Why does it still hurt when my uric acid level is normal?

Uric acid is a product of the body's normal metabolism and is excreted from the body mixed with other fluids. However, the uric acid content should be controlled within a certain range. High uric acid levels can cause metabolic disorders in the body and lead to complications. For some people, uric acid levels return to normal through treatment. But the body still feels uncomfortable, which has a lot to do with the sequelae of high uric acid. Let us learn about it.

Hyperuricemia and gout definition

Hyperuricemia - When the blood uric acid concentration exceeds the upper limit of the normal range, it is called hyperuricemia. The commonly used nodes in clinical practice are uric acid levels exceeding 420 μmol/L in men and uric acid levels exceeding 360 μmol/L in women.

Gout – When hyperuricemia causes acute arthritis attacks, tophi formation, and changes in joints and kidneys, it is called gout. Usually, hyperuricemia alone or hyperuricemia combined with kidney stones does not fall into the category of gout. To put it simply, the mere discovery of elevated blood uric acid levels cannot be called gout, it can only be called hyperuricemia. It is only when joint pain caused by elevated blood uric acid levels occurs that it is called gout.

Why does gout cause joint pain?

Not all cases of hyperuricemia will develop into gout. Some patients with hyperuricemia may not develop gouty arthritis throughout their lives. Why do I experience joint pain during a gout attack? First, why do we feel pain? This is because under certain conditions, uric acid in the blood precipitates and deposits in the joints, forming crystals. Uric acid crystals are "foreign bodies". Our joints should not have these crystals. These crystals are "foreign bodies" to our human body, so the human body sends out "soldiers" - white blood cells to eliminate these "foreign bodies".

The white blood cells that eliminate "foreign bodies" release inflammatory factors. During the battle, the white blood cells will release some inflammatory factors (such as leukotrienes, bradykinin, etc.), and these substances will make the human body feel pain. Therefore, the pain is not only caused by the increase of uric acid in the blood, but also by the deposition of uric acid crystals in the joints due to various reasons.

1. Hyperuricemia state. For example, there is a glass of water on the table, and we throw a handful of salt into it. At this time, the salt dissolves and the salt content in the water is high. For us, this is a state of hyperuricemia.

2. Uric acid crystals appear as we continue to add salt into the water, and eventually the salt content far exceeds the solubility of water. The salt can no longer dissolve and precipitates from the water, just like the uric acid crystals appearing in our body, causing gout attacks.

3. Temperature changes, solubility changes. However, there is another situation. When water can still dissolve salt, we put this cup of water in a low temperature place. The solubility of salt in water changes due to the change in temperature, and it will precipitate out of the water.

This is just like when certain factors (such as cold, cold, local sprain, excessive fatigue, infection, etc.) cause uric acid in the blood to precipitate and form crystals that are deposited in the joint cavity, which can also cause pain. However, at this time, our blood uric acid test may not show a significant increase, or may even be normal, because part of the uric acid has already precipitated from the blood and turned into crystals deposited in the joint cavity. This is the answer to the question we asked at the beginning.