High Uric Acid levels ! Is there something to worry about ?

Uric acid is produced naturally by the body as a result of metabolism. Our kidneys filter and throw out uric acid normally.

In some cases, the body produces more uric acid than it can excrete or the kidneys are not able to excrete uric acid being produced, it leads to a rise of uric acid levels and leads to a condition called hyperuricemia.

Hyperuricemia is defined as an excess of uric acid in the bloodstream. If your uric acid is in excess of 7 mg/dL – you may have hyperuricemia.

Hyperuricemia has a few major health effects. They are as follows :


Gout : It is defined as a type of arthritis that causes inflammation in the smaller bones of the joints. Typically, chalky deposits of uric acid called “tophi” deposit as lumps under the skin causing severe pain and redness specially in the base of the big toe over a long period of time. This tophaceous gout compresses the nerves and is visible to the naked eye – making it disfiguring and making the pain worse. Gout, is characterised by episodes of intense pain. Sometimes uric acid crystals start to deposit in other joints such as elbow, knee, fingers, hand etc and may also damage surrounding cartilege.
Though extremely rare, sometimes, due to damage of the cartilage a joint replacement surgery such as total knee replacement may be required.

Doctors very rarely let patients come to this stage though and prescribe medication to take care of the pain and to shrink the uric acid crystals.

Incase Tophi or the uric acid crystals become too large or become infected, a surgery though rare, may be needed to remove crystals.

Large Tophi may also affect the range of movement of the joint such as hand or knee and a simple surgery may be required.

Kidney Stones : Kidney stones are defined as a hard mass formed in the kidneys due to insoluble calcium compounds. Initially, the kidney stones are small and pass out with the urine; however, over time the kidney stones become larger and block the urinary tract causing a difficulty in the passing of urine and urinary tract infections due to the buildup of bacteria in the tract. A high level of Uric acid is also a predictor and indicate’s renal dysfunction well in advance before the dialysis stage or the kidney transplant stage .
In patient’s with Rheumatoid arthritis or RA, high uric acid levels, call for a visit to the doctor.

Possible surgeries and procedure to take care of kidney stones are SWL(Shockwave lithotripsy), Ureteroscopy, PCNL(Percutaneous Nephrolithotomy ).

PCNL is best for treatment of medium to large stones , for complex stones or if there are too many stones in one kidney and needs a good, trained urologist.

Ureteroscopy is slightly more invasive than Shockwave lithotripsy but is good for stones which are very small and also way down in the urinary tract.

The best way to take care of gout related problems is to prevent hyperuricemia.

The following natural remedies are easy to implement and help prevent hyperuricemia :
Lemon Juice : Lemon is a natural antioxidant and contrary to popular belief, helps neutralise the uric acid in the body. A glass of lukewarm lemon juice water in the mornings before breakfast may go a long way in preventing uric acid buildup.
Apple Vinegar : Vinegar contains malic acid that helps to breakdown uric acid and make the solution alkaline. A glass of water with 2 tablespoons of apple vinegar has anti – inflammatory benefits.
Water : It is supposed to flush out toxins from the body and regulate kidney function. 8-10 glasses of water a day help dilute uric acid in the body and help excrete out the same from the body. Additionally, care should be taken to include water rich fruits such as watermelon and vegetables such as cucumber in ones diet.
Berries : Cherries and other purple or blue coloured berries contain anthocyanin that have anti- inflammatory and anti- oxidant properties and that help lower uric acid in the body. A bowl of cherries a day greatly reduces the risk of hyperuricemia.
These natural remedies are suggested to be followed post a doctor consultation and are by no means an alternative to prescription medication which is critical for treatment of gout.

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Does your X -ray look like this ?

Degenerative joint disease or degenerative arthritis, leads to breaking down of cartilage causing pain, swelling and problems with joint movement and bones  rubbing against each other.

The most common chronic conditions affecting  the joints is Osteoarthritis, ( OA) , Rheumatoid Arthritis ( RA) and Gout.

Osteoarthritis  commonly affects knees, hips, small joints off the fingers, big toe, thumb and also the lower back and sometimes even neck.

