Question:
Hi
New member here, can anyone give me some advise on treating a client with gout? I am about half way through my trainging and I want to treat my father but he has gout in his big toe (left foot), can you give me any advise on what kind of treatment I should give him and how often.
Thanks
Hi,
Gout is not something you can easily treat physically. The only two topical therapies that help are warm foot baths and gental skin brushing.
Gout is caused by an excess of Uric acid in the bloodstream. The uric acid can christalise to form monosodium urate christals, just where you don't want them, but normally in the big toe joint. The excess uric acid can come from 3 sources: hereditary predisposition, inhibition of excretion by kidneys, excess purines in the diet. You cannot do much about the first, the second is usually caused by excess alcohol, the third is often caused by beer, which has an exceptionally high purine content. Protein containing foods contain purines, but you have to eat them. Beef and chicken are better than pork and lamb. Liver, pulses and lentils also contain purines, but you can find lists of the foods to avoid on the net.
Historically gout was caused by port or porter. Port was once contaminated by storage in lead lined casks. Lead can bring on the condition. Porter is beer we know as guiness, high in purines. Many people think that red wine brings on gout (due to the confusion of it being port-like), but in fact it contains stuff that helps (but don't drink too much because of the negative effects of the alcohol). Other dietary helpers are water (drink lots), fresh lemon juice (3 lemons/day) but use juice of 1 lemon with 1pint of water or it will take the enamel of your teeth, potatoes and berry juice (especially cherries).
Herbal helpers in order of importance: Pycnogenol, Quercitin, Ruthin, potassium citrate, bromelain, vitamin C, celery seed & grape seed extract. You can get most of these at a healthfood shop.
The symptoms of gout (swelling, inflamation and pain) are brought on because the body detects the christals and thinks that they are invaders and so mounts an immune response. Acute conditions like that are probably best treated by the doctor. The initial treatment is usually with Naproxen which is often very effective.If it keeps reoccuring, or you are suffering from continued small depostions of chistals called tophi, the doctor will give you allopurinol, which is effective at keeping gout at bay (but has side-effects).
It is important to tackle gout, because excess uric acid can cause the development of kidney stones. For an accute attack see the doctor, for ongoing management seek dietary improvements as autlined above and herbal helpers,
Cheers,
Nick
.
I have treated an elderly lady who suffered from gout.
She had 6 treatments with me and the pain she experienced with the gout lessened considerably.
I noticed that she seemed to suffer from loss of sensation in her feet and would often ask for more pressure, which I simply wasn't comfortable to do, cause I felt it was inappropriate and didn't want to risk causing her pain, a lighter treatment can be just as effective as a deeper one if applied correctly.
As we were treating the gout itself as one of our primary objectives, I included a lot of mobilisation and massage and a slightly shorter reflexology treatment overall. The massage is good for loosening up tight muscles and really helps relieve the tension and pain gout sufferers experience. If you've been taught diaphragm rocking it's a technique I use a lot with people who have gout and arthritis cause it frees up tension so quickly and can be quite gentle too.
After her first treatment she said she felt a bit achy, but as the next treatments went on she really started to feel the benefits, she had permanent aching in her feet and this subsided, also pain when she stood which was greatly reduced. The improvements were also visual - her toes were very stiff and bent up and they were much more relaxed when she stood.
I would personally advise weekly treatments, more regular if you can, focussing on the massage and see how he goes. Use as many mobilisation strokes as you know, toes circles aren't bad either. Make it quite light and I would probably just do a massage and walk the zones for the first treatment, and then assess how he got on with that and makw the next ones a bit longer and in depth.
Apologies if this is a bit garbled, if you need me to expain any more let me know.
Don't be afraid to treat him, when you are studying it's the best time to experiment, you have the support of your tutor and if you go to them with a treatment concept and ask their advise, they will normally let you know if your plan sounds feasible. You wont harm him, you might just make him feel a bit better. :)
Hi,
Just to comment that the christals are there in the joint no matter what. It is feasible that massage can make them disolve and be taken up by the lymph system. This is more likely to happen at higher temperatures when christals dissolve more easily. Long term management must address the issue of excessive serum uric acid, which is usually postprandial.
Cheers,
Nick
Thanks for that Info Nick
Very thouragh - I will print a copy of it a give to my dad
My dad also suffers from gout but he just loves his Guiness - but hes not an excessive drinker or anything
As an occassional gout sufferer I offer some comments from the victims side of the fence.
Untreated it can be agony with extreme swelling in the worst cases
I (of course) went to my GPabout it long ago, and he prescrbed me some pills (indomethicin I think - from memory). Catch the attack early and they kill it immediately.
More recently I was chatting to a firend who had become a recent sufferer.and he had been recomended (by whom I know not) one of these magnetic bracelets and was swearing by its efficacy - butI think you do have to wear it all the time.
