Rheumatoid arthritis and gout – Key differences in symptoms, causes, and treatments

Currently, more than 54 million individuals in the country suffer from arthritis. This disorder stands as a leading cause of disability as well. Under the family of arthritic diseases, rheumatoid arthritis (RA) and gout are some common types which are often confused as one. This is because both cause painful inflammation of the joints. Both the conditions can impact any joints, but in the majority of cases, they attack the joints in the foot.

What are the key differences between rheumatoid arthritis and gout?
Rheumatoid arthritis (RA)
RA is a chronic, autoimmune condition that causes the swelling of the joints accompanied by symptoms such as pain, tenderness, and stiffness. In its early stages, it is more likely to strike smaller joints such as fingers and toes. As this inflammatory disease moves towards its advanced stages, other joints in parts like wrists, shoulders, elbows, knees, ankles, and hips are affected. It also happens to be a systemic disease, i.e., it can distress other parts of the body as well such as the heart, kidneys, lungs, nerve tissues, skin, eyes, blood vessels, and bone marrow, amplifying the risk of other health complications.

Cause – It isn’t exactly determined what causes the immune system to attack its healthy cells; however, studies point towards multiple factors associated with genetics, environment, and lifestyle.

According to the recent statistics, around 1.3 million people in the country are suffering from RA. Interestingly, RA is observed more among women than men.

Gout
Gout, however, is a type of arthritis that commonly impacts the big toe. However, it can also affect the ankle and top area of the foot. In some cases, it might also attack other joints of the body. Furthermore, gout unfolds as an acute attack rather than a chronic condition. The foot pain caused by gout can be extremely intense during the first 4–12 hours of the attack.

Cause – Gout is caused due to the accumulation of urate crystals around the impacted joint. Urate crystals can form when the body produces high levels of uric acid, a substance that is created when the body breaks down purines. Purines are naturally found in the body, however, they are also present in numerous foods such as seafood, organ meats, steak, alcohol, sodas, mushrooms, spinach, and asparagus.

As compared to RA, gout is relatively more widespread. As per the current statistics, approximately 8.3 million people are dealing with it. Unlike, RA which is more common in women, gouty arthritis predominantly affects men.

Why is rheumatoid arthritis misconstrued as gout?

• Areas of pain – Both conditions tend to affect the joints in the toe. However, gout is confined to one joint, whereas RA gradually affects multiple joints and organs in the body.
• Symptoms – Both conditions share similar symptoms such as pain and swelling in the affected joints which can even hamper mobility if left untreated. Although, since gout attacks are sudden, the foot pain it causes can be more excruciating.

What are the diagnostic measures used for rheumatoid arthritis and gout?
For implementing the right foot pain treatments, doctors will run some tests to determine the exact cause.

• Blood tests can be used to measure the elevated erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), or levels of uric acid and creatinine. High ESR and CRP levels indicate high inflammation levels in the body. Moreover, abnormal levels of uric acid and creatinine may suggest the onset of gouty arthritis. However, blood tests aren’t always conclusive and can be misleading.
• Imaging tests such as X-rays, MRI, ultrasound, and dual-energy CT scan can be used to examine the structural changes in the joint or to detect the presence of urate crystals.

What type of foot pain treatments are used for gout and rheumatoid arthritis?
Since the causes of both conditions are unique, different foot pain treatments will be used for relieving gout and rheumatoid arthritis symptoms.

• Foot pain treatment for rheumatoid arthritis
  As compared to gout, multiple medications can be used to alleviate the foot pain caused by rheumatoid arthritis such as Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologic agents. Along with medicines, foot pain treatment for rheumatoid arthritis can be coupled with physical therapy to cope with the degenerative symptoms. In severe cases, surgery can be used as a last resort to lower pain and correct any deformities in the foot. Synovectomy, tendon repair, joint fusion, and total joint replacement are some types of surgery that can be used for treating foot pain caused by rheumatoid arthritis.
• Foot pain treatment for gout
  Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can be used to ease pain during a gout attack. To prevent such attacks in the future, doctors may recommend xanthine oxidase inhibitors (XOIs) to block the high production of uric acid and uricosurics for eliminating excessive uric acid from the system.

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