What is Gout?
Hyperuricemia (elevated levels of uric acid) is always present in cases of gout but it is not always the level of uric acid in the joints that causes gout attacks in most cases, rather it is the rapid increase in uric acid. Many people with hyperuricemia don’t actually have gout at all and the condition can be caused by an overproduction of uric acid, an inability to excrete uric acid in a timely manner, or as a secondary condition.
Can You Get Gout in the Neck?
Most cases of gout attacks occur in the hands and feet but it is possible to get gout in the neck or in other joints. It can be harder to diagnose gout in the neck because it can look so similar to other causes of neck pain, such as rheumatoid arthritis or cervical spondylitis. Gout attacks normally have a rapid onset, however, and pain escalates to its peak at about ten hours after onset. There is often visible swelling and inflammation and gout in the neck, proximal, or larger joints is usually seen only in cases where the condition is left untreated when first appearing in the distal joints (hands and feet).
Why Gout is Usually Seen in the Hands and Feet
About half of all those with gout have symptoms in the joint of the first toe, this is because the extremities are not as warm as joints closer to the torso and so the uric acid crystals more readily form here. Most cases of gout will resolve over ten days to two weeks and symptoms disappear between attacks. However, those with gout in the neck may already have significant crystal formation in other joints and find that attacks are more frequent and persistent. These crystals may also lead to calcification in the joints, along with scar tissue that affects joint mobility. Gout is also often associated with slower wound healing.
Gout – The Christmas Connection
Christmas and New Year can be particularly problematic for those with gout as there are lots of rich foods served at dinners and parties, and plentiful wine to consume, as well as colder weather that leaves the hands and feet cooler and more liable to facilitate crystal formation. Key foods to avoid include sweetbreads, kidneys, anchovies, sardines and mussels as these are high in purine. Other animal-derived foods moderately high in purine that those with gout are advised to avoid include:
- Calf tongue
- Chicken soup
Alcohol, especially beer, is also associated with an increase in incidence of gout attacks and so should be avoided by those with a history of the condition, or enjoyed in moderation whilst minimising other potential gout triggers. Whilst vegetables do tend to be lower in purine there are some plant-based foods that it is worth avoiding if you suffer from gout:
- Kidney beans
- Lima beans
- Navy beans
Treating gout involves both acute relief and preventative measures between attacks. Non-steroidal anti-inflammatories (NSAIDs) are commonly used, as are corticosteroids and colchidine. Those with neck pain or other conditions alongside gout, such as kidney disease may be given alternative medications better suited to their circumstances. Allopurinol may be prescribed to help reduce the production of uric acid and patients may be referred to a rheumatologist where the gout is proving difficult to manage, or where comorbidities, such as cervical spinal stenosis and/or rheumatoid arthritis exist.