Arthritis is a term utilized to describe a number of musculoskeletal conditions. It is important to note that arthritis can be instigated by infections, injuries, immune conditions, hormonal disorders, neurologic diseases, metabolic disturbances, cancer and aging. Osteoarthritis is considered as the most common form of arthritis that affects individuals over the age of 65. The exact cause of osteoarthritis has not been identified until today. As for the underlying cause of gout, it has been well established.
Crystal formation vs wear and tear
When it comes to gout, it is described as a metabolic condition that causes high blood levels of uric acid which is a byproduct of cellular breakdown and recycling. Individuals who have gout cannot effectively eliminate uric acid from the body, thus accumulates in the bloodstream and tissues. Once uric acid increases in the body, crystals of monosodium urate gather within the joints where they instigate an intense inflammatory reaction. After some time, recurrent episodes of gout can progress to severe joint destruction.
Osteoarthritis is not yet fully understood until today since it has various factors contributing to its onset and progression. As an individual starts to age, the muscles, tendons and ligaments weaken which subjects the joints to mechanical forces that trigger inflammation. If the individual is genetically predisposed to osteoarthritis, aging might reduce the ability of the immune system to deal with the inflammation. Incessant inflammation results to joint damage that contributes to instability and a cycle starts.
Slow progression vs flare-ups
Gout is characterized by intermittent episodes of intense joint inflammation including swelling, redness, warmth and tenderness. These intense periods are separated by symptom-free periods. An acute attack can last for a few days up to a few weeks and usually subsides with or without treatment.
As for osteoarthritis, there is a steady progression. Injury or overuse to an affected joint can initiate abrupt worsening of pain but these are not as severe as the attacks from gout.
Involvement of various joints
Even though there is a similarity in the affected joints involved in gout and osteoarthritis, these conditions has the tendency to include distinctive areas of the body. The joint at the base of the big toe is typically affected by gout, especially early in the course of the disease. The ankles, feet and knees are also prone to gout.
When it comes to osteoarthritis, it typically affects the hips, hands, spine and knees. The difference with gout is that other joints can be affected as well. In addition, those who have gout can develop tophi that are build-up of monosodium urate crystals present under the skin in the elbows, hands and ears.
During an acute flare-up of gout, non-steroidal anti-inflammatory drugs (NSAIDs) are the basis of treatment. Corticosteroids can also help as well. The moment a flare-up has subsided, the key in management is to control the level of uric acid which requires life-long use of medications such as allopurinol.
Osteoarthritis involves a stepwise approach. The initial treatment includes medications such as acetaminophen, NSAIDs, glucosamine and even narcotic pain medications. Corticosteroid joint injections are also useful as the condition progresses. Over time, severely affected joints might require replacement with artificial joints. It is vital for those who have osteoarthritis to stay active.