Gout can affect your knees, but not your spine. Your low back carries the weight of your entire upper body, so it is most prone to injury and wearing out of the discs that cushion the vertebrae. You are very young, and even though losing weight sounds hard, it isn't nearly as hard as living with chronic back pain, having to possibly have back surgeries, and knee replacements. Staying overweight will accelerate the arthritis and degeneration of the spinal structures, and those problems can be devastating and disabling. Your best bet is to make up your mind to change your lifestyle, lose weight, get low impact exercise and stay active. Prolonged sitting is the worst position for the back pain, as it increases disc pressure more than standing, walking. Strengthening your core muscles (back, abdominal and obliques) will help support your back structures. The aforementioned swimming in a warm pool is great advice. I would avoid weight lifting and do low impact aerobic exercise. A few visits with a good dietician and joining a weight loss club such as weight watchers could be very helpful. Exercising with others at a gym can provide extra motivation to keep moving in the right direction. There is no easy answer, and no time like the present to start making some healthy changes. It will be worth it in the long run. I remember you couldn't imagine living with gout when you were diagnosed, and you are doing it! The arthritis may very well get better when you take the strain off your joints. In the meantime, antiinflammatories like Naprosyn OTC can help with the pain when you need something. I would be sure your uric acid is checked periodically too to keep it under 5.5, to protect your joints from gout damage.