Joint pain, is it gout or arthritis?

[Yellowtail]

23 minutes ago, Pedrogaz said:

I never met anyone with gout until I came to Thailand....now I hear it all the time, even in young people. Fortunately colchicine is a cheap and effective cure for an episode....but it has many side-effects and a number of drug-drug interactions with a wide range of frequently used medications. Go see your doctor.

 

Exactly. The drug is great for treating an attack, but it is critical that you get a handle on your uric. 

[AgMech Cowboy]

19 hours ago, fdsa said:

Too young for arthritis

"Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis.

"Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years but can progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. 

"Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints."

 

@jak2002003 Go see a Doctor!!!  This is something new for you??? Get it checked out and quit listening to the TVF medics... Sheryl gives good advice, none of can diagnose without examination.

 

Edited October 4, 2020 by AgMech Cowboy

[misterphil]

19 hours ago, fdsa said:

Too young for arthritis, could be just a random inflammation, go visit a doctor.

 

Wrong. I got arthritis in my hip in my early 40's. 

[misterphil]

Get some Arcoxia from the pharmacy. Works a treat. 

[Cod Face]

19 hours ago, Pilotman said:

same same, treat the same way. Try Diclofenic, 50 mg is 80 baht per 10 tabs at my local pharmacy.  

Are you a flying doctor?

[Cod Face]

4 hours ago, Yellowtail said:

 my wife brought home a beautiful bushel of fresh asparagus... 

That much?

[Sheryl]

There are indeed many types of arthritis. In a younger person especially, rheumatoid type needs to be considered. 

 

OP should be aware that if he has this and delays treatment, permanent disability can occur. He should nto delay seeing a doctor unless his dislike of hospitals outweighs his desire to use his hands.

 

 

[Pilotman]

47 minutes ago, Cod Face said:

Are you a flying doctor?

no, just a suffer who has it under control. 

[Stocky]

2 hours ago, stouricks said:

Colcachine works too, two tablets every two hours until you feel sick, get the runs, and in a few hours or so it's gone. Back to the red wine!

That's extremely bad advice, an overdose of colcachine can be fatal. 

Standard dosage is 1.2 mg orally at first sign of gout flare-up (2 tablets) followed by 0.6 mg 1 hour later. Maximum dose: 2.4 mg/day.

 

I find 2 tablets once a fortnight forestalls any gout attacks.

[tomazbodner]

Uric acid check incl. doctor's visit is about 1000 baht at a private hospital, probably less in public hospital. And that's really what would give a very quick answer.

 

In range is 3.5-7.2. If OP has over 9, definitely check ultrasound for kidney stones as well, since the uric acid ones (unless coated with calcium) don't show on x-rays.

 

I'm in the same boat as the OP age and diet wise, except I've been in and out of hospital because of this for many years. What I wrote earlier is what works for me and has few if any side effects.

 

Now if we go to other things that may have worked (inconclusive), it's cherries (I had cherry extract capsules but they haven't done anything as uric test before and after a month of taking the supplements would be testament of), and coconut water (likely due to potassium) to trigger the stones to release (if OP has any).

 

The thing that reduced swelling and pain (which can get to the point that even bed-sheet can't touch your foot as several pointed earlier), was Nurofen. Due to stones I have several much stronger painkillers, but none of them was nearly as effective as Nurofen. Zavance (alas double dose from standard pink pills) worked way better than these pills.

 

Don't postpone seeing a doctor until you can no longer walk.

 

I've already written previously what doctor would prescribe if stones are also found. In most cases they can be melted away to the size that can pass out naturally and avoid 150,000 baht shockwave per stone. Uralit-U is a box of granules to mix in water and drink. Pocitrin are pills.

 

Main point however is to get uric acid under control. Most gout medication has severe side effects, but some supplements and change of diet may help, while increasing water consumption generally helps as well.

[Sheryl]

4 minutes ago, Stocky said:

That's extremely bad advice, an overdose of colcachine can be fatal. 

Standard dosage is 1.2 mg orally at first sign of gout flare-up (2 tablets) followed by 0.6 mg 1 hour later. Maximum dose: 2.4 mg/day.

 

I find 2 tablets once a fortnight forestalls any gout attacks.

 

Agreed.

 

Should not self prescribe colchicine. 

 

Even at correct dose it can have some serious side effects and liver and kidney function need to be checked before it is started.

