Joint pain has many possible causes, and it important to discuss the issue with a health care professional for appropriate diagnosis and treatment. Joint pain with eating meats such as beef or chicken is likely to be a condition called gouty arthritis. The condition causes very painful joint inflammation and is linked to a number of risk factors. There are two general mechanisms of its development, and in most cases it is a treatable condition.
Inflammation
Inflammation is classically characterized by swelling, redness, heat, loss of function and pain. In gouty arthritis, the affected joints become inflamed. The blood vessels in the area enlarge and leak fluid into the surrounding tissues. Immune cells enter the tissues and release chemicals that attract other immune cells and cause pain.
Signs and Symptoms
Attacks of gout can happen anytime but tend to happen more frequently at night. The attacks are sudden and without warning. It causes intensely painful, red, tender and swollen joints mostly at the big toe. The pain usually peaks in about a day and can linger for a week or more. Other symptoms may include fever and fatigue. In addition, some people with gout are at a higher risk of kidney stones.
Mechanisms
Gout occurs when crystals of uric acid precipitate in the joints. These crystals cause tissue damage and start the process of inflammation. Uric acid precipitates in the joints when levels get too high in the blood. They can be too high from the overproduction of uric acid or under-excretion from the kidneys. Overproduction is less common. Uric acid is a product of the breakdown of chemicals called purines, found in DNA and energy-carrying molecules. As an example of overproduction of uric acid, chemotherapy causes cancerous cells to die and results in the breakdown of their DNA to excess uric acid. Under-excretion can be caused by kidney problems, medications and systemic diseases.
Risk Factors
Risk factors for the development of gout include a family history of gout or certain kidney diseases; certain medications such as immune-suppressive drugs; and some diuretics, dietary factors including high-fructose corn syrup, and excessive amounts of meat or alcohol. Obesity is another risk factor, as is male sex and advancing age. There is a reduced risk of gouty attacks with physical fitness, vitamin C, coffee and dairy foods.
Treatment and Prevention
Gout is prevented with medical management and lifestyle changes, such as dietary choices. Medical treatments for an acute attack include pain medicines, the drug colchicine and corticosteroids to decrease the immune response and inflammation. If gout is caused by overproduction of uric acid, the number of attacks can be reduced by drugs that decrease production, such as allopurinol. If gout is caused by under-excretion, medicines to increase excretion, such as probenecid, are given.
References
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar, et al.; 2009
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci, et al.; 2008
- "Current Medical Diagnosis and Treatment 2011"; Stephen McPhee, Maxine Papadakis and Michael W. Rabow; 2010