Hi,
I discovered all the things about gout when I first started to suffer. I have only had the one attack and manage to keep it a bay whilst still drinking a moderate amount of beer. The factors that I think have been the most effective are:
1. Avoid eating too much protein. The max amount needed by a human is probably about 70 gms. 1 oz of meat or cheese has about 7 gms of protein, but you find protein in lots of food in lesser amounts, even bread and potatoes. Protein is used to support growth and repair, it is only the excess protein that is metabolised to produce uric acid. Most people over-eat protein, so keep it moderate and supply only what your body needs.
2. Keep fluid intake high. Your kidneys are responsible for extracting uric acid from the blood and discarding it in urine. The more fluid you drink, the more urine you generate, the more likely you are to flush out the unwanted uric acid. Try drinking plain spring (not mineral) water rather than tap water. All fluids count, but water and dilute lemon juice help the most. Tea and coffee are diuretics, so they will help to get the kidneys "going".
3. Use sea salt in moderation. Sea salt contains all the minerals from the sea and is beneficial to the body. The normal table salt not only does not contain all these extra minerals, it contains residual contaminants from its processing and so is bad for you. Monosodium urate needs sodium (from salt) to form, so be careful how muchyou eat. Unless you sweat profusely or live or work in very hot conditions you only need about 6 gm/day. The most likely sources of unwanted excess are processed foods.
4. I recently discovered that potatoes contain substances that help keep uric acid levels down. Use plain boiled new potatoes and retain the water for gravy or soup.
5. Beer and especially Guiness contains nutrients, but red wine contains even more and things that help releave gout - so less beer and more wine. It is believed that moderate drinking has greater health benefits than no drinking. It is not known whether it is actually the alcohol that does this or just experiencing a more relaxed convivial atmosphere on a regular basis. Aguide to sensible drinking can be found at
The Australian guidelines are most in line with published research. The two days "off" are very important becausethey allow the liver to recover. The days should be consecutive. Note that research is always done using a "drink" as a standard measure. This is 12 fl oz for beer. So 4 drinks is 48 fl oz. An "English" "pint", you might think is 20 fl oz, but in fact it is 19.2. Take off1 fl oz for the standard English head and it is nearer 18. So surprisingly, 4 drinks lies equivalent to somewhere between 2.5 and 3 English (4%) pints.
Cheers,
Nick
New member here, can anyone give me some advise on treating a client with gout? I am about half way through my trainging and I want to treat my father but he has gout in his big toe (left foot), can you give me any advise on what kind of treatment I should give him and how often.
Thanks
Answers:
Hi,
Gout is not something you can easily treat physically. The only two topical therapies that help are warm foot baths and gental skin brushing.
Gout is caused by an excess of Uric acid in the bloodstream. The uric acid can christalise to form monosodium urate christals, just where you don't want them, but normally in the big toe joint. The excess uric acid can come from 3 sources: hereditary predisposition, inhibition of excretion by kidneys, excess purines in the diet. You cannot do much about the first, the second is usually caused by excess alcohol, the third is often caused by beer, which has an exceptionally high purine content. Protein containing foods contain purines, but you have to eat them. Beef and chicken are better than pork and lamb. Liver, pulses and lentils also contain purines, but you can find lists of the foods to avoid on the net.
Historically gout was caused by port or porter. Port was once contaminated by storage in lead lined casks. Lead can bring on the condition. Porter is beer we know as guiness, high in purines. Many people think that red wine brings on gout (due to the confusion of it being port-like), but in fact it contains stuff that helps (but don't drink too much because of the negative effects of the alcohol). Other dietary helpers are water (drink lots), fresh lemon juice (3 lemons/day) but use juice of 1 lemon with 1pint of water or it will take the enamel of your teeth, potatoes and berry juice (especially cherries).
Herbal helpers in order of importance: Pycnogenol, Quercitin, Ruthin, potassium citrate, bromelain, vitamin C, celery seed & grape seed extract. You can get most of these at a healthfood shop.
The symptoms of gout (swelling, inflamation and pain) are brought on because the body detects the christals and thinks that they are invaders and so mounts an immune response. Acute conditions like that are probably best treated by the doctor. The initial treatment is usually with Naproxen which is often very effective.If it keeps reoccuring, or you are suffering from continued small depostions of chistals called tophi, the doctor will give you allopurinol, which is effective at keeping gout at bay (but has side-effects).
It is important to tackle gout, because excess uric acid can cause the development of kidney stones. For an accute attack see the doctor, for ongoing management seek dietary improvements as autlined above and herbal helpers,
Cheers,
Nick
.
Answers:
I have treated an elderly lady who suffered from gout.
She had 6 treatments with me and the pain she experienced with the gout lessened considerably.
