Why worry about back pain with gout?

[Keith Taylor (GoutPal Admin)]

It’s great to welcome @spookymulder to the gout forum.

Erik, I’m really please to see that you’ve started adding personal gout facts to your profile at https://gout-pal.com/users/spookymulder/profile/

I hope you will keep returning to add to your profile, and finally get control of your gout that you’ve endured for over 10 years. I notice you made a mention of back pain, so I thought I’d share some of my thoughts on back pain and gout.

My most serious worry is always kidney problems. This is not intended to cause alarm, but it definitely underlines the need to get proper medical care, especially if you are taking allopurinol.

Though many gout sufferers (myself included) avoid allopurinol for too long, taking it has benefits that are not always obvious. If a competent doctor prescribes allopurinol, they are duty-bound to follow-up with blood tests. These tests should always be 2 to 4 weeks after starting allopurinol, or changing dose. As treatment stabilizes, the period between blood tests can lengthen, but all allopurinol takers must be tested at least once a year. The 3 tests are uric acid, liver function, and kidney function.

Those tests, especially the function tests, are the hidden benefit of taking allopurinol. Kidneys and liver are being monitored, so if gout is causing kidney problems, then allopurinol takers should be the first to know. Actually, this also applies to Uloric (febuxostat), probenecid, and any other uric acid lowering treatment – including herbal medicines and diet changes.

I don’t want to dwell on the kidney risks when you have back ache with gout. There are lots of other possibilities, but I would recommend any lower back pain is immediately referred to a doctor if you suffer from gout. This applies whether or not you are taking treatment, but especially if you allow yourself to be dehydrated. Hydration is not always the complete answer, but it is often all you need to avoid crystal formation. Mote that kidney stones can form from uric acid or from allopurinol by-products. Fluid intake varies between people, and is affected by weather and exercise. Your target is urine that is pale straw colored. Completely colorless urine is a sign of over-hydration.

There are lots of other ways gout can cause back pain. Gout back pain really needs to be investigated by properly qualified medics, as it is possible to do more harm than good if the wrong cause is treated. Here are some common causes of back pain with gout:

• Poor posture due to limping or other distortion from gout pain
• Direct gout attack in spinal joints
• Weakness to discs and other joint erosion from prolonged exposure to uric acid crystals
• Spinal tophi – lumps of uric acid crystals that impede mobility and can cause pain.

Erik, I hope that whatever is triggering your back pain is temporary and benign, but I urge you to seek medical attention as soon as you can.

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