 

NSAIDs are preferred and colchicine used only if they are insufficient to relive the pain of an attack.

 

And drugs to reduce uric acid levels, like Allopurinol, are the preferred preventive if dietary measures alone do not suffice. Obviously need blood test of uric acid levels first.

[Yellowtail]

50 minutes ago, Cod Face said:

That much?

Or close to it. I was amazed at how good it was and how much she got. I ate it a couple times a for for two weeks. Even pickled some...

[connda]

What did you have to eat before the event?  If you had a meal heavy in purines like chicken it could have caused a flare up if you have gout.

[Deli]

Sounds pretty much like gout. Welcome to the club ????

Dosenac or similar for less than 50 baht solves the problem for the moment.

Check you diet and beer consumption... I know, not fun but this is how to control it without meds.

[Deli]

Sounds pretty much like gout. Welcome to the club ????

Dosenac or similar for less than 50 baht solves the problem for the moment.

Check you diet and beer consumption... I know, not fun but this is how to control it without meds.

[Cod Face]

5 minutes ago, Yellowtail said:

58 minutes ago, Cod Face said:

That much?

Or close to it. I was amazed at how good it was and how much she got. I ate it a couple times a for for two weeks. Even pickled some...

Good to see the dropping of the use of those old-fashioned kilos and grammes at last.

[vandeventer]

19 hours ago, jak2002003 said:

Thanks for replies. Seems a bit of a bother to go to a hospital and get blood tests just for one painful knuckle and achy big toe.  I also hate having needles and hospitals !!!  

 

However, if it's not cleared up or if it gets worse in a month o will go and get a blood test.

 

I think arthritis in my finger is possible even in my 40s. That is the thing I really don't want it to be as my hobby is playing piano????. I was most worried about that...as my mother had bad arthritis in her hands and I read it can be genetic. 

My sister has gout, she's had it for years, taking her pills every day but it still left her in a wheelchair for over 2 years. So yes, go see the best doctor in your area and take the test. It is also possible to have arthritis at you age. I would also checkout your diet again as there might be a few things lacking in it.

[Yellowtail]

2 minutes ago, Cod Face said:

Good to see the dropping of the use of those old-fashioned kilos and grammes at last.

 

A bushel is a measure of volume, not mass. Standard fruit boxes and baskets are typically a bushing. If you've never actually seen a box of produce it's about 35 liters. 

 

 

[bjaz]

One thing to look out for is chikungunya - I'm guessing you would have mentioned this but if you had a fever and a rash at some point in the recent past it could be this.
 

My wife and I both were infected by chinkungunya in Bali (Sanur) in September 2017, fever for 36 hours, dengue-like rash, then swelling and joint pains, oh my, like instant arthritis, focused on feet, ankles and hands, and fatigue - lasted about three month, very difficult in the morning, better in the evening, repeat.

 

In 2019, my father came to visit us for a few weeks where we were working in Thailand and he caught it there (Khao Lak, Phang Nga province) - he ended up in hospital back in Europe, showcasing this rare tropical disease for med students. Same thing, joint pain in hands and feet for about 3 months than full recovery (SE Asian strain is not as nasty as others, apparently)
 

There was a bit of an outbreak in Phang Nga and Phuket a couple of years ago, so it might have reached other places.

https://www.cdc.gov/chikungunya/index.html

https://www.who.int/news-room/fact-sheets/detail/chikungunya

https://en.wikipedia.org/wiki/Chikungunya

[transam]

Do you have any Psoriasis, a few of us sufferers get the internal version too, Psoriatic Arthritis?

Affects any joint at any time, comes and goes, over active immune system... 

[Yellowtail]

Remember when burning joints was a good thing?

[Cod Face]

3 minutes ago, Yellowtail said:

A bushel is a measure of volume, not mass. Standard fruit boxes and baskets are typically a bushing. If you've never actually seen a box of produce it's about 35 liters.

"Standard fruit boxes and baskets are typically a bushing".

Really?  A bushing [sic]?  That reminds me, I've got to get the anti-roll bar bushels on my car replaced.

 

Yes, I know what a bushel is, I was just teasing.

