Is gout in elbow common? Causes, symptoms, and treatment of elbow gout

About gout and elbow gout

Can you get gout in your elbow? The simple answer is yes. Elbow gout or gout in elbow can cause swelling, redness, and pain to occur in that region of the body. While the elbow is a rare location for gout symptoms to present, it is quite possible for those who have lived with poorly treated gout for many years. It is estimated that about one million Americans are affected by gout pain each year.

Gout is a type inflammatory arthritis caused by the accumulation of uric acid. Uric acid crystals are created by the body as it breaks down purines, substances found in some foods and drinks such as beer, beans, seafood, and organ meats.

What is gout in elbow?

Gout is a complex form of arthritis and can affect anyone. It is typically documented as occurring mostly in men, but postmenopausal women become increasingly susceptible in their later years. It is thought that female hormones play some role in the prevention of gout, which would explain why it’s more prevalent in women after menopause.

A gout attack can occur suddenly in the affected joint, such as the elbow, but it occurs more commonly in the big toe. It may present as a sudden pain in the joint, accompanied by swelling and a sensation of heat. The affected joint may also be so tender that even the weight of your bed sheet may seem intolerable.

Gout occurs due to the accumulation of urate crystals in the joint, which causes inflammation and intense pain. These crystals can form when you have high levels of uric acid in the blood. Your body produces uric acid when it breaks down purines, which are found naturally in the body as well as in certain foods.

What are the causes and risk factors of gout in elbow?

Now that you know what elbow gout is, you’re likely wondering what causes gout in elbow. In a normal individual without gout, uric acid dissolves in the blood and passes through the kidneys to be excreted in the urine. But sometimes the body produces too much uric acid, or the kidneys excrete too little of it, and when this happens, uric acid can build up, forming sharp, needle-like urate crystals that become deposited in a joint or surrounding tissue and cause pain, inflammation, and swelling. If the condition is not managed properly, symptoms of elbow gout become more likely.

Uric acid crystals tend to form in cooler temperatures, which is why they tend to form in the distal extremities, such as the hands and feet.

Some people are more susceptible to the condition than others. This may be attributed to the following risk factors:

Age: Gout commonly affects those over the age of 40, with peak incidence occurring at 75 years of age.
Diet: Binge drinking alcohol and consuming fructose-based drinks and seafood increases the chances of having high uric-acid levels in the blood, and therefore increases your risk of developing gout.
Being overweight: Having a BMI over 35 increases gout risk by three times. Carrying excess weight also increases your risk of developing metabolic disorders and increases the risk of joint problems.
Medical conditions: Diabetes, high blood pressure, and kidney disease are just some of the conditions that can affect the production and elimination of uric acid, and therefore contribute to the development of gout.
Medications: Certain drugs, such as water pills for blood pressure, may increase the chances of developing gout. Certain immunosuppressant medication has also been linked to gout flare-ups.
Family history: Having family members who have suffered from gout issues throughout their lives may increase your chances of developing the condition.
Recent trauma or surgery: Injured joints are more likely to develop gout.

How common is elbow gout?

In terms of gout flare-ups, the elbows are not the most commonly affected joints; the big toe, knees, hands, and even ankles are more likely to suffer from the condition. It is speculated that this may be due to the fact that the elbow joints are somewhat warmer than the joints found in the distal extremities. This makes sense as the parts of the body closest to the heart tend to be warmer due to increased blood circulation from the heart. Also, remember that uric acid crystal formation is promoted by colder temperatures.

Another explanation for the relative rarity of elbow gout is that the synovial fluid of the elbow joint is more alkaline, which means it has a higher pH level. Observations of previously documented cases of gout found that the higher pH levels of the synovial fluid of the elbow were associated with less virulent attacks.

Gout in elbow symptoms

Gout in the elbow can cause sudden severe pain. This gout elbow pain may be so bad that it can wake you up at night. Gout episodes typically occur rapidly over a few hours, with the skin of the affected joint appearing shiny and small, firm lumps possibly developing underneath the skin. Symptoms of gout in elbow include:

Swelling
Redness
Fatigue
Pain
Possible fever

After an acute attack of elbow gout, it may begin to spread down to other joints such as the wrist and fingers over the coming days. Gout in elbow symptoms tend to recur anywhere from six months to two years after the initial episode, with approximately 60 percent of gout patients having a recurrence within one year.

Diagnosing gout in elbow

An experienced doctor can often make a diagnosis of gout simply by taking a detailed history and looking at your presenting symptoms. However, in order to be absolutely sure, diagnostic testing is required. The following are some commonly ordered tests to diagnose gout.

