Gout is a type of inflammatory arthritis which inflames the joints – this is caused by an excess of uric acid in the blood, which forms crystals at the joints. Gout can be severely disabling and it affects around 1% of the UK population, the majority of whom are male.
What are the signs and symptoms of gout?
The uric acid build-up causes joints to swell and become painful, often suddenly. The skin at the affected joint or joints – commonly the big toe, fingers, wrists, elbows or knees – can also become hot and red.
Symptoms can recur every few months or years, even if treated.
How is gout diagnosed and treated?
A GP will ask questions about someone’s diet, including whether they drink beer and spirits, to determine whether their swollen joints are caused by gout specifically, as opposed to another condition or another type of arthritis.
A blood test or a sample of fluid from the affected joint can determine whether there is an excess of uric acid in the blood which will be causing the joint pain.
Painkillers, such as ibuprofen, can help alleviate the pain at the joints. If this is ineffective, steroid injections may be administered.
Self-treatment may also include:
- Maintaining a healthy weight to reduce undue pressure on joints.
- Resting the limb and keeping it cold – with a cold pack and at night by not having it under bedclothes
- Drinking plenty of water
- Cutting down on alcohol
- Taking vitamin C supplements
- Avoiding red meat, fatty foods and seafood (which are high in uric acid)
If untreated, gout can become chronic and permanently damage the joint.
There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with gout:
An employer can ask questions regarding the nature of an employee’s gout and what extra support they may need can be broached sensitively. For example:
- Have they required adjustments in the past? For example, avoiding tasks which require them to be on their feet for a while at a time if they suffer from gout in their toes.
- Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs.
What reasonable adjustments are possible for employees with gout?
Employers have a legal duty to make reasonable adjustments for employees with gout if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has gout which is having a long-term, adverse effect on their day-to-day life. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.
If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of gout:
- Allowance for regular breaks to reduce any impact on the affected joints, including time to break if the employee is taking pain medication for their condition which may affect their concentration, or to prepare a hot water bottle or heat pack to alleviate pain.
- Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. This may include delegating tasks requiring walking or standing, or use of the hands or arms to a colleague.
- Raising awareness so that colleagues understand the need for the employee’s adjustments.
- Alternative parking space so that the employee doesn’t need to walk as far from their car to their workstation.
- Ergonomic equipment such as wrist supports, adapted keyboard or leg rest to reduce pressure on affected joints.
UK Gout Society – charity providing information to people living with gout and increasing public awareness of the potential severity of the condition, with expertise from rheumatologists and other health professionals informing the support the charity gives.
Arthritis Action – charity giving practical advice to people living with all types of arthritis, including gout (an inflammatory arthritis), and focusing on encouraging people to self-manage their condition through dietary and lifestyle changes (020 3781 7120).