Gout

While gout commonly affects the big toe, it can also affect small joints like those in the finger and hands. Gout is a type of inflammatory arthritis that causes pain, swelling and redness in your joints or soft tissues of the hands and wrists during an attack.

What are the causes of gout?

Gout is caused by a build-up of uric acid in the bloodstream, either due to too much or difficulty to eliminate excess uric acid. When this occurs, the acidity can easily become concentrated in the wrist, hands, and fingers, resulting in a gout attack. An acute gout attack can last from 3 to 10 days, but thereafter it may be years before you experience another one. Nonetheless, your medication will be chronic, aimed at preventing gout attacks.

How is gout treated?

Left untreated, gout attacks will become more frequent, and the uric acid in the bloodstream may form microscopic spike-like crystals in joints or soft tissues. These crystals are then attacked by the immune system, and can be severely painful and may lead to permanent damage and deformity in the hands and fingers, among other joints.

Non-surgical treatment is aimed at lowering high levels of uric acid in the bloodstream, reducing the occurrence of gout attacks and the damage to the joints. This may involve long-term medications that assist in the excretion of excess uric acid and lower the amount the body produces. Various other lifestyle changes may also be beneficial.

In cases where non-operative methods fail, surgery may be advised to remove these gout crystals known as tophi, from the joint or soft tissue.

In advanced stages where destruction of the joint and deformity have already taken place, a fusion of the joints - such as those in the finger - may be done to limit movement and relieve chronic pain. In specific cases, joint replacement surgery, otherwise known as arthroplasty, may be considered. After a comprehensive consultation and diagnosis, your hand surgeon at the Garden Route Hand Unit will be able to assist you in the treatment needed for your particular case.