persistent pain in Hands

[healeyguy]

I’ve had gout for years. My current UA level is below 300 managed through diet and Allopurinol. While i get the traditional pain in Toes, ankles and knees, the most debilitating pain is in arm tendons (tennis elbow) and my hands (joints are stiff and painful).

With my UA levels below 300, I don’t understand why my hands hurt so much. I currently take 100mg of Allopurinol daily. I tried increasing to 200 but got pain everywhere so, stopped.

Is it possible that I have UA crystals in my hands that are not being diluted away? Should I increase the Allopurinol dosage and put up with the pain while my body get’s cleansed?

Does anybody else get Gout symptoms manifesting in their hands?

Thanks

[Keith Taylor]

healeyguy, the answer lies in your uric acid levels and your attitude to gout pain.

Physically, what is happening to you is exactly what you describe in:

Is it possible that I have UA crystals in my hands that are not being diluted away? Should I increase the Allopurinol dosage and put up with the pain while my body get?s cleansed?

So, yes, you should increase the allopurinol dose, but please do it right.

Get uric acid test, with liver function and kidney function tests. Every time you get uric acid test results, log the date and value in your gout profile under “Other personal gout facts” and change “My uric acid level to the latest value.”

Increase from 100 to 200 for 2 to 4 weeks, then retest. Then we can review, but it might be good to go for another increase. My reason for suggesting that is because you’ve had gout for years. That’s a lot of old uric acid deposits hanging around, and the lower you get uric acid for a few months, the quicker you get rid of them.

In my experience, which includes gout pain in my hands, knowing your current uric acid level is below 300 gives you the confidence to tackle the pain.

Once you start to see every painful episode as some more crystals gone, it’s easier to cope psychologically. But, you also need to cope with the pain physically.

Consider daily colchicine for at least 2 weeks around every dose increase, then as required.

That can stop most gout pain starting, or stop it getting worse, but it often needs help. For that, I recommend ibuprofen, naproxen, or other NSAID, and you should discuss this with your doctor to get the maximum strength prescription for gout pain. At the same time, discuss with him a compatible pain blocker.

There are options in your gout pain control package, and we can discuss those in detail whenever you like. The important goal is confidence to know you can control the pain and get on with your life whilst allopurinol saves it.

That combination of confident pain control and confident uric acid control is magic. You take control of your gout, and life gets better every day.

Because your hands are a specific problem, treat them with more care. Try to avoid prolonged exposure to cold. If you flex them as you wake, you can take emergency action first thing at the first sign of a twinge. The specifics depend on which pain control package you choose, so let me know what you decide on, and I’ll give more specific advice on what to take, and when to take it, for maximum relief as you dissolve those old crystals.

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