POSTERIOR TIBIAL BLOCKS TO TREAT ACUTE GOUT ATTACKS
posted: Dec. 28, 2020.
Drs. Allen Jacobs and Elliot Udell comment about the use of PT blocks in acute gout. Dr. Udell also remarks about the late Dr. Marvin Steinberg who employed PT blocks in treating acute gouty attacks. I spent a number of years in his office at least once a week which literally resulted in my love for podiatric medicine. The use of PT blocks was not only for anesthesia for virtually immediate relief from the acute pain, but also because it was a sympathetic nerve block.
This resulted in vasodilatation which created a dramatic increase in temperature as well as an increase in the flow of blood by blocking the autonomic nerve component. The increase in blood flow increased the volume of fluid to the area and since much of this fluid is water and a solvent, resulted in dilution of the supersaturated solution of monosodium urate. Reducing the sharp crystals of monosodium urate also results in increasing the pH (reducing acidity). Thus, these combined effects of a PT block make such an intervention quite effective.
Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL
Courtesy of Barry Block, editor of PM News