How to Remove Gout Crystals from a Joint
Gout is a painful inflammatory condition caused by a buildup of uric acid crystals in the joint. These crystals form due to high levels of uric acid in the blood – either from genetics, diet, or lifestyle factors.
At certain points – for example, dehydration – the concentration of uric acid spikes in the blood, causing crystals to form in the joints. These crystals inflame the surrounding tissue, leading to symptoms of pain, swelling, redness, and loss of function. Indeed, an acute attack of gout is considered to be extremely painful.
Breaking down gout crystals is the only way to reduce the immediate effects of gout, alongside a long-term reduction in uric acid to prevent further flare-ups.
Below we'll explain how to remove gout crystals from a joint, including medications and dietary and lifestyle changes.
How are gout crystals formed?
Gout crystals form from crystallized uric acid: a chemical naturally found in your bloodstream. Where gout differs from normal is in the concentration of uric acid. Your body produces uric acid as a waste product from the breakdown of purines – a building block of DNA and RNA. Purines are found in many foods, namely meat and meat products.
Normally, extra uric acid is excreted by the kidneys or digestive system. But, when levels get too high, these waste disposal systems become overloaded, further increasing uric acid levels. At a critical point, tiny crystals form in the joint space, causing gout.
Identifying the signs of gout
Most commonly, patients will notice significant joint pain. While gout crystals theoretically can form anywhere in the body, they typically do so in the extremities, particularly the big toe. This is because uric acid is very sensitive to temperature, crystallizing in cooler body areas. Other affected areas include knees, ankles, wrists, elbows, finger joints, and foot joints.
When crystals form and the pain comes on suddenly, we call this an acute gout attack. Alongside pain, patients may notice swelling, redness, and loss of function in the affected joint. Other symptoms include kidney stones and tophi (painful, tender lumps under the skin).
Over time, repeated gout attacks will cause chronic gout, as the joint begins to become permanently damaged. In such cases, chronic pain is not unusual, albeit not as severe as in an acute attack. Preventing chronic gout is why learning how to remove gout crystals from a joint is so important.
How to remove gout crystals from a joint
Diagnosing gout
Before removing the gout crystal from the joint, we must first check the diagnosis. A gout attack in the big toe is characteristic. However, other conditions can present similarly to the condition. Pseudogout, for instance, is caused by calcium pyrophosphate crystals and will not respond to the same treatments.
Gout is diagnosed by x-ray or CT scan, looking for crystals. Additionally, arthrocentesis, where a needle removes fluid from the joint, can also check for crystals.
Treating gout
In the immediate period of a gout attack, treatment primarily revolves around pain relief and inflammation reduction. Removing the gout crystals is not possible at this point. Instead, the gout attack will naturally subside as the crystals dissolve back into the blood.
Options for pain relief include:
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
Corticosteroids are potent anti-inflammatories.
Colchicine is a specific drug designed to relieve pain and inflammation caused by gout crystals.
The primary method for removing gout crystals is to lower the overall levels of uric acid in the blood. As the levels drop, crystallization runs in reverse, and the symptoms subside. There are three main methods for reducing uric acid levels in the blood:
Reduce the production of uric acid (allopurinol)
Increase uric acid output in the urine (probenecid)
Break down uric acid (pegloticase)
Speak to your podiatrist regarding which treatment is best suited to your case. Furthermore, your podiatrist is likely to recommend diet and lifestyle changes that reduce uric acid production. Such advice will include:
Reduce alcohol consumption
Reduce consumption of foods high in purines, e.g., organ meats, red meats, and seafood
Lose weight
Exercise frequently
Drink plenty of water
While these recommendations won't relieve an acute gout episode, they will prevent further episodes (or reduce their severity).
Final thoughts
Gout is an acute condition caused by high uric acid levels in the blood that crystallize inside a joint. Removing these crystals involves lowering your uric acid levels. This can be achieved with prescription medications, like allopurinol or probenecid, or with dietary and lifestyle changes.
If you're struggling with acute or chronic gout, please book an appointment with a podiatrist. We're here to relieve your symptoms and prevent future attacks.
