Thermal Treatment for Gouty Arthritis

Gouty arthritis is a rheumatological disease that can affect the musculoskeletal system as a whole, primarily involving the joints, but it can also have systemic repercussions on various organs, especially when associated with other pathologies such as obesity or high blood pressure.

It becomes well-known when an acute crisis arises, popularly referred to as "gout," which results from the accumulation of uric acid crystals in joint tissues. "Gout" can occur when there is low elimination of uric acid by the kidneys or when our body produces too much uric acid, a clinical condition known as hyperuricemia.

Hyperuricemia can be caused by ingesting foods with high levels of purines (chemical compounds that form uric acid when metabolized).

however, most uric acid in the blood does not come from the diet. For unknown reasons, not everyone with abnormally high levels of uric acid in the blood (hyperuricemia) develops gout.

Gout most frequently affects the joints of the feet, especially the base of the hallux (the "big toe"), causing pain of varying intensity, edema (swelling), rubor (redness), fatigue, and stiffness, with limited movement.

However, it can affect other areas: ankles, the dorsum of the feet, knees, wrists, and elbows. Gout tends to affect these cooler areas since uric acid crystals form more quickly in cold environments than in warm ones. Gout rarely affects joints in the warmer, central parts of the body, such as the spine, hips, or shoulders.

Diagnosis and treatment for gouty arthritis

A timely and accurate diagnosis is essential to implement appropriate treatment, control disease progression, prevent complications, relieve symptoms (especially during an acute gout attack), and improve the patients' quality of life.

The ideal approach is to maintain healthy lifestyle habits, avoiding excessive consumption of purine-rich foods (red meat, seafood, alcoholic beverages, especially beer, and soft drinks), drinking plenty of water, and practicing physical exercise. This also aims to prevent obesity or excess weight, diabetes, and high cholesterol, which can increase the risk of triggering a gout attack.

The lack of chronic treatment can lead to tophaceous gout (crystal nodules in the skin/joints), joint deformities, bone lesions, and kidney stones.

Following diagnosis, your attending physician should start treatment as quickly as possible. Treatments exist that are capable of slowing disease progression and attenuating symptoms, namely pharmacological therapy (medication), even though it may have some side effects.

Thermal treatment is an excellent complementary or alternative option to medication, offering several advantages and benefits for patients, as explained throughout this article.

How does thermal treatment work for gouty arthritis?

Thermal water, particularly that of Termas de Chaves, contains specific therapeutic minerals in its composition with proven benefits in treating various pathologies, including rheumatological ones.

Thermalism uses thermal water at a high temperature (warmer water than usual, between 34ºC and 38ºC) to relax muscles and raise the temperature of the joints submerged in it, producing an anti-inflammatory effect.

Immersion in thermal water causes vasodilation (dilation of blood vessels in the affected areas), which increases the flow of oxygen and nutrients to the muscles and joints, helping to reduce pain and discomfort.

Hydrotherapy is frequently recommended in cases of rheumatic diseases since it allows the patient to practice physical exercise safely and with greater ease. Body immersion in water reduces weight and pressure on the joints, facilitating movement and promoting muscle relaxation.

Is there scientific evidence that thermal treatment is effective?

Yes. Several randomized clinical trials have demonstrated that thermal treatment is effective in various rheumatological diseases. Results may vary depending on the specific pathology, the severity of the disease, the individual characteristics of each person, the type of thermal treatment performed, and the specific properties of the waters used.

Thermal treatment has numerous benefits and allows for the treatment of rheumatological diseases in a more natural way, requiring fewer pharmaceuticals.

Hot, mineral-rich thermal waters, such as those at Termas de Chaves, are particularly indicated for rheumatological diseases like gouty arthritis, as they naturally reduce joint inflammation and alleviate pain in the affected areas.

The combination of different therapeutic methods can also contribute to better results. For instance, the association of hydrotherapy with Physical Medicine and Rehabilitation techniques (physiotherapy), among others, tends to provide more long-lasting and effective results.

Benefits of thermalism in gouty arthritis

Thermal treatment provides multiple benefits and allows for a natural approach to rheumatological diseases, relying on fewer pharmaceuticals (medication).

The thermal water of Termas de Chaves, with its specific hyperthermal and hypermineralized characteristics, contributes to relieving the symptoms of these diseases, reducing joint inflammation and attenuating pain in the affected areas.

Other advantages and benefits related to thermalism in the treatment of rheumatological diseases include:

• Relaxation of muscles and joints;

• Improvement of joint mobility, thereby increasing flexibility in the affected areas;

• Better sleep quality;

• Improvement in the patient's overall quality of life.

What should I know before starting the treatment?

As this is a chronic disease, this pathology requires regular medical follow-up throughout the patient's life. It is fundamental to seek medical advice before starting a thermal treatment and to maintain follow-up consultations with your attending physician.

In most situations, thermal treatment reveals greater efficacy when performed regularly and for prolonged periods, which contributes to slowing disease progression and improving the patient's general well-being.

Following an evaluation during a consultation, the hydrologist physician will define an appropriate thermal treatment plan, which can be combined with other therapies to enhance the results. The success of the treatment varies from person to person and depends on the type and severity of the disease, as well as the characteristics of the thermal water and the techniques applied.

Finally, it is worth highlighting that hot and hypermineralized thermal waters, such as those at Termas de Chaves, remain the most indicated for rheumatological pathologies like gouty arthritis.

This article was originally published in Saúde e Bem-Estar - www.saudebemestar.pt and written in partnership with Termas de Chaves.