Gout or Arthritis

[tanglewood]

My daughter had pain in her big toe that moved up to her knee and is now in her hip. My first thought was "gout" but she said her doctor did not mention gout. Her pcp said she thought it might be arthritis and gave her some "Sulindac". She is also taking Flexiril which I have; and buspirone. I am not familiar with "Sulindac" and haven't "googled" it yet, but wondering if anyone had any thoughts about her pain?

[tanglewood]

thanks everyone; I will pass this on to her and suggest she talk to her pcp more about what's going on - especially since she has my genes

thanks!

[Tuckamore]

Hi Tanglewood,

I am sorry that you daughter has arthritis. What many ppl do not realize is gout is a form of arthritis, hence the name, gouty arthritis. Gouty arthritis is usually an extremely painful attack with a rapid onset of joint inflammation. The inflammation is precipitated by the deposition of uric acid crystals in the synovial lining of the joint, the fluid within the joint, tendons and surrounding tissue. Intense joint and tissue inflammation occurs when white blood cells engulf the crystals of uric acid and release chemicals that promote inflammation. This inflammation can causes swelling redness and severe pain, often the joint is warm or even hot to touch. Most often the big toe is affected and/or the ankle. However any joint can develop gouty arthritis.  

The gold standard medication for gout is Allopurinol (Zyloprim, Lopurin, Purinol). It is a uric acid lowering drug. However once you are in a full blown attack of gout Allopurinol is not an effective treatment. It is more effective in presenting one.

Gout use to be known as the "rich mans disease as it is often seen in ppl that have diet rich in proteins, fat, and alcohol. Hereditary also plays a factor. If a family member has gout you are may be more predisposed to having it also.

So when your daughter's PCP said she has arthritis that does not mean she doesn't have gout as often those words are used interchangeable in the medical profession. Some PCP's or rhumatoidologist will initially attempt to treat gout by diet. A low purine diet can be very difficult to follow. Often if there are repeated flares, Gout will be treated prophylactically with medications such as Allopurinol. The more often you experience a flare of gout the more damage may be caused to your tissues and joints.

NSAID are the usual treatments for gouty arthritis. Indocin, which is a very potent NSAID, has often been prescribed for the condition but is can result in very serious GI issues and is not as widely used as it once was. Muscle relaxants should provide little if any relief from the acute pain of gout.

Best of luck to your daughter. She is lucky to have such a concerned parent as you. If she has more flares of gout I would suggest she be evaluated by a rheumatologist. I'd be interested in hearing how she is doing.
Take Care, Tuck  

[sandee1818]

Sulindac is a nonsteroidal anti-inflammatory drug (NSAID) effective in treating fever, pain, and inflammation in the body. As a group, NSAIDs are non-narcotic relievers of mild to moderate pain of many causes, including injury, menstrual cramps, arthritis, and other musculoskeletal conditions. Since the response to different NSAIDs varies from patient to patient, it is not unusual for a doctor to try different NSAIDs for any given condition.

[sandee1818]

For most people, gout pain usually shows up first in the joints of the big toe. However, as gout progresses, and more and more uric acid builds in the system, it has to find other joints where it can go. This means you might get gout pain in other places that can cause even more pain than that which you might feel when it is in your toe.One of the first things many do when they have gout and hip joint pain is take NSAIDS. These are pain relievers that can also reduce some of the swelling in the area. That takes some of the pressure off of the joint, and can add some flexibility where it might have been stiff and unforgiving.

A treatment of heat and ice can also help when gout and hip joint pains are making it hard to move around. Ask your doctor about the proper way to do this type of simple treatment. The heat and then the cold ice packs can help bring some of the swelling down and then keep it from flaring back up right away. If you can apply this therapy and stay at home, try using a walking stick when up and about to avoid putting weight on the hip. Avoid swift motions, and take your time moving around. When seated or lying down, find a position that puts the least amount of stress on your hip and pelvis area.
http://www.isnare.com/?aid=196331&ca=Wellness%2C+Fitness+and+Diet


I read several articles and I copied this one for you. It is possible she has arthritis but gout seems to be an option also. I would have her talk to her doctor about it and see what he/she thinks.