Gout in knee: Causes, symptoms, diagnosis, treatment and home remedies of knee gout

By: Mohan Garikiparithi | Arthritis | Wednesday, September 06, 2017 - 07:00 AM

goutWhat is gout in knee?

Gout in knee or “gout knee” is an inflammatory condition of the joint leading to swelling, pain, and redness of the knee. Gout is a complex form of arthritis that can affect anyone. Men are documented as having the condition more often, but postmenopausal women become increasingly susceptible in their later years. It is estimated that about one million Americans are affected by gout pain each year.

The most common joint affected by gout is the big toe, but joint pain may also be experienced in the knees, hands, ankles, and wrists.

Causes and risk factors of gout in knee

Gout occurs due to the accumulation of urate crystals in the joint, causing inflammation and intense pain. These crystals can form when you have high uric acid in the blood. Your body innately produces uric acid when it breaks down purines—substances that are found naturally in the body. Purines are also found in certain foods, such as steak, organ meats, and seafood. Other foods that promote higher levels of uric acid include alcoholic beverages, and drinks sweetened with fructose (fruit sugar).

In a normal individual without gout, uric acid dissolves in the blood and passes through the kidneys to be expelled in the urine. But sometimes the body produces too much uric acid, or the kidneys excrete too little of it. When this happens, uric acid can build up, forming sharp, needle-like urate crystals that become deposited in a joint or surrounding tissue, causing pain, inflammation, and swelling.

Uric acid crystals tend to form in cooler temperatures. This is why they accumulate most often in the distal extremities—areas that are more likely to become colder than the rest of the body—such as the hands and feet.

Several influences play a role in the development of gout, making some people more susceptible to it than others.

Here are some gout risk factors:

  • Genetics: Seen to play a role in about 20 percent of gout cases
  • Age: Gout usually affects people over the age of 40, with most cases occurring at 75 years
  • Obesity: Having a body mass index (BMI) greater than 35 increases gout risk by three times
  • Diet: Binge drinking, consuming too many fructose-based drinks, and eating too much seafood account for approximately 12 percent of gout cases
  • Medical conditions: This may include problems with the kidney or metabolism
  • Drug treatments: Certain drugs, such as water pills for blood pressure treatment, may increase your chances of developing gout
  • Trauma: People with injured joints are more likely to develop gout

Knee gout symptoms

Knee gout symptoms tend to occur at night, as this is the time when your body temperature goes down. Gouty episodes typically occur rapidly over a few hours. The skin of the affected joint appears shiny with possible small, firm lumps felt underneath the skin. Symptoms of gout knee include:

  • Swelling
  • Redness
  • Fatigue
  • Pain
  • Possible fever

Symptoms tend to recur anywhere from six months to two years after the initial episode, with approximately 60 percent of gout patients having a recurrence within one year.

Diagnosis of gout knee

An experienced doctor can often make a diagnosis of gout in the knee or any other area of the body simply by taking a detailed history and looking at your presenting symptoms. However, in order to be absolutely sure, diagnostic testing is required. This will include blood tests to determine the level of uric acid in the system and/or through joint fluid examination under a microscope. The latter test will be able to detect the presence of excessive uric acid crystals and is more reliable than blood tests. Kidney function tests may also be done to assess whether the organs are playing a role in your decreased uric acid excretion.

Possible complications of knee gout

If improperly treated, gout knee can develop into a more severe condition.

Recurrent gout is when a person experiences gouty attacks several times a year. If left untreated, it can cause erosion and destruction of a joint.

Advanced gout occurs when deposits of urate crystals form under the skin in nodules called “tophi,” which develop in areas such as the fingers, hands, feet, elbows, or Achilles tendon. Tophi usually aren’t painful, but they become swollen and tender during attacks.

Lastly, as a result of urate crystals in the urinary tract, kidney stones may occur.

