Can You Get Gout in the Hands

Gout can affect any joint in the body. However, it occurs more commonly in certain joints, such as the toe, ankle, and knee. If gout progresses without treatment, or a person is unable to manage the condition, it can affect multiple other joints, such as the fingers and hands.

Like other joints, gout in the hands occurs due to an accumulation of uric acid in the blood, which results in the formation of uric acid crystals that collect in the joints. Uric acid is a waste product that usually forms when the body breaks down substances known as purines. These substances are present in many foods, such as liver, shellfish, and alcohol.

The kidneys are usually capable of filtering uric acid from the blood and eliminating it in the urine. However, if a person produces too much uric acid, or the kidneys are not functioning correctly, uric acid can accumulate in the blood and form uric acid crystals. After a long period, these crystals can deposit and build up in the joints, forming tophi.

What Causes Gout

Gout crystals form when your body makes too much, or does not get rid of, uric acid. Genetics is the main factor in determining uric acid levels. These levels can also be affected by:

• Certain medications including medicine for high blood pressure, diuretics (water pills), some blood thinners, and cyclosporine which is used for patients who have had a transplanted organ.

• Consuming meat, seafood, and alcohol (this can raise uric acid levels)

Obesity, insulin resistance, high cholesterol, heart disease, hypothyroidism, and kidney disease can be associated with gout. Episodes of gout have been noted after injury or surgery, sometimes involving infection or the use of contrast for X-rays. Physical fitness seems to help with prevention of gout.

Symptoms of gout in the hands

Gout causes similar symptoms in the hands as it does in other joints. A person may notice the following symptoms in the affected joint:

• intense pain

• swelling

• heat

• discoloration

If uric acids levels remain high over an extended period, people may develop white, chalky deposits around the joints and tendons. These deposits appear as visible lumps under the skin and can result in permanent damage and deformity.

Gout leads to attacks, or flares, that appear suddenly with hot, red, or swollen joints. The joints can be so painful that they hurt to move. Sometimes the joints look like they are infected, even though they are not.

Diagnosis

A doctor will diagnose gout by assessing a person’s symptoms and performing a physical examination. An X-ray and additional laboratory tests can also detect uric acid crystals in the joint. It is easiest to diagnose gout during a flare, when the joint is painful, swollen, and hot.

The symptoms of gout are not specific, and a person could mistake them as being due to other inflammatory conditions. Therefore, it may be necessary for a rheumatologist to make the diagnosis. A rheumatologist is a doctor who specializes in gout and other forms of arthritis.

Treatment

When a painful episode of gout begins, the goal is to decrease swelling, redness, and pain. New episodes of gout are often treated with non-steroidal anti-inflammatory (NSAID) medication or a medicine called colchicine. Steroid pills and shots may be used to treat gout as well.

Episodes of gout often come and go. When the gout episodes are infrequent, an NSAID or colchicine can be used as needed. For more frequent gout episodes, other medications can be given that are managed by your primary care doctor or a rheumatologist.

Gout is usually treated without surgery. There are medicines, splints, and compression modalities to help swelling and lessen the gout pain. If your gout has worn out the joints, or if tendons have been hurt, surgery may be needed.

If gout is not treated, the inflammation can cause damage to joints and tendons. Crystal deposits on tendons can cause the skin to wear down, which can lead to infection. In addition, tendons can tear, which can lead to loss of function.

Talk to your doctor about the best treatment plan for your gout.

Other possible causes 

Other conditions may also cause a person to experience pain and swelling in joints, such as the hands. Many people often confuse gout with calcium pyrophosphate deposition disease, or pseudogout. While both are forms of arthritis, they result from the buildup of different crystals in the joints.

It is possible to mistake other types of arthritis, such as psoriatic arthritis (PsA), osteoarthritis (OA), and rheumatoid arthritis (RA), for gout due to the similarity in their symptoms. Joint pain and swelling can also be due to an infection of the joint tissue and fluids, which is called septic arthritis. 

In some cases, different types of arthritis may occur together. Evidence shows that it is possible to have more than one type of arthritis and that gout can occur alongside PsA, OA, or RA. 

When to contact a doctor

If you suspect that you may have gout, contact a doctor for a diagnosis. Other conditions that may cause similar symptoms will also likely require treatment. Gout and other forms of arthritis that go untreated can cause joint damage.

People with a diagnosis of gout should attend regular appointments with a doctor. During these, they should mention any worsening of symptoms, new symptoms, or concerns about other conditions that may occur alongside gout.

Gout is a very painful condition, but it is manageable with medications and self-management strategies. If a person suspects gout or notices a worsening of gout symptoms, it is advisable for them to contact a doctor.