Any Hope For Gout When It’s Gone Too Far?
All too often, gout management is focused too much on pain relief, with too little emphasis on uric acid management.
Failure to correct high concentrations of uric acid, which is the root of all gout pain, leads to damage to joints (osteoarthritis). This in turn, leads to the question, “Can anything be done to help repair gout-damaged joints?”
More specifically a reader asked:
Was wondering if anyone had some info on glucosamine supplements in regard to helping to heal the damage done by years of gout.
Well, there is information available, but the results are not encouraging. Though the British Medical Journal has had responses to the following report that raise some questions about the conclusions, the hope of joint repair through supplementation does seem very doubtful. In “Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis,” (Glucosamine Or Chondroitin For Damaged Joints) Warner & colleagues conclude:
Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.
They also note that:
Our findings indicate that glucosamine, chondroitin, and their combination do not result in a relevant reduction of joint pain nor affect joint space narrowing compared with placebo. Some patients, however, are convinced that these preparations are beneficial, which might be because of the natural course of osteoarthritis, regression to the mean, or the placebo effect. We are confident that neither of the preparations is dangerous. Therefore, we see no harm in having patients continue these preparations as long as they perceive a benefit and cover the costs of treatment themselves. Coverage of costs by health authorities or health insurers for these preparations and novel prescriptions to patients who have not received other treatments should be discouraged.
I do not know if there are other effective treatments once gout has caused osteoarthritis, but commonsense dictates that you should see your doctor immediately about uric acid lowering gout medications before permanent joint damage occurs.
