Working For Gout
Whilst researching heat and ice as gout relief therapy, I discovered the phrase “occupational gout.”
This is not some new form of our much-reviled ailment. It refers to the situation where someone gets gout, or their gout is worsened, simply because of the work they do.
In the latest issue of the Irish Medical Journal, Conway, Carey, and Coughlan report A Case of Occupational Gout. My layman’s summary is:
Working For Gout Introduction
The authors note that gout commonly affects the big toe, but can affect any joint. There is no agreed reason for this, and they offer support for low temperature as a cause. They introduce a man who has gouty fingers that are exposed to cold through his job. They coin the phrase “occupational gout” to describe gout as a result of work.
Working For Gout Case Report
A 62-year-old fisherman had painful, swollen fingers for six weeks. He did not respond to antibiotics or oral steroids from his family doctor, but got some relief from naproxen. He was referred to rheumatology where tophi were recognized on his fingers, and blood uric acid was measured at 399 µmol/L (6.7 mg/dL). The rheumatologists prescribed colchicine plus allopurinol, which resolved symptoms in two weeks.
Working For Gout Discussion
The authors discuss some reasons why gout appears first most often in the big toe. Among other potential associations, they focus on low temperature, and reference a relevant 1972 study of gout affected by temperature. Loeb’s “The influence of temperature on the solubility of monosodium urate”:
The limited solubility of monosodium urate in the presence of physiological sodium concentrations is shown to fall sharply with decreasing temperature. It is suggested that this phenomenon may play a role in determining the clinically observed distribution of tophi and the susceptibility of certain joints to acute gouty arthritis
The authors conclude that this case supports the assertion that low temperature increases the incidence of gout. They also note that differences from the expected presentation in the big toe may be occupation related.
Working For Gout: Next Steps
If you are ever told “you can’t have gout because…” it is a good idea to look at your work environment to see if you might be affected by lower temperatures. It might not be work – perhaps hobbies or other aspects of your life expose you to cold conditions.
Regular readers will be aware that I recommend avoiding ice as a way of reducing gout pain. I accept that studies show it can bring short-term relief. However, there have been no long-term studies to test if this prolongs gout or has other negative effects. I accept that the cases of gout exacerbated by cold temperatures happen when prolonged exposure happens over a long time period. It may be that the relatively short sessions of ice therapy will not cause more uric acid crystals to form.
As a gout sufferer, I prefer to wait for proof that ice is safe long term, and I therefore recommend warmth to ease painful joints. Though my gout is now under control, I used to simply use extra clothing. Or wrap a warm towel around the affected area. I found that prevention, by eliminating drafts, especially at night, was also very effective.
I have used microwave bags, and I found these effective. So I have added a list of these, and similar gout relief products to the Treat Gout pages.
Leave Do You Work For Gout to read more about GoutPal Plan for Secondary Gout.
Do You Work For Gout Comments
GoutPal visitor responses and associated research include:
Further research has told me about several other forms of occupational gout. So I will add more information about how some jobs can make gout worse. Or even cause gout. If you want email notification when I publish new facts please subscribe: