6 Ways to Deal with Painful Gout Attacks

How to Treat Gout Attacks at Home

If you have gout, you know the signs that a flare-up is on the way. There’s nothing you can do to stop an attack once it starts, but you can ease some of the symptoms at home.

Warning Signs of a Gout Flare-Up

Some people with gout, also known as gouty arthritis, say an attack begins with a burning, itching, or tingling feeling in a joint maybe an hour or two before the flare-up starts. The joint may feel a little stiff or a bit sore. Not long after, the telltale signs of gout begin. If you get repeated attacks, you’ll learn your body’s signals that one is about to begin.

Sometimes, people with gout have no early signs that a flare is about to start. They may just wake up in the middle of the night with a very painful joint.

When the flare starts, most people have redness, swelling, and severe pain, usually in one joint. The most common place for gout is the base of the big toe, but it can happen in other joints such as the elbow, knee, wrist, ankle, and instep.

Home Care for a Gout Flare-Up

If your doctor has diagnosed you with gout and given you medicine for a flare-up, take the medicine as directed when you know you’re having one. In most cases, that will probably be as soon as the first signs begin.

Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib, indomethacin, meloxicam, or sulindac or suggest you take over-the-counter NSAIDs, like naproxen or ibuprofen. Depending on your medical history, your doctor may prescribe steroids or other medicines to reduce inflammation, such as colchicine (Colcrys).

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In some cases, you already may be taking medicine like colchicine to prevent gout flare-ups. Your doctor may have also suggested:

• Allopurinol (Aloprim, Lopurin, Zyloprim)
• Anakinra (Kineret)
• Canakinumab (IlarisIlarisIlaris)
• Lesinurad (Zurampic)
• Pegloticase (Krystexxa)
• Probenecid (Probalan)
• Rasburicase (Elitek)

If you can’t take allopurinol or it is not effective, your doctor may prescribe febuxostat (Uloric). It should be used with caution, however, because it has been linked to increased risk of death from heart disease and from other causes.

Just because you have a flare doesn’t mean these medicines aren’t working. In the first few months that you take them, you may have an attack as your body adjusts to the drug. Your doctor will likely have given you something to take if this happens, too.

If you’ve been taking preventive gout medicine for a long time and you’re having flares for the first time in a while, call your doctor. They may talk to you about changing your dosage or your medicine.

Pain Relief Without Medicine

Use cold. If your pain isn’t too bad, try cold packs or compresses on the joint to lower inflammation and soothe the ache. Wrap ice in a thin towel and apply it to the joint for up to 20 minutes several times a day. Do not apply ice to your hands or feet if you have nerve problems from diabetes or other causes.

Rest the joint. It’s a good idea to rest it until the pain eases up. You probably won’t want to move it much anyway. If you can, raise the joint on a pillow or other soft object.

Drink water. When your body doesn’t have enough water, your uric acid levels rise even higher. Stay hydrated to help keep those levels normal.

Watch what you eat and drink. Foods that are high in substances called purines, such as some seafood, organ meats like liver, and fatty foods, can raise the uric acid in your blood even more. So can fructose-sweetened drinks and alcohol — especially beer.

When to Get Help for a Gout Flare

It’s always a good idea to let your doctor know that you are having a flare. Sometimes, you may need to follow up to make sure your treatment plan is working or if your symptoms don’t improve. Call your doctor if:

This is your first flare-up. There are several other conditions, such as a joint infection, that have some of the same symptoms as gout attacks.

You have a highfever and chills. Gout attack symptoms may include a mild fever, but a higher temperature may be a sign of an infection.

Your symptoms don’t get any better after 48 hours or don’t end after about a week. If you don’t start to feel somewhat better after a few days, call your doctor. They may suggest a different treatment. Most gout attacks will go away by themselves in several weeks, even without treatment.

Show Sources

Rebecca Manno, MD, MHS, assistant professor of medicine, division of rheumatology, Johns Hopkins University School of Medicine.

Robert T. Keenan, MD, MPH, assistant professor of medicine, division of rheumatology and immunology, Duke University School of Medicine.

Scott Zashin, MD, clinical professor of medicine, University of Texas Southwestern Medical School; attending physician, Presbyterian Hospital.

Lan Chen, MD, PhD, attending rheumatologist, Penn Presbyterian Medical Center.

Gout and Pseudogout Treatment & Management: “Treatment.”

Johns Hopkins Arthritis Center: “Gout — Treatments for Gout.”

Merck Manual: “Gout.”

Arthritis Foundation: “Managing a Gout Attack.”

6 Ways to Deal with Painful Gout Attacks

It’s difficult to focus on work or other daily activities when you’re experiencing gout inflammation and pain. Symptoms can last for a few days or even weeks, with the worst pain usually occurring in the first day or two.

