Joint pain is often directly associated with gout. However, not all joint pain is caused by the same condition. Many people still find it difficult to differentiate between gout and rheumatism because both cause joint symptoms such as pain, swelling, and impaired movement.
In fact, gout and rheumatism are two distinct conditions, differing in their causes, symptoms, and treatment. Misunderstanding these conditions can lead to inappropriate treatment and increase the risk of long-term joint damage.
Therefore, understanding the difference between gout and rheumatism is an important step so that the treatment given is appropriate to the cause of the disease.
Gout and Rheumatism: What's the Difference?
Although they both attack the joints, gout and rheumatism have different disease mechanisms.
Gout is a joint inflammation caused by the accumulation of monosodium urate crystals in the joints. This condition occurs when uric acid levels in the blood become too high, forming crystals that trigger inflammation and severe pain.
Meanwhile, rheumatism, often referred to as rheumatoid arthritis , is an autoimmune disease. In this condition, the immune system mistakenly attacks healthy joint tissue, causing chronic inflammation.
Another fundamental difference is the pattern of symptom onset. Gout often appears suddenly and abruptly, while rheumatism develops slowly and can persist for a long time.
The causes of gout and rheumatism are different.
Causes of Gout
Gout occurs when the body produces too much uric acid or the kidneys are unable to remove it properly. As a result, uric acid levels in the blood rise and form crystals in the joints.
Some things that can increase the risk of gout are:
- Foods that contain high levels of purine, such as offal, red meat, and seafood
- Obesity or overweight
- Diabetes mellitus
- Hypertension
- Consumption of alcoholic beverages
- Not drinking enough water
- Use of certain medications, such as diuretics
Causes of Rheumatism
Rheumatoid arthritis is caused by an autoimmune disorder that causes the immune system to attack the lining of the joints ( synovium ). Continuous inflammation can damage cartilage, bone, and other joint structures.
Some factors known to be associated with an increased risk of rheumatism include:
- Genetic factors or family history
- Smoking habit
- Exposure to certain infections
- Hormonal changes
- Female gender has a higher risk than male gender
Symptoms of Gout and Rheumatism Are Often Confused
The difference in symptoms is the easiest way to understand the difference between gout and rheumatism. Although both cause joint pain, the characteristics of the symptoms differ.
Symptoms of Gout
Gout attacks usually appear suddenly and often occur at night.
Some of the symptoms include:
- Sudden joint pain
- Joints feel hot, red and swollen
- Most often attacks the big toe joint
- Attacks the ankles, hands, knees or elbows
- Attacks may recur
- In chronic conditions, uric acid crystal lumps called tophi can form.
Rheumatic Symptoms
Rheumatic symptoms generally develop slowly and last for a long time.
Symptoms include:
- Chronic pain and stiffness in the joints
- Joint stiffness especially in the morning
- Often attacks both sides of the body
- Easily tired and feeling powerless
- There is a risk of causing changes in shape or deformity of the joints if not treated properly.
Treatment for gout and rheumatism must be adjusted accordingly.
Because the causes are different, the treatment for gout and rheumatism is also not the same.
Gout Treatment
The main goal of gout therapy is to reduce inflammation during an attack and lower uric acid levels to prevent recurrence.
Doctors can provide:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Colchicine
- Corticosteroids in certain conditions
- Uric acid lowering drugs (allopurinol or febuxostat)
In addition, patients are also advised to regulate their diet and avoid foods high in purines.
Rheumatism Treatment
Rheumatism treatment aims to control the activity of the immune system and prevent further joint damage.
Commonly used therapy options include:
- Disease-Modifying Antirheumatic Drugs (DMARDs)
- Corticosteroids
- Biological therapy according to doctor's indications
- Physiotherapy and joint exercises
- Lifestyle changes to maintain joint function
Rheumatism treatment usually requires long-term monitoring by an internist or rheumatologist.
How to Keep Joints Healthy
Maintaining joint health is important to help reduce the risk of joint disorders, including gout and rheumatism.
Some steps that can be taken include:
- Limiting foods high in purines helps reduce the risk of gout attacks.
- Maintaining an ideal body weight can reduce pressure on joints.
- Light physical activity such as walking or swimming can help maintain joint flexibility.
- Quitting smoking and getting enough sleep helps reduce the risk of chronic inflammation.
- Regular health check-ups are important to detect joint disorders early.
When Should Gout and Rheumatism Sufferers See a Doctor Immediately?
Joint pain should not be taken lightly, especially if the complaint continues to recur or gets worse.
See a doctor if you experience the following conditions:
- Joint pain appears suddenly and is so severe that it interferes with daily activities.
- The joint appears swollen, red, or feels hot.
- Complaints do not improve within a few days.
- Joint stiffness occurs every morning and lasts for a long time.
- Joint pain accompanied by fever or prolonged fatigue.
- There is a change in the shape of the joint.
A medical examination is essential to determine the cause of joint pain and determine the most appropriate treatment. With a correct diagnosis, the risk of complications and long-term joint damage can be minimized.
The article was written by Dr. Andrian Setiabakti, BMedSci (Hons), Sp.PD (Internal Medicine Specialist at EMC Alam Sutera Hospital).