How to treat gout in knee

The following are examples of gout treatment:

  • Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs are a common pain-relieving medication that can be found in most pharmacies and grocery stores. They are designed to reduce pain and swelling. However, long-term use of these drugs may lead to liver damage and even increase the risk of heart attacks. NSAIDs can also purchased as a topical solution, which doesn’t pose as much risk as oral formats. NSAIDs such as ibuprofen or naproxen can work well if taken soon after gout symptoms develop.
  • Rest: Constantly putting stress on your joints will make the recovery process difficult. Not taking the time to rest will often worsen gouty pain. So rest is necessary. Elevating the leg can also help relieve pressure on your knee joint and return blood to the upper part of the body.
  • Steroids: A highly effective therapy for reducing inflammation and pain, steroids can be either taken orally or via injection.
  • Colchicine: This medication is used to prevent or treat the symptoms of gout flare-ups. It works by decreasing the swelling and buildup of uric acid crystals that lead to pain. Colchicine is not a direct pain reliever, but instead helps to prevent the causes behind the pain.
  • Ice: Apply ice to the affected joint to help reduce pain and swelling. Using an ice pack is ideal, but ice cubes in a towel or a bag of frozen vegetables will also do the trick. It is recommended you ice the affected part of the body for about 15 to 20 minutes every two to four hours.

Home remedies for gout in knee

Knowing that gout can be caused by the food we eat, modifying your diet can be an effective way to prevent the condition. The following are some natural remedies for gout in the knee that you can try at home today:

  • Cherries: Known for having cyclooxygenase (COX) inhibitor properties. This is an enzyme in the body that can be responsible for the production of pain. Cherries are thought to help halt this process, but results may vary from person to person. Cherries can be consumed raw, as fruit juice, or even in dried form
  • Celery: It is believed that celery, in general, could be a cure for gout symptoms, or at the very least help to alleviate them. While it may have a beneficial effect, celery is not meant to be an immediate cure, but rather it takes at least six weeks to show any beneficial effect on gout. It is thought that celery acts as a diuretic, which helps to remove uric acid from the body.
  • Strawberries: Strawberries are often used as an alternative to or in combination with the above-mentioned foods. It is thought that the high vitamin C content of strawberries could help reduce uric acid levels in the body or that there is a special property in strawberries themselves that gives them a protective effect against gout.
  • Baking soda: Some patients affected by gout will say that taking baking soda helps them feel better, but others say it has no effect. Baking soda is an alkaline substance and, in effect, could allow the blood to reduce the amount of uric acid crystallization, and therefore eliminate uric acid crystal deposition in joints. However, it is highly advised you speak to a medical professional before attempting this particular treatment, as it may induce several side effects.
  • Water: Staying hydrated can be a good way to relieve gout pain, as it can help increase uric acid excretion via the kidneys.
  • Apple cider vinegar: This is a common natural remedy used by gout patients. It is said that taking apple cider vinegar as soon as you feel a gout attack coming on, you could help relieve the associated pain.
  • Milk: This is a remedy used through the centuries for the treatment of gout. Milk is known for having low levels of the uric acid-producing substances known as purines, but it has also been found to reduce existing uric acid levels as well. However, studies have found that you would need to drink about 10 glasses of milk a day to achieve this effect.

How to prevent knee gout

A general rule in medicine is that prevention is the best form of treatment, as never developing the condition through proper preventive measures will save you from distress as well as expensive medical bills. The following are recommendations to follow to prevent the development of gout:

    • Lose excess weight: Obese individuals are more likely to suffer from gout. If weight loss is difficult, it may be worth it to speak to your doctor about the best methods to shed weight.
    • Stay hydrated: Drinking at least two liters of water a day will help ensure your kidneys are working properly to excrete toxins such as uric acid.
    • Avoid purine-rich foods: This may include oily fish, organ meats, and vegetables such as asparagus and spinach. Purines are metabolized into uric acid, so eliminating them from your diet will help prevent gout.
    • Avoid fructose-sweetened drinks: This may include fruit juices and soft drinks.
    • Avoid excessive alcohol consumption: You should especially avoid bitter, stout, and fortified wines, as these are more likely to increase urate levels in the body.
    • Vitamin C: While it’s not widely regarded as effective gout prevention, one study found that taking 1,500 mg of vitamin C per day could decrease the risk of gout by 45 percent. It is advised you speak with your doctor before implementing any diet supplementation.
    • Speak to your doctor: When facing any sort of health issue, it is always worth it to get an expert’s opinion on how it should be treated. This is especially important if you currently take other medication, as some home remedies may interact with previously prescribed medication. There are also cases where the medication you are currently taking predisposes you to developing gout, so you might need to be reevaluated by your doctor to get prescribed an alternative.

Related: Gout is on the rise

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Purine-rich foods: Foods to avoid to reduce the risk of gout

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