Gout is one of the most common types of inflammatory arthritis that can most commonly form in your lower joints. When it develops in your knee, it can make everyday movements uncomfortable.
Gout is a type of arthritis that can result in intense and sudden pain. It usually develops on one joint at a time, often starting with your big toe, but it can also affect your knee joint and the surrounding area.
When gout affects your knee, it can make everyday tasks such as climbing stairs or standing painful. You can manage symptoms of gout in several ways, such as taking medications like corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs).
Symptoms
Guille Faingold/Stocksy United
One of the main symptoms of gout is pain in the affected joint and possible discomfort in nearby areas. The condition may also result in flare-ups lasting between 3–10 days.
This can cause more inflammation in your prepatellar bursa, the slippery sacs at the front of your kneecap that help cushion the joint.
Gout develops when the uric acid levels in your bloodstream are too high. In people with severe gout, this can cause clusters, or tophi, to grow in your knee joint and surrounding tissues. These are crystals of uric acid that form in your cartilage and bone.
If you do not take preventive treatments and continue to experience gout flare-ups, you may be at risk of developing permanent arthritis.
Kidney stones are a possible complication of gout. The high uric acid content in your bloodstream causes uric acid stones to develop in your kidneys. While this only happens in 15% of people with gout, it can be serious and lead to further kidney damage.
If you experience any of these symptoms, it’s important to speak with a healthcare professional who can suggest a suitable treatment plan.
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You may experience gout symptoms in your knee due to small crystals building up between the bone and cartilage. These crystals cause pain and swelling.
The cause of these crystals is a natural waste product that your body creates called uric acid. It develops after breaking down certain foods containing substances called purines. When at a healthy level, uric acid can act as a powerful antioxidant.
However, crystals begin forming if the levels in your bloodstream go over a certain level. This can happen when your kidneys cannot filter the uric acid out properly.
The uric acid crystals trigger your immune system’s inflammation pathways. This can affect your knee joint, leading to visible swelling and pain.
Treatment
Several treatments are available for gout, which lower uric acid levels and prevent symptoms such as progressive bone and tissue damage.
Medication
When you first experience symptoms of gout in your knee, a doctor will likely prescribe medications to help manage pain and reduce inflammation. These may include:
NSAIDs: These can be prescription strength, or over-the-counter (OTC). NSAIDs that doctors often prescribe for gout include:
Colchicine: If NSAIDs are ineffective or you cannot take them for another reason, colchicine (Mitigare) may work as an alternative. This medication reduces some of the swelling around your knee, but you should only take low doses to avoid side effects like diarrhea.
Corticosteroids: These are strong medications that can treat severe flare-ups of gout. A doctor may prescribe a short course, but they are not suitable for managing symptoms long term. They can come as injectables or oral tablets. Examples include prednisone (Rayos) and hydrocortisone (Cortef).
Certain long-term medications may help reduce the levels of uric acid in your bloodstream. They aim to prevent further gout flare-ups and reduce the severity of your symptoms. A doctor will only prescribe these if your blood tests show that you have hyperuricemia (high uric acid levels).
Allopurinol helps to reduce the amount of uric acid in your bloodstream. While it can help prevent gout attacks, it will not help manage symptoms during an attack.
This medication also reduces uric acid but takes a few weeks to take effect. Your doctor will likely recommend pain-relieving medications at the same time.
If your kidneys hold onto uric acid, these medications can help. They encourage uric acid excretion and help balance the levels in your bloodstream.
lesinurad
Zurampic
This medication is useful for people who see no effect from Febuxostat or allopurinol. You will usually have to take lesinurad alongside another gout medication.
pegloticase
Krystexxa
This medication is reserved for severe gout with high levels of uric acid. It is given via intravenous (IV) infusion and can rapidly decrease uric acid levels and dissolve tophi.
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If you develop arthritis due to a buildup of uric acid crystals, a doctor may recommend arthrocentesis surgery. This is where a needle is inserted to remove joint fluid and inject anti-inflammatory steroids.
However, surgery is only done if a tophi is affecting a vital structure and medications would take too long to dissolve the mass.
If gout leads to late-stage arthritis, a knee replacement may be necessary. The knee is the most common joint needing replacement surgery due to gout.
Several options can help you prevent a future flare-up.
Some of these strategies aim to prevent the buildup of uric acid in your bloodstream and include:
Avoiding alcohol: Alcohol limits your body’s ability to excrete uric acid from the kidneys, increasing your risk of hyperuricemia.
Maintaining a healthy weight: Exercising and following a healthy diet can help reduce your risk of gout.
Drink plenty of water: Keeping your kidneys healthy will prevent them from losing efficiency.
Summary
Gout is a common type of inflammatory arthritis that can affect your knees. Symptoms can often worsen due to sudden and severe flare-ups.
You can experience gout in your knee due to crystals building up between the bone and cartilage. These crystals result in pain and swelling in both the knee and the surrounding area.
If you experience gout symptoms, consider speaking with a healthcare professional who can suggest treatment options to help manage symptoms and prevent further flare-ups.
