Dengan Nama Allah,yang tidak memberikan mudarat sesuatu di bumi dan juga di langit dan dia maha mendengar lagi maha mengetahui..

Sunday, December 13, 2015

Physiotherapy for GOUT

What Is Gout

History
·         Historically known as ‘disease of the kings’
·         Gout dates back to 2,600 BC when Egyptians noticed gouty arthritis of the big toe.
·         Hippocrates (400BC) commented on gout.
·         Alfred Baring Garrod (1848) noticed that gout was due to excess uric acid in blood

Introduction
·         Gout is a medical condition that presents with recurrent attacks of acute inflammatory arthritis.
·         Gout is a medical condition that usually presents with recurrent attacks of acute inflammatory arthritis (red, tender, hot, swollen joint).
·         Gout affects the joints which appear red, swollen, tender and hot.
·         Gout usually affects the big toe first but can affect any joint in the body

Causes
·         12% of gout is attributed to dietary causes.
·         Gout is linked with the consumption of food high in purines like alcohol, sugar, meat and seafood
·         Gout presents as a complication of other medical conditions like hypertension and diabetes.
·         Gout may also occur as a result of kidney failure.
·         Gout is caused by a build up of uric acid in the body.
·         Uric acid is a waste product produced by a body’s metabolism.
·         People who kidneys do not excrete uric acid properly, or too much uric acid can have high levels of uric acid in their blood which forms crystals in the joints.
·         Crystals cause the joints to become inflamed and painful.

Who suffers?
·         Gout affects 4 times the amount of men than women. 1% of men in the UK will be affected by gout.
·         Gout usually affects men between the ages of 40 and 60 and women between the ages of 60 and 80.
·         Occurrence of gout is high among African Americans, Pacific Islanders and Maori.

Diagnosis
·         A blood test can measure the amount of urate in the blood.
·         Fluid can be removed from the joint with a needle.
·         X ray may rule out other conditions.

Prevention
·         Avoid food high in purines like red meat, seafood (mackerel and herrings), vegetables (Asaparagus) and food which contain a yeast extract (Marmite/Quorn).
·         Exercise helps decrease levels of uric acid in blood.
·         Allopurinol will help to lower your uric acid levels by disrupting the enzyme that is responsible for converting purines into uric acid.

Management
·         Ice applied for 20-30mins/day decreases pain.
·         NSAIDs reduce the level of pain and inflammation. (Diclofenac+Naproxen)
·         Colchicine helps reduce the level of Uric acid in the blood
·         Corticosteroids can also be used in more severe cases of gout

Gout Complications
·         Frequent and recurring attacks of gout may eventually damage joints permanently.
·         Small white lumps of crystal called Tophi form underneath the skin.
·         10-25% of people with gout have kidney stones which are crystals that collect in the urinary tract causing pain and UTI’s

Physiotherapy and Gout
·         Physiotherapists can help reduce joint stiffness and improve muscle tone through exercise.
·         Acupuncture
·         Laser Therapy
·         Coping Strategies (RICE)





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