Reply To: Getting mobile fast during an acute flare.

Stopping Gout Together Forums Help My Gout! The Gout Forum Getting mobile fast during an acute flare. Reply To: Getting mobile fast during an acute flare.

Keith Taylor

“I’d be interesting in knowing the opinion of your current rheuma.”
So would I. But, I’m looking for a specific opinion on whether mobility helps inflammation or not.

To explain, I’ve caused confusion between:

-habitual exercise (that is, when you’re NOT having an acute attack… and I do mean “acute” as opposed to whatever you might have that lasts for months)
-exercise during an attack
-weight-bearing exercise involving a joint affected by an attack

I believe habitual exercise is a separate topic. Specifically: “But, please note this is not about the general benefits of exercise for gout sufferers. Because I should already have explained that at Gout & Exercise.”

But, I do think I could have been clearer about the other points.

To explain, I do not want to encourage gout sufferers to risk further damage to joints that have already been weakened through gout. So, if you suspect this is the case, you should get imaging tests immediately. Certainly, standard X-rays and ultrasound are useful. But, if funding is available, then CAT scans or MRI scans reveal a better picture.

As an aside, let’s look at that damage for a moment. Because uric acid crystals cannot cause “mechanical damage” in the way I understand the meaning. Uric acid crystals cause tendinitis, osteoarthritis, and other damage through the immune response system. That is to say, when white blood cells (WBCs) attack uric acid crystals, all hell breaks loose. Because our bodies rely on many different types of WBCs. Some of which were destined to repair bone, cartilage, etc.

So, there is no mechanical wearing down of joints. But, lack of maintenance because the janitors have been sacrificed to battle.

I think that this is a separate topic. Unless forced mobility of inflamed joints increases the chances of more specialist WBCs being sacrificed. Which means we have one meaningful question to ask a rheumatologist:

“Is there any evidence to support the notion that osteoblasts, tenocytes, and other specialized cells are at risk if mobility is increased during periods of inflammation”

Finally, I return to my suggestion that mobility can reduce the duration of inflammation where there is no indication of joint damage. So, my second question for d_q’s rheumy is:
“Please can you explain Pinto’s reasons for recommending “sit less and move more”, particularly light-intensity activities and/or breaking-up sedentary time.”

Because that is key to understanding mobility during gout attacks.

Of course, the real issue remains to get uric acid controlled. Then, gout stops and none of this matters. But like d_q, I love a good debate. Which is why I proposed the Mass Debating Society in high school. 😉