Is Your Back Pain Gout?

Could your back pain be gout?

Back pain can be distracting and just painful. What's causing your lumbar to ache? It could be any number of things. Could your back pain be symptoms of gout?

Rheumatologists over the past decade have recorded more gout cases appearing in spines. This arthritis is a form of inflammation and it comes with back or neck pain, arm/leg tingling, or numbness, it could be not just pain-- it could be gout.


Is Spinal Gout Common?

Spinal gout is rare. A 2016 study in European Spine Journal documented just shy of 150 cases in medical journals describes. However, Theodore Fields (M.D.) suggests that spinal gout may be more common than expected.

Early studies suggest there's more spine gout than previously thought. One explanation for low numbers is that doctors might not be looking for gout. He adds that patients with this type of gout typically have a history of having it in other locations.

Gout will affect the joint of the big toe along with other extremities (finger tips, knees) first. Described as being painful, back pain could be an initially-presenting symptom of gout. Gout can even move to any joint. The rarest place to have gout is the hip.


Gout and How It Affects the Spine

World Journal of Orthopedics published a 2016 study where there were 68 case reports of those that had a diagnosis of spinal gout in the period of 2010-2014. Nearly seventy percent of these patients had neck or back pain and sixty-six percent had elevated levels of uric acid. Some people may also experience 'classic neuropathy' in addition to back pain and even arm pain from a pinched nerve.

Over half of those same patients got a 'laminectomy' to relieve pressure on the nerve roots or spinal cord. 29% also did well with non invasive treatments, such as medications to lower the uric acid. However, keep in mind that many people that have spinal gout do not present any symptoms.

Doctors used to think of this type of gout as being mainly affecting patients that had gotten transplants and were taking organ rejection drugs such as cyclosporine. These could send levels sky high, but then researchers started looking at spinal pictures using advanced imaging. They began finding gout in unexpected places.

New scans allow doctors to see uric acids clumps along the spine that are colored green. You can see a collection in areas with symptoms and predict what nerves may be affected. While it's more common than previously believed, it is not that common of a problem overall.


Overlooking Patients

An attack and resulting back pain could be misdiagnosed or even mistaken and treated incorrectly. Patients with spinal gout need medication so that they can have their uric acid levels decrease. Even if a doctor knows their patient does have gout, they may think the resulting back pain is from something else (osteoarthritis, herniated disc).

Acid spinal deposits can be found through a biopsy or imaging. Even though spinal gout can be rare, you may want to bring it up to your doctor if you have back pain and have had gout.

If you know you are overweight/obese, experience higher blood pressure, or use diuretics, you may want to see a doctor. Diagnosis and early treatment using drugs to lower uric acid could save you having to get surgery in the future.
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