[Dazinoz]

I was getting an intermittent pain in one heel. At times it was so bad I literally had to crawl around the house. Then started getting more regular, moved to other heel, then to toes of one foot and to the side of the foot. Finally moved to one knee and was very painful. I visited a specialist (cant remember if rheumatologist or orthopaedist) at RAM in Chiang Mai. First thing he did was an X-ray on my knee and also a blood test for uric acid. The knee showed fluid and he said he could fix that immediately. After a couple of painful injections and the removal of 40ml of fluid pain was gone and has not come back in 18 months.

 

The blood test showed I had high uric acid of 10.9. Normal is about 4 to 7. I said I guess I need to change diet. His reply was if I went on the best possible diet it only reduces the levels by about 10% which was still too high. He also said I need to have some fun in life enjoying foods. He said most uric acid is produced in the kidneys.

 

He then me told me of an excellent medication that has been used for 40 years and is excellent for gout and a good preventive medicine for the kidneys, but........ some people are allergic to it and if taken can kill them. I had to have another blood test and the sample sent to a special lab for testing. It came back safe for me to take. He gave me that and 2 other medications to take 3 months. I went back and uric acid was less than 7. Another 6 months around the same and he took me off one tablet. 6 months later still low. So after nearly 18 month have never had another pain since. NO change to diet.

 

Just my experience take it for what its worth. I will not give name of medication in case someone goes and buys and is allergic.

[bodga]

20 hours ago, Bender Rodriguez said:

eat too much organ meats? 

 

Gout  is a disease caused by Uric acid precipitation Which is a substance It is obtained from the degradation of purine, which is abundant in high-protein meats such as poultry. Organ offal, squid, shellfish, crabs or small fish that eat whole bones, such as anchovies, canned sardines.

 

 

there is a THAI herb for sale you "could" try

 

before anyone says quack to a proven THAI herbal medicine HUNDREDS of years old

 

https://www.google.com/search?q=thai+herb+for+gout

 

when people say quack when they have zero knowledge in herbal medicine, TCM, Ayurveda, I say, you are the ignorant QUACK that has been brainwashed by big pharma that everything needs to be CHEMICAL for big profits while originally and for hundreds of years, everything was HERBAL & NATURAL and it is only the patenting of a certain modification of a molecule to sell it 1000x original price for PROFITS and not for the benefit of the people

 

will herbal medicine  sew a  leg back on?

[DogNo1]

A lot of chemical medicine was derived from the effective ingredient(s) in herbal sources.  You will find that many supplements contain extracts from the herbal source to ensure that the supplement has an adequate amount of the herbal active ingredient.  So the distinction between herbal and chemical is sometimes illusory.

[spidermike007]

A simple uric acid test would likely reveal if it is gout. Or you can self treat with colchicine. Usually, within a few doses, I start seeing relief, when I have a gout attack. Limit yourself to two or three pills a day, or you may get nauseous. But, it is effective for most people. Gout is awful, but easily treated, and fairly easily regulated with diet. Certain meats and seafood are bad. As is beer. Easy to find a list online of foods with high purine content. 

[Yellowtail]

27 minutes ago, spidermike007 said:

A simple uric acid test would likely reveal if it is gout. Or you can self treat with colchicine. Usually, within a few doses, I start seeing relief, when I have a gout attack. Limit yourself to two or three pills a day, or you may get nauseous. But, it is effective for most people. Gout is awful, but easily treated, and fairly easily regulated with diet. Certain meats and seafood are bad. As is beer. Easy to find a list online of foods with high purine content. 

 

So Big Pharma is okay when you have a gout attack....

[Nout]

Gout is very destructive not just painful. You must get a test for your uric acid levels and an aspiration of liquid from the swelling to see whats happening. You must get this checked to enable a suitable course of treatment. Let's hope its not rheumatoid arthritis!

Edited October 4, 2020 by Nout

[Seeall]

On 10/3/2020 at 5:00 PM, Pilotman said:

same same, treat the same way. Try Diclofenic, 50 mg is 80 baht per 10 tabs at my local pharmacy.  

https://www.medicines.org.uk/emc/product/2660/pil#:~:text=DICLOFENAC SODIUM 50mg tablets relieve,(form of spinal arthritis).

 

https://www.nhs.uk/medicines/diclofenac/

[Seeall]

On 10/3/2020 at 6:02 PM, Sheryl said:

Gout is possible but you need to see a doctor and have a blood test.

 

 

 

 

And then is the big question of what meds to take and diet....  I dont think the Dr's know all,  just give what they think... and diets contradict....   Bellpeppers, mushrooms, bocolli... its a nightmare....