Blood tests

High uric acid levels in the blood are very suggestive of gout, but if a blood test is conducted during a gout attack, it may present blood uric acid as being at normal levels since the majority of uric acid has accumulated within the afflicted joint. Other strategies include looking for inflammatory biomarkers such as ESR and CRP that can help determine the severity of the condition. Looking at other blood constituents will also help rule out other conditions that may mimic gout symptoms.

Imaging studies

These may include X-rays, CT scans, and MRIs, which provide an image of the bone that can be used to diagnose possible deformity or damage. They can also be used to monitor the efficacy of gout treatment.

Joint fluid analysis

Arthrocentesis is a therapeutic procedure as well as a diagnostic tool. It is the most accurate test for diagnosing gout in the elbow or in any affected joint. The procedure involves using a syringe to collect synovial fluid directly from the affected joint. Once this fluid is collected, it can be analyzed by looking at color, clarity, viscosity, white blood cells, and uric acid crystals, which would confirm the diagnosis of gout. Arthrocentesis has the added benefit of being quick and easy while inflicting minimal discomfort on the patient.

Treatment and diet for elbow gout

Elbow gout treatment falls into several domains: treatment for acute flare-ups, prevention of further attacks, and lifestyle changes. The following are examples of gout in elbow treatment aimed at relieving pain, reducing swelling, and minimizing permanent damage.

Rest

Constantly putting stress on your elbow joints will hinder the recovery process. Not taking the time to rest will often worsen gout pain. Light compression of the affected elbow can help, but it shouldn’t be done for long periods of time or while sleeping.

Ice

Ice can be applied to the affected joint to help reduce pain and swelling. Using an ice pack is ideal, but ice cubes in a towel or a bag of frozen vegetables will also do the trick. It is recommended to ice the affected part of the body for about 15 to 20 minutes every two to four hours.

Non-steroidal anti-inflammatory drugs (NSAIDs)

These are common pain-relieving medications that can be found in many pharmacies and grocery stores. They are designed to reduce pain and swelling. However, long-term use of these drugs may lead to liver damage and even increase the risk of heart attacks. NSAIDs can also be found in topical solutions and don’t pose as much of a risk as oral treatments. NSAIDs such as ibuprofen or naproxen can work well if taken soon after symptoms develop.

Steroids

A highly effective therapy for reducing inflammation of the joint and pain. Steroids can be taken orally or injected.

Diet modification

Eating foods that are low in purines will help to reduce uric acid levels in the body and decrease the chances of gout development. High-purine foods include red meats, organ meats, beans, lentils, and other foods that have high amounts of protein. Berries are known for helping to reduce uric acid in the body. Also, staying hydrated by drinking an adequate amount of water will ensure that your kidneys filter out uric acid effectively. Avoiding alcohol will also prevent gout flare-ups.

Colchicine medicine

This medication is used to prevent or treat the symptoms of gout flare-ups. It works by decreasing swelling and the buildup of uric acid crystals that lead to pain. Colchicine is not a direct pain reliever but instead helps to prevent the causes of pain.

Preventative treatment

Depending on your particular uric acid metabolism, you may be given either allopurinol, which helps to control the production of uric acid, or probenecid, which helps to increase the excretion of uric acid from the body.

Surgery

If all other treatment has failed and joint damage has occurred, surgery may be a viable option to help restore function.

Complications and prevention of gout in elbow

If improperly treated, gout can develop into more severe conditions. Recurrent gout is when a person experiences gout attacks several times a year, and if left untreated it can erode and destroy a joint. Advanced gout occurs when deposits of urate crystals form under the skin in nodules called tophi, which develop in several areas such as the fingers, hands, feet, elbows, or Achilles tendons. Tophi usually aren’t painful, but they can become swollen and tender during attacks.

Repeated gout flare-ups in the elbow can affect its function and even lead to permanent damage. Surgery would then be required to either restore function or to replace the joint entirely.

High levels of uric acid in the blood also lead to the formation of uric acid stones. Having stones in the kidney can cause excruciating pain and even lead to kidney damage and failure.

For these reasons, it is highly recommended to seek medical attention for gout as soon as possible and to take treatment for the condition very seriously. Your lifestyle plays an important role in the production of uric acid, with unhealthy diets and obesity being major contributors. If you are currently experiencing gout-like symptoms but are unsure if you actually have gout, it is advised that you speak to a health-care professional as they have the tools to reach a definitive diagnosis. By maintaining a healthy diet and exercising regularly, gout is relatively easy to avoid.

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