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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Flare Up Of Gout After Back Surgery?

I had back surgery 8 months ago with placement of 2 rods and screws. I developed gout 5-6 months ago. My gout is not responding well to allopurinol and colchicine. However steroids do alleviate the pain and swelling. As soon as I stop the steroids the pain and swelling are back. Is it possible for the rods in my back to have some affect on the gout or to have stimulated it?
Wed, 11 Jan 2017
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General & Family Physician,  's  Response
Hi,

There is no known link between the use of the rods and screws and the onset of gout but having said that, persons react differently to treatment. Colchicine is used to treat the acute gout attack though it is not as widely used as before because NSAIDs have been found to help the pain and also due to the fact that colchicine has a narrow dose range. This means that only a small dose range is helpful, above this it is causes problems. Mostly, NSAIDs are used for pain management at least initially that is Indomethacin, Naproxen, Ketoprofen, Voltaren. Maintaining your uric acid below 6 mg/dl has been shown to reduce the frequency of attacks so this level should be monitored every 3 to 6 months. Medication to decrease uric acid levels are not recommended during an flare up though because they intensify and prolong the attack, it is supposed to be started after.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Michelle Gibson James
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What Causes Flare Up Of Gout After Back Surgery?

Hi, There is no known link between the use of the rods and screws and the onset of gout but having said that, persons react differently to treatment. Colchicine is used to treat the acute gout attack though it is not as widely used as before because NSAIDs have been found to help the pain and also due to the fact that colchicine has a narrow dose range. This means that only a small dose range is helpful, above this it is causes problems. Mostly, NSAIDs are used for pain management at least initially that is Indomethacin, Naproxen, Ketoprofen, Voltaren. Maintaining your uric acid below 6 mg/dl has been shown to reduce the frequency of attacks so this level should be monitored every 3 to 6 months. Medication to decrease uric acid levels are not recommended during an flare up though because they intensify and prolong the attack, it is supposed to be started after. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Michelle Gibson James