Gout

Definition

What is gout?

Gout (medical: arthritis urica) is one of the rheumatic diseases. Gout is a metabolic disorder in which elevated uric acid levels in the blood trigger inflammation and severe pain in a variety of the body’s joints. The inflammatory joint disease is caused by the deposition of uric acid crystals. Colloquially it is sometimes referred to as the “gout ailment."

In medical terminology there are different forms: an acute gout attack with suddenly occurring symptoms, chronic gout with permanently present deposits, or gouty arthritis when the disease is accompanied by inflammation of individual joints. Chronic gout also includes the development of so-called gout nodules (tophi), which can sometimes be visible under the skin.

Small joints are particularly frequently affected. The best known is podagra, i.e. gout in the big toe joint, which in the past was described as the typical manifestation of “gout in the foot.” However, other joints can also be affected by elevated uric acid. For example, gout in the knee, gout in the finger joints or gout in the hand are possible. Gout in the hip or gout affecting the kidneys can also occur.

In diagnostics, the uric acid level is often measured or uric acid crystals are detected in the affected joints. These reliably indicate whether gout is present. In a healthy person, the uric acid concentration in the blood is three to six milligrams per 100 milliliters of blood serum. From a value of about 6.5 milligrams per 100 milliliters of blood serum, physicians speak of hyperuricemia — that is, elevated uric acid levels in the blood.

Causes of gout

The causes of gout lie in a disturbance of uric acid metabolism. Too much uric acid accumulates in the blood, which in the long term promotes the formation of uric acid crystals. The body produces uric acid when breaking down purines, which come from both diet and natural cell metabolism. Normally the kidneys reliably excrete this substance. If excretion is impaired or production is too high, uric acid levels rise significantly. Not every person with an elevated uric acid level automatically becomes ill, but certain risk factors increase the likelihood. These include genetic predisposition, a purine-rich diet, lack of exercise, overweight, and high alcohol consumption. Conditions such as high blood pressure or impaired kidney function can also play a role as causes of gout.

Depending on the cause of the high uric acid level in the blood, a distinction is made medically between a congenital and an acquired form of gout. Congenital or primary gout is the most common form and arises from a genetic predisposition that leads to overproduction of uric acid or causes reduced excretion of this substance by the kidneys. In this case, the origin of the disease is a disorder in uric acid metabolism. Typically, primary gout begins with an acute gout attack. If the disease remains untreated, it can lead to chronic gout and the formation of gout nodules (tophi). Secondary gout is a consequence that is caused by other health problems or factors that affect uric acid metabolism. Common causes are kidney diseases, in which the excretion of uric acid is disturbed, or the intake of medications such as diuretics that reduce uric acid excretion in the urine. Conditions like hypertension or diabetes can also promote the development of secondary gout.

An important difference from primary gout is that secondary gout is not present from birth but develops due to external factors. Patients with secondary gout show symptoms similar to those of primary gout, but treatment must be tailored to the underlying condition or the triggering factor.

Symptoms of gout

Gout symptoms can appear in many ways and most often affect the joints. It is typical that symptoms occur suddenly in the form of gout attacks and reach a very high intensity of pain within a few hours. Below are the most common gout symptoms:

• Acute gout attack: sudden, very severe pain, often starting at night. Even a light touch of the joint can be almost unbearable.
• Podagra (gout in the foot): the big toe joint is particularly commonly inflamed. This form is considered the classic presentation of the disease.
• Gout in the knee: the knee joint can also be affected by uric acid crystals in the joint, causing severe swelling and a sensation of heat.
• Gout fingers and gout in the hands: pain in the finger joints or wrist is possible.
• Redness and overheating: affected joints are strongly reddened, overheated and swollen.
• Gout nodules (tophi): in chronic gout, hard deposits often form under the skin, for example on the auricle, fingers or elbows.
• Gout flare in foot or hand: recurring attacks, so-called gout flares, can repeatedly affect the same joints.
• Restricted movement: affected joints are often limited in load-bearing capacity; everyday movements such as walking or grasping become agonizing.
• Morning stiffness: many patients report stiff joints after getting up, especially in chronic gout.
• Joint hypersensitivity: even the weight of a blanket can cause unbearable pain during acute gout attacks.
• Burning sensation: some patients describe the pain not only as stabbing but also as burning.
• Skin changes: the skin over the inflamed joint can appear shiny and tense.
• Fever and fatigue: in severe gout attacks there is occasionally a slight fever, tiredness and a general feeling of illness.
• Gout symptoms in unusual locations: besides the classic regions such as foot, knee or fingers, shoulder, hip or elbow can also be affected.
• Long-term joint deformities: repeated gout attacks and gout nodules can lead to permanent changes or deformities of the joints.

