noted the authors.
Gout and Diet
If you have gout disease, it’s important to pay attention to your diet because some foods can trigger the agonizing symptoms while others can protect against them.
There are several types of foods that may help protect against gout attacks. These include complex carbohydrates, low-fat dairy foods, coffee, and fruits, especially citrus fruits. You should also be sure to get 12 to 16 cups of fluid daily.
“Any kind of fluid that keeps that blood flowing and urine flowing” is a good choice, says Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas. So, be sure to drink the recommended glasses of water a day, and avoid beverages sweetened with high-fructose corn syrup, such as non-diet sodas or “fruit” drinks.
Vegetables that contain purines such as asparagus, cauliflower, spinach, and mushrooms should be avoided when experiencing a gout flareup. Red meat also contains a high number of purines, so white meat would be a better choice to avoid aggravating gout.
Acute gout attacks can be managed through a healthy lifestyle, including diet, weight management, and a proactive approach to signs and symptoms. Be sure to discuss all nutritional concerns with your doctor before starting a new diet or exercise routine.