Can intense exercise or physical trauma trigger a gout attack?

Yes, absolutely, and it's quite common. Let me give you a few examples to make it clear.

This can be explained in two scenarios:

1. Strenuous Exercise

Think about it, several things happen during strenuous exercise:

• Excessive sweating, body "dehydrated": When your body loses a lot of water, the concentration of uric acid in your blood increases. It's like a glass of salted water; if you drink half of it, the remaining water becomes saltier, right? Similarly, when uric acid in the blood "concentrates," it's more likely to crystallize and precipitate, forming small, stone-like deposits in your joints.
• Lactic acid "causes trouble": Strenuous exercise produces a lot of lactic acid, which is one of the culprits behind muscle soreness after a workout. Both lactic acid and uric acid need to be excreted by the kidneys, and they have to "queue up." Lactic acid, however, "cuts in line," getting excreted before uric acid, leading to impaired uric acid excretion. This causes uric acid to accumulate in the body.
• Minor "wear and tear" on joints: Exercise itself, especially high-intensity activity, can cause minor damage and pressure fluctuations in the joints. For people with high uric acid levels, there might already be "seeds" of uric acid crystals hidden in their joints. When exercise stresses them, these "seeds" can be activated, leading to an attack.

2. Trauma

This is even easier to understand. For example, if you sprain your ankle, hit a joint, or even undergo surgery.

• Stirring up a "hornet's nest": For gout patients, there might already be urate crystals suspended in the joint fluid, but they are usually "quiet" and don't bother you. However, once an injury occurs, the body activates an "emergency alarm," sending many white blood cells to the injured area to deal with the situation (i.e., inflammation). When these white blood cells arrive, they suddenly discover these "unwanted" urate crystals and treat them as invaders, launching a fierce attack. Once this battle begins, your joint immediately becomes red, swollen, hot, and painful, and a gout attack ensues. So, trauma is like the stick that stirs up a hornet's nest.

In summary:

Strenuous exercise primarily induces gout by making uric acid "concentrated" and "unable to be excreted." Trauma, on the other hand, directly ignites a "battle" in the local joint, turning previously dormant uric acid crystals into targets of attack.

Therefore, friends with a history of gout should exercise gradually, avoid overdoing it, and always drink plenty of water. If you accidentally get injured, pay extra attention, as it is indeed a common "trigger."