Cartilage a smooth, rubbery material covers the end of each bone and helps in smooth joint movement and acts as a cushion between bones  in normal joints.  If the cartilage breaks down, joint movement gets affected. As arthritis worsens over time,  small growths called spurs may develop on the bones.  Small bits and pieces of bones and cartilage often chip off and and float around in the joint.   Due to inflammation, cytokines (proteins) and enzymes develop in the body that further damage the cartilage.

As Osteoarthritis progresses, the cartilage wears away and bone knock and rub against each other  leading to more  joint damage, excrutiating pain.

There is no cure for Osteoarthritis but medical management along with moderate exercise ( atleast 30 minutes, with stretches to help joint mobility and flexibility)  and weight reduction, may help in managing pain, stiffness, swelling and in improving joint mobility..

Osteoarthritis largely affects people over 65 though even younger people, teenagers also get affected.

 OTC pain relievers, NSAID’s (non steroidal  anti -inflammatory drugs) , corticosteroids (oral or injections)  and Hyaluronic acid injections are the various treatment options which provide relief. Surgery or joint replacement such as total knee replacement, hip replacement can replace severely damaged knees and hip joints.

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Knee Pain- When to consider Knee Replacement as an option

Knee Pain, Knee Replacement Surgery Cost In IndiaCauses of Knee Pain

Knee Pain is caused by either knee injury or degenerative arthritis which affects middle aged and older people such as Osteoarthritis or Rheumatoid Arthritis.

Arthritis can affect walking, sitting, climbing and even lying down and affects the quality of life.

If the pain is debilitating, surgery can bring relief , however the following options must be considered before option for surgery

Oral Pain Relief Medication and Topical Ointments– OTC pain medication such as Advil, Ibuprofen, Tylenol, Paracetamol  can help with pain relief for some time. Topical Ointments may also provide short term pain relief.

Corticosteroid injections- Especially hyaluronic acid boost the natural joint fluid  which helps in movement of knees. Affect of cortisone shots may last upto 6 months or a bit more.

Weight loss– Incase you are obese, weight loss can take pressure off the knees and offer relief.

Regular Exercise- helps with muscle strengthening. Our muscles support our knees and strong muscles help with easier movements.

Arthroscopic surgery– A surgeon inserts an endoscope and  flushes the knee and removes cartilage, loose bones etc which maybe causing pain. Recovery is quick and the surgery may delay a  total knee replacement surgery.

Knee Replacement Surgery– During a knee replacement surgery, the damaged knee joint is replaced partially or completely with a new plastic or metal joint.

Although complete recovery and natural movement takes some time, relief lasts often of several years.

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Osteoarthritis: Is Knee replacement surgery a good option?

What is Osteoarthritis?

As a person grows old, his or her bones grow old as well. The advancing years take a toll on the bones, especially the knees. It is quite natural as we age to have an odd creaking knee. This is because the lubricating fluid that helps the proper functioning of the knee joint dries up causing the bones to clash against each other. This could cause the chipping of the bones in the knee joint causing excruciating pain to the person. This degeneration of the knee joint is known as ‘Osteoarthritis’.

 Total Knee Replacement
Osteoarthritis, leading to Knee Replacement

What causes Osteoarthritis?

 Old age is a primary cause of osteoarthritis. Obesity is also a cause as the knee joints gets affected due to heavy loadand have to work harder thereby causing the fluid to dry up earlier resulting in Osteoarthritis.

It is not that Osteoarthritis affects the knees alone. It can affect other areas of the body as well such as the fingers, lower back, and the hips as well. However,  most  knee problems  happen due to OA  than the other forms of Osteoarthritis.

OA also affects people who have one leg of a different length from the other. This is because of the extra effort , exerted on one leg causing the knee joint to degenerate faster.

How does Osteoarthritis affect us?

 As Osteoarthritis progresses, it means have to endure tremendous pain. Completing easy tasks such as climbing stairs would be difficult. In fact, climbing onto your bed would be a tough task. The most common method of treatment people adopt is the use of painkillers. Painkillers can relieve the problem for a while. However, they can offer temporary relief alone. In addition, the painkillers can cause a host of other problems as well such as acidity, etc, they can cause problems to your digestive system and thus affect your kidneys as well.

Hence, the need of the hour would be to adopt a permanent kind of a treatment such as a knee replacement surgery. You can try out alternate methods of treatment as well such as injections which offer temporary relief but  for complete relief,  bilateral knee replacement or total knee replacement or a unilateral or single knee replacement may be the only option.

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