Is it Gout or Rheumatoid Arthritis?

Gout and the Rich

Gout is a very painful form of inflammatory arthritis. The attacks can have a sudden onset and are characterized by swelling, redness and intense pain. Another major symptom is that it most commonly occurs in the foot, particularly at the base of the big toe. Gout can occur in other areas of the foot and ankle. Sometimes it may occur in other joints of the body as well.

Rheumatoid arthritis also causes intense pain. Other symptoms of RA include stiff, swollen and inflamed joints. RA is an autoimmune disease and it can cause permanent damage to joints. Not only does it affect joints, if it is not adequately addressed, it can also attack other areas of the body.

RA is a systemic disease that will also attack the body’s organs. It can affect the lungs, heart, eyes and skin. RA patients also have a higher risk of heart disease than people who do not have the condition.

Gout and the Rich

The references to gout stretch back to ancient Egypt. In that era, it was called Podagra. Hippocrates described it as the “unwalkable disease” and noted that it was most common among rich people. He also noted that attacks of gout usually disappeared within six weeks. Eunuchs seldom had the disease. They also had a simple, non-indulgent lifestyle.

In the first century AD, it seems that more women were becoming affected by gout. At that time, women were rivaling men in living lavish lifestyles. The lifestyle of the wealthy seemed to be a factor in developing the disease.

Traditionally, people have thought of gout as a wealthy person’s disease since it seemed mainly relegated to those who had riches and power. Royalty and those in the upper echelons of society were said to have episodes of gout as a result of their diet when they showed symptoms of the condition. These were the people who had diets with an abundance of rich foods including red meat and organ meats, wine and other alcoholic beverages including beer, certain fish high in purines and wild game, which also is high in purines.

A Look Back at RA

Like gout, RA has a long history. Hippocrates, often called the father of modern medicine, referred to a disease many have thought was RA. He referred to an arthritic condition that affected the hands and feet and spread to the elbows and knees. Unlike gout which mainly affected the foot, this disease would spread beyond the feet. He also recorded the onset of the disease as beginning in the mid-30s.

Recovered remains of ancient Egyptian, Macedonian and Greek people show indications of RA. It has also been identified in the remains of American indigenous people. Some of these remains go back as far as 4500 BC.

Gout and RA Today

About four million Americans are affected by gout. It is no longer a disease of the wealthy. RA affects about 1.3 million Americans. Gout is more prevalent in men, whereas RA mostly affects women. Gout mainly affects those who have certain risk factors including obesity, diabetes, hypertension, kidney failure and metabolic syndrome. It is also partially genetic.

RA risk factors also include family history of the disease. Women 55 and under who are obese have a higher risk of developing the disease. Smoking is a factor and the risk is increased when there is a genetic predisposition for RA.

While the cause of RA has not yet been discovered, gout is triggered by purines. Rich foods often contain these substances, particularly meats, fish and some vegetables. Purines are converted to uric acid. While usually eliminated through urine, high levels will accumulate in the joints, forming sharp crystals. These cause the intense pain and inflammation associated with gout.

Both RA and gout can cause debilitating pain along with swelling in the joints. The causes are different and they respond to different treatments. Pain management can be attained for both diseases, but it is important to be properly diagnosed for optimal relief.

Silicon Valley Orthopaedics provides treatment for all types of arthritis. We develop personalized treatment plans to help you feel better. Contact us today to schedule a consultation with one of our doctors and get back on the road to health.

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