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Diagnosis is key to Relief of New York City Spinal Gout

July 25, 2023

Gout. If you’ve had gout, you know how painful it is. You may also know how tough it was to diagnose, particularly if it was in the spine. Back pain or leg pain might have been your first symptom. Your New York City chiropractor at Rosenberg Wellness Center is aware of spinal gout, its similarities with other conditions’ symptoms, and the latest advised assessments to diagnose it early to direct you to the (appropriate!) care you need.

PREVALENCE OF SPINAL GOUT

Arthritis is an inflammatory condition impacting people around the world - 47.8 million US sufferers, 8 million UK sufferers, 108 million European sufferers - with osteoarthritis being the most common affecting joints in the knee, hands, etc. Gout is just such an inflammatory cause of pain in similar areas, making it tough to diagnose and discrimainate from other inflammatory issues. (1) A recent narrative review reported that 94% of spinal gout patients described back or neck pain, 86% displayed neurological symptoms, 72% noted a history of gout, 80% had elevated levels of serum uric acid, and 76% went through a surgery. Though an uncommon cause of spine pain, gout’s inflammatory arthritis results from monosodium urate crystals in synovial fluid and other joint tissues (ankle, foot, hands, wrists, elbows, knees, hips, and spine). (2) An early, suitable diagnosis of spinal gout can better direct treatment and improve clinical outcomes.

DIAGNOSIS OF SPINAL GOUT

Researchers have explored various ways to safely and accurately diagnose gout in people who have never had gout. They have analyzed studies from as far back as 1945! They found that synovial fluid monosodium urate crystal analysis and imaging were better than a clinical algorithm of signs and symptoms only for diagnosis and treatment planning. (3) Facet joint disorders, osteoarthritis, synovial cysts, etc., can muddle the diagnostic process for spinal gout. Fortunately, dual energy computed tomography (DECT) illustrates the crystals. However, healthcare providers must be aware that gout is a possible cause to request the right test. (4) A narrative review of published studies on spinal gout that was done by two chiropractors agreed. To enhanced the quality of life of spinal gout sufferers as well as the diagnosis, treatment planning and prevention of surgery, a combination of clinical symptoms, lab tests, and DECT may be the key. (2) Rosenberg Wellness Center notes that cases of spinal gout are emerging in the medical literature.

CASES OF SPINAL GOUT and TREATMENT

One case of a 48-year-old man with sudden, severe, sharp low back pain that limited his mobility and with no history of gout wound up with a diagnosis of spinal gout after an MRI showed a mass in his right erector spinae muscles which lead to a biopsy that exposedspinal gout. 29% of patients with gout have spinal gout, too, which did not help in this case of a patient without gout but is a noteworthy stat to consider in the next case. (5) A 41-year-old male who did have a 7-year history of gout came for help with severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was diagnosed negating an initial diagnosis of vertebral osteomyelitis. Primary treatment often includes symptom management with colchicine, steroids, urate decreasing therapy, and NSAIDS. (6) If spinal gout is speculated, Rosenberg Wellness Center will get the right tests ordered.

CONTACT Rosenberg Wellness Center

Listen to this PODCAST with Dr. Joseph Beissel on The Back Doctors Podcast with Dr. Michael Johnson as he illustrates the relief with The Cox® Technic System of Spinal Pain Management for chronic back pain.

Schedule your New York City chiropractic appointment now. Your New York City chiropractor will do a thorough examination to determine the best course to appropriately diagnose, treat, and attain the best relief of spinal gout. 

Rosenberg Wellness Center is aware that inflammatory spinal gout is a differential diagnosis to consider for patients who present with back pain and other spine related symptoms.