The number of cases is on the rise.. To make sure that the swelling number of sufferers is treated in the most modern way, an association of rheumatologists, arthritis experts, has made some recommendations.
For musician Rob Affuso, having limber joints is essential to explode the sounds from a set of drums. Some years ago in the middle of the night, it was his foot that seemed to explode.
"I don't remember falling. I didn't know what was going on. It was so painful I couldn 't walk on it, all swollen up," Affuso, a drummer with Soul System Orchestras, said.
Rob has gout from too much uric acid in the blood.
Uric acid starts depositing in joints, very painfully. Rob's Achilles tendon has a big deposit, and there are small ones over his knuckles. Without help, it can cripple joints over time.
The new guidelines are meant to help family doctors and experts treat it the right way, and to drive home a point.
"The vast majority of patients get a cure, not meaning that they can get off medications, but that they have no attacks and forget that they have gout," Dr. Theodore Fields of HSS said.
Those medications are mainly allopurinol and a new one, uloric. Both drop the uric acid level in the blood to normal over time. For acute attacks, these anti-inflammatory drugs work well. Some foods such as shrimp and liver can raise uric acid to cause attacks. Alcohol is also a culprit, but there's more.
"High fructose corn syrup that you find in soft drinks raise the uric acid," fields said.
High uric acids are often associated with a devil-may-care lifestyle, and some patients feel embarrassed to think they may have gout. "I was embarrassed that the perception would be that I didn't take care of myself, which I try hard to do," rob said.
Remember, gout is genetic, and though it has lifestyle factors, they don't create gout and there's nothing to be embarrassed about. Dr. Fields says that most gout cases can be treated by a family doctor or internist. The more serious should be seen by a rheumatologist, an arthritis specialist.