Conventional therapies – what helps with gout?

There are different approaches to treat gout, depending on the severity of symptoms and the type of disease — from acute gout attacks to chronic gout. Some established options for conventional gout treatment are presented below. The list is not exhaustive, as combinations of individual measures may also be useful. A medical consultation is recommended in any case to determine the appropriate therapy.

• Acute gout attack guideline: According to medical guidelines, rapid pain relief and lowering uric acid levels are the main priorities in gout.
• Pain medications: Ibuprofen or diclofenac are frequently used to relieve pain and inflammation during gout attacks.
• Corticosteroids: For severe symptoms or when pain medications are contraindicated, corticosteroids can be used orally or by injection.
• Medicinal therapies for gout treatment and prevention: Some medications relieve acute inflammation, others permanently lower the uric acid level in the blood, and others promote the excretion of uric acid via the kidneys. Together they help reduce symptoms and prevent recurrent gout attacks.
• Dietary measures: A controlled diet low in purines supports therapy and prevents recurrent attacks.
• Exercise: Regular physical activity can help by stabilizing body weight and thus favorably influencing uric acid levels. Activity also promotes circulation and joint mobility, which can prevent inflammation and improve overall quality of life.
• Rest: During a gout flare, the affected joint is often barely loadable. Short-term rest helps reduce pain.
• Physiotherapy: Targeted exercise therapy promotes joint mobility, strengthens muscles and supports the function of affected areas.
• Orthopedic aids: Bandages or insoles relieve painful joints, e.g. in gout of the foot or gout in the knee.
• Weight reduction: Overweight increases the risk of elevated uric acid levels. Weight loss can support long-term gout therapy.
• Fluid intake: Drinking enough fluids promotes the excretion of uric acid via the kidneys and helps prevent deposits.
• Cold applications: Cooling compresses or ice packs relieve pain and swelling in the affected joint.
• Heat therapy for chronic gout: For longer-standing complaints, heat can help relax muscles.
• Long-term therapy for chronic gout: The goal is to dissolve gout nodules, prevent the formation of new uric acid crystals and preserve joint function.

kybun mode of action – what helps with gout?

kybun products aim to reduce the health-damaging effects of hard, flat floors and immobile, supportive shoes — two factors that often cause additional discomfort for people with gout. Especially with gout in the foot, gout in the knee or gout in the hip, those affected can benefit from the unique elastic-springy property of kybun products. This ensures that the joints are both relieved and activated. Thus, both in everyday life and during acute phases of gout attacks or in chronic gout, mobility can be improved and pain reduced. The central modes of action of kybun products for gout are explained below:

• Promotion of movement and reduction of inactivity

  Many people with gouty arthritis avoid movement, especially during an acute gout attack, because pain and stiffness limit the joints. However, lack of movement worsens symptoms in the long term because the joints receive less blood flow and surrounding muscles are weakened.
  The elastic-springy kybun shoes promote gentle, less painful movement. Due to the soft cushioning when walking, the affected joints are noticeably relieved, so movement becomes enjoyable again. Increased activity can help improve quality of life and reduce everyday limitations — for example with gout in the foot.

• Activation and strengthening of muscles through the elastic-springy property

  The elastic-springy material of kybun products creates a deliberate instability, causing the whole body to be active when walking and standing in order to maintain balance. This activates the muscles in the feet, legs and trunk. Stable muscles protect the joints, improve balance and prevent poor posture that often results from protective movements during gout pain. In this way, those affected can stabilize their joints better in the long term and handle everyday movements more easily.

