Gout, a form of arthritis caused by uric acid buildup, can affect the spine. When the body struggles to eliminate excess uric acid, urate crystals can form around joints, causing pain and inflammation. Untreated, this can spread to other areas, including the spine. According to the UK's Arthritis Action, spinal gout is uncommon but often undiagnosed due to its varied symptoms.

Typically, urate crystals accumulate in lower body joints like toes, ankles, and knees. In severe cases, tophi (hard uric acid deposits) may form under the skin and eventually in other areas, including the axial skeleton (skull, rib cage, and spine).

Spinal gout can affect areas like the facet joints connecting vertebrae, the vertebral arch linked to the spinal cord, ligaments connecting the dura mater, and the epidural space. Symptoms include back and neck pain, muscle weakness, numbness, tingling, loss of bladder or bowel control, reduced sensation in the back, legs, and buttocks, and cramps.

Spinal gout causes back pain and numbness in the lower back. AI generated illustration.

Diagnosing spinal gout can be challenging due to its rarity. Doctors consider spinal pain radiating to the hips and legs, and nodules around joints. Blood tests measure uric acid levels; levels above 7 mg/dl can indicate hyperuricemia. Imaging tests like MRIs can help detect spinal compression.

Treatment for spinal gout is similar to gout affecting other joints, focusing on lowering uric acid and managing acute flare-ups. Lifestyle changes like weight loss, limiting alcohol, and reducing purine-rich foods (red meat, organ meats, seafood) are essential. Avoiding medications that increase uric acid levels, such as diuretics, is also important. Regular low-impact exercise like walking or swimming can also help.

Anh Ngoc (According to Medical News Today)