Gout is a type of arthritis caused by uric acid in the body’s system. An acute gout attack shares many symptoms of a sprain and is easily misdiagnosed, especially in younger patients. Gout usually does not affect patients (normally men) until middle age, so it can be common to misdiagnose it in younger patients because doctors aren’t looking for it. Sprains exhibit similar symptoms as gout such as pain and inflammation of a joint. Swelling and redness can be present in both instances and the pain from gout can be severe. Acute gout attacks, however, may not last as long as a severe sprain. Gout attacks may last as long as ten days when first experienced, and if they do it can be hard to tell the difference between a severe sprain, but when they first start occurring it is common that the symptoms disappear in a couple of days. A sprained joint will not recover in this short amount of time. Bloodwork is a good way to determine if gout is present.
Sprains are usually caused by the hyperextension of a joint, or pulling it out of its normal range of motion. For example, falling down and twisting your ankle might cause an ankle sprain, or pulling your finger back while catching a football might sprain your finger. A sprain is the stretching or tearing of the tendons around the affected joint, and is caused by a trauma to that area. The area, depending on the severity of the sprain, can become inflamed, red, and hard to walk on (if it’s in the foot or ankle). Gout usually starts by an attack in the toe, but it can start in any joint including the ankle, which is the most common site for a sprain. Regardless of where it starts, gout attacks come on with no trauma to the affected joint area. Again, sprain symptoms usually last for an extended period of time, where gout symptoms may disappear in a couple of days.
Gout is caused by the buildup of uric acid in the body. Uric acid is a natural byproduct of the body as it breaks down purines, which are found in many foods. Everyone has some level of uric acid in their system, but in those who suffer from gouty attacks the levels are very high. In a patient who has gout, the uric acid crystallizes and settles into the joints of the body. The acid becomes very sharp and jagged as it forms in the joints and is the cause for the inflammation and extreme pain. Gout attacks joints and so it is classified as a form of arthritis. A gout patient either produces too much uric acid as the body breaks down purines, or the body does not clear the acid from the body fast enough and it accumulates. Patients with kidney problems might find that they develop gout as a result of their kidneys not functioning at the proper level. Gout is problematic to men more than women, and usually shows up in mid-life, but it can affect women, and can show up earlier in life (say in a person’s twenties, but usually not any earlier). Gout is one of the most painful forms of arthritis, and in later stages (or even in the beginning stages) usually affects more than one joint.
Luckily the common treatments for a sprain often help the acute gout attack as well. In the long run, however, gout will return and these treatments will only help with the short term pain of an acute attack. It is important to determine whether a person has gout, because if not properly treated it will return and add to the deterioration of the affected joints. Initial treatments of a sprain can include the wrapping of the joint, ice (which reduces swelling), and ibuprofen for pain. These will also help with the immediate attack of gout, but it is important not to take aspirin because it can inhibit the excretion of uric acid. Bloodwork is the easiest way to determine if a patient has gout, the uric acid levels in the blood will be much higher than normal if the patient does have the disease. Some people may have high levels of uric acid, but never exhibit an acute attack. Usually it takes a buildup of uric acid over time (years) before an attack occurs. By the time of the first attack the levels of uric acid in the system have usually built up to the point that simple dietary changes are not sufficient to prevent further bouts.
Gout attacks can come in bouts and for no apparent reason. Sometimes years can pass between attacks, and this occurs commonly in people who develop it at a younger age (say, in their twenties). If you have symptoms of a sprain, but haven’t had any trauma to the affected area you may want to be tested for gout, especially if the symptoms disappear quickly. Symptoms may come on and then disappear in the span of a couple of days, but as acute gout persists the symptoms usually linger for longer periods of time. Acute gout will move from the first affect joint to other joints. It may start in the big toe, which is the most common place that it starts, but may soon affect the ankles or knees. It may affect one joint more than others, however. Gout can attack any joint, even elbows, fingers and shoulders. It commonly will attack more than one joint at a time (i.e. left ankle and right toe). If the patient is young, gout may be overlooked, but it can affect younger patients too. It usually doesn’t affect anyone under twenty, however, because it takes years for the acid levels to rise high enough to trigger an attack.
There are many treatments that are effective for gout. Dietary restrictions can work in some cases by avoiding foods that are high in purines (shellfish, organ meats). But in most cases a medicine is prescribed that helps the body process the uric acid from the system. There are also medications that are designed specifically to help with acute gout attacks that work really well. If you have symptoms that may be gout, it is important to get tested because gout will damage the joints that it affects. The longer gout goes untreated, the more damage it may do to the joints.