Balance and EMG

Balance ability was measured with a force plate by tracking the movement of the body’s center of mass front-to-back (ant-post) and side-to-side (med-lat) while standing. In parallel, an electromyography (EMG) recorded muscular activity.

• Reduction of force impact from hard, flat floors through damping effect

  When walking on hard, flat floors, high forces act on the body at heel strike, which must be absorbed by the joints. These impact forces act particularly strongly on the foot, knee and hip joints, causing mis- and overloading with every step. Especially in gout attacks, existing gout nodules and inflamed joints, the increased force impact can worsen the situation and thus increase pain. In kybun shoes the heel gently sinks into the elastic-springy material when walking. This damping effect reduces peak loads on the feet and the joints above and provides relief with every step.

• Natural foot roll thanks to muscle activation and rolling function

  At heel strike in kybun shoes the elastic-springy material is compressed. Due to this slower sinking into the kybun sole, the moment of maximum force impact is delayed. This additional time gain helps the muscles to contract in time. Thanks to the active muscles, the transverse and longitudinal arches are stabilized on the one hand, utilizing the foot’s natural shock absorption. On the other hand, muscle activation at heel strike prevents the harmful collapse of the foot, allowing the foot to transition into a natural roll. Through both mechanisms, the foot joints and the structures above are relieved in gout, thereby reducing pain.
  By actively rolling over the forefoot, the acting force is redirected into forward motion while the joints are used in their full range of motion. This relieves inflamed and painful joints because peak point loads are avoided.

• Care and protection of the fasciae

  Fasciae — the connective tissue around muscles, joints and organs — react particularly sensitively to movement. In chronic gout, adhesions and hardening of the fasciae can occur due to inflammation and protective postures. The springy impulses when walking in kybun shoes promote fluid exchange in the fasciae and support their natural elasticity. This results in smoother movements, less pain and better joint function — even in advanced gouty arthritis or with gout nodules at the affected joints.

• Improved circulation through increased movement activity

  Good circulation is crucial to better transport metabolic products — such as elevated uric acid in gout — away from tissues. Elastic-springy walking stimulates circulation thanks to the increased range of motion and can thus improve metabolism in the affected tissue. This supports regeneration after an acute gout attack and can help in the long term to make gout flares occur less frequently or with less intensity.

• Optimized pressure distribution

  The entire sole of the foot is surrounded by the elastic-springy material when standing and walking. This leads to optimized pressure distribution in the feet and a reduction of focal pressure points on the sole. In gout, the first metatarsophalangeal joint (podagra) is often affected, which is excessively loaded in conventional shoes and when walking on hard, flat floors. This also means that walking on the forefoot is extremely painful during a gout attack. In addition to the first metatarsophalangeal joint, other areas of the foot joint as well as knee and hip joints can be affected. Thanks to optimized pressure distribution, peak loads are reduced, relieving inflamed and painful joints. In addition, the constant slight movement on kybun products increases the load-bearing area, which can also reduce individual pressure points. This helps protect the joints from overload and injury.

Usage tips for gout

Before wearing kybun shoes for the first time, you should consider a few points. Proper use can help relieve inflamed joints, reduce pain and gradually improve mobility.

• Start slowly: begin with short wearing times and increase them gradually. This is particularly important for gout, where uric acid crystals cause inflammation in the joints — often in the area of the first metatarsophalangeal joint — and a careful adaption is essential.
• Avoid pressure points: fasten the shoes loosely to prevent pressure on the affected joint. This avoids additional irritation of inflamed or swollen areas.
• Use gentle cushioning: consciously step with the heel and let the foot sink evenly into the elastic-springy material. This special cushioning reduces impact on pain-sensitive joints and thereby relieves discomfort when walking.
• Practice calm walking: pay attention to small, even steps. Avoid jerky movements, as these can place greater strain on the inflamed structures.
• Choose an individual pace: listen to your body. During acute gout attacks or when in pain, reduce wearing time and take breaks to avoid overloading the joints.
• Gently promote mobility: as you become more accustomed, you can carefully deepen the roll over the forefoot. This activates muscles, tendons and joints, supports circulation and can improve mobility in the long term despite recurrent inflammations.