I noticed that she seemed to suffer from loss of sensation in her feet and would often ask for more pressure, which I simply wasn't comfortable to do, cause I felt it was inappropriate and didn't want to risk causing her pain, a lighter treatment can be just as effective as a deeper one if applied correctly.
As we were treating the gout itself as one of our primary objectives, I included a lot of mobilisation and massage and a slightly shorter reflexology treatment overall. The massage is good for loosening up tight muscles and really helps relieve the tension and pain gout sufferers experience. If you've been taught diaphragm rocking it's a technique I use a lot with people who have gout and arthritis cause it frees up tension so quickly and can be quite gentle too.
After her first treatment she said she felt a bit achy, but as the next treatments went on she really started to feel the benefits, she had permanent aching in her feet and this subsided, also pain when she stood which was greatly reduced. The improvements were also visual - her toes were very stiff and bent up and they were much more relaxed when she stood.
I would personally advise weekly treatments, more regular if you can, focussing on the massage and see how he goes. Use as many mobilisation strokes as you know, toes circles aren't bad either. Make it quite light and I would probably just do a massage and walk the zones for the first treatment, and then assess how he got on with that and makw the next ones a bit longer and in depth.
Apologies if this is a bit garbled, if you need me to expain any more let me know.
Don't be afraid to treat him, when you are studying it's the best time to experiment, you have the support of your tutor and if you go to them with a treatment concept and ask their advise, they will normally let you know if your plan sounds feasible. You wont harm him, you might just make him feel a bit better. :)
Answers:
Hi,
Just to comment that the christals are there in the joint no matter what. It is feasible that massage can make them disolve and be taken up by the lymph system. This is more likely to happen at higher temperatures when christals dissolve more easily. Long term management must address the issue of excessive serum uric acid, which is usually postprandial.
Cheers,
Nick
Answers:
Thanks for that Info Nick
Very thouragh - I will print a copy of it a give to my dad
My dad also suffers from gout but he just loves his Guiness - but hes not an excessive drinker or anything
Answers:
As an occassional gout sufferer I offer some comments from the victims side of the fence.
Untreated it can be agony with extreme swelling in the worst cases
I (of course) went to my GPabout it long ago, and he prescrbed me some pills (indomethicin I think - from memory). Catch the attack early and they kill it immediately.
More recently I was chatting to a firend who had become a recent sufferer.and he had been recomended (by whom I know not) one of these magnetic bracelets and was swearing by its efficacy - butI think you do have to wear it all the time.
Answers:
Hi,
I discovered all the things about gout when I first started to suffer. I have only had the one attack and manage to keep it a bay whilst still drinking a moderate amount of beer. The factors that I think have been the most effective are:
1. Avoid eating too much protein. The max amount needed by a human is probably about 70 gms. 1 oz of meat or cheese has about 7 gms of protein, but you find protein in lots of food in lesser amounts, even bread and potatoes. Protein is used to support growth and repair, it is only the excess protein that is metabolised to produce uric acid. Most people over-eat protein, so keep it moderate and supply only what your body needs.
2. Keep fluid intake high. Your kidneys are responsible for extracting uric acid from the blood and discarding it in urine. The more fluid you drink, the more urine you generate, the more likely you are to flush out the unwanted uric acid. Try drinking plain spring (not mineral) water rather than tap water. All fluids count, but water and dilute lemon juice help the most. Tea and coffee are diuretics, so they will help to get the kidneys "going".
3. Use sea salt in moderation. Sea salt contains all the minerals from the sea and is beneficial to the body. The normal table salt not only does not contain all these extra minerals, it contains residual contaminants from its processing and so is bad for you. Monosodium urate needs sodium (from salt) to form, so be careful how muchyou eat. Unless you sweat profusely or live or work in very hot conditions you only need about 6 gm/day. The most likely sources of unwanted excess are processed foods.
4. I recently discovered that potatoes contain substances that help keep uric acid levels down. Use plain boiled new potatoes and retain the water for gravy or soup.
5. Beer and especially Guiness contains nutrients, but red wine contains even more and things that help releave gout - so less beer and more wine. It is believed that moderate drinking has greater health benefits than no drinking. It is not known whether it is actually the alcohol that does this or just experiencing a more relaxed convivial atmosphere on a regular basis. Aguide to sensible drinking can be found at
The Australian guidelines are most in line with published research. The two days "off" are very important becausethey allow the liver to recover. The days should be consecutive. Note that research is always done using a "drink" as a standard measure. This is 12 fl oz for beer. So 4 drinks is 48 fl oz. An "English" "pint", you might think is 20 fl oz, but in fact it is 19.2. Take off1 fl oz for the standard English head and it is nearer 18. So surprisingly, 4 drinks lies equivalent to somewhere between 2.5 and 3 English (4%) pints.
Cheers,
Nick
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