While the best thing to do is talk to your physician, there are several steps you can take right away ease your gout symptoms:

Excess uric acid in the bloodstream can lead to the formation of uric acid crystals in one or more joints, resulting in gout. Read: All About Gout – Symptoms, Diagnosis, Treatment

1. Take an NSAID (but not aspirin)

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help relieve gout pain. Avoid aspirin and other medications that contain acetylsalicylic acid, which can make your gout worse. 1 Ben Salem C, Slim R, Fathallah N, Hmouda H. Drug-induced hyperuricaemia and gout. Rheumatology (Oxford). 2017 May 1;56(5):679-688. doi: 10.1093/rheumatology/kew293 Keep in mind NSAIDs carry potential side effects, such as an increase in blood pressure, 2 Snowden S, Nelson R. The effects of nonsteroidal anti-inflammatory drugs on blood pressure in hypertensive patients. Cardiol Rev. 2011 Jul-Aug;19(4):184-91. doi: 10.1097/CRD.0b013e31821ddcf4 , 3 Aljadhey H, Tu W, Hansen RA, Blalock SJ, Brater DC, Murray MD. Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. BMC Cardiovasc Disord. 2012;12:93. Published 2012 Oct 24. doi:10.1186/1471-2261-12-93 so discuss this treatment with your doctor.

2. Take your prescription drugs

If you’ve had a gout attack before, your physician may have prescribed drugs to treat attacks. This may be your first line of defense or you may decide to use them only when NSAIDs fail to relieve your pain.

Prescription medications to treat gout include:

• Prednisolone oral tablets, which has been shown to work as well as NSAIDs and often doesn’t cause the same stomach upset. Prednisolone is a type of corticosteroid and does carry other potential side effects, particularly if it is taken for longer than the recommended 5 days. 4 InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Gout attacks: Pain relief. 2015 Mar 11 [Updated 2018 May 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK284948/
• Colchicine, which has been shown effective in reducing pain and inflammation if taken in the first 24 hours of an attack. Always follow your physician’s instructions regarding dosing to decrease your risk for potential complications and side effects.

Opioid painkillers, such as codeine, hydrocodone, and oxycodone, are not recommended to treat the pain caused by gout.

3. Apply ice to the joint

Cold therapy can offer significant pain relief by decreasing inflammation and dulling pain signals. If this treatment works for you, you can apply the cold pack intermittently throughout the day for 10 to 20 minutes at a time.

4. Elevate the joint

Propping up the affected joint can ease pressure and reduce pain. If your big toe is affected (about half of all gout cases affect the big toe), prop it up on a pillow or footstool.

5. Take it easy

Rest the affected joint and keep pressure off it until your pain subsides. Have roomy slippers on hand, so you can keep your feet comfortable until the attack passes.

6. Stay hydrated

Drinking water throughout the day will help flush the uric acid from your system. Aim for drinking 8 glasses a day. Stay away from alcohol and sugary drinks, such as soda and sports drinks, which can make your gout worse.

When medical attention is needed

For severe cases of gout that don’t respond to the treatments above, your physician may recommend corticosteroid injections into the affected joint. Injections can also be useful for people who are sensitive to oral medication.

Prevent gout attacks

You can help prevent a future gout flare-up by avoiding food and drinks high in purines.

Learn more:

• 1 Ben Salem C, Slim R, Fathallah N, Hmouda H. Drug-induced hyperuricaemia and gout. Rheumatology (Oxford). 2017 May 1;56(5):679-688. doi: 10.1093/rheumatology/kew293
• 2 Snowden S, Nelson R. The effects of nonsteroidal anti-inflammatory drugs on blood pressure in hypertensive patients. Cardiol Rev. 2011 Jul-Aug;19(4):184-91. doi: 10.1097/CRD.0b013e31821ddcf4
• 3 Aljadhey H, Tu W, Hansen RA, Blalock SJ, Brater DC, Murray MD. Comparative effects of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in patients with hypertension. BMC Cardiovasc Disord. 2012;12:93. Published 2012 Oct 24. doi:10.1186/1471-2261-12-93
• 4 InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Gout attacks: Pain relief. 2015 Mar 11 [Updated 2018 May 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK284948/

Immediate Gout Pain Relief – 7 Best Options

Gout is one of the medical conditions affecting the big toe and some other joints. You will have pain and swelling in your joints. Although your big toe has a small joint, the first gout attack mostly occurs in this part. However, as the pain is unbearable, patients always desire immediate gout pain relief.

There are multiple treatment options available for gout. You can treat your gout in the knees, ankles, fingers, wrists, and elbows. But, most of the common treatments take time to show results. Thus, how will you get the desired results within the shortest time?

Apply ice compression

You may take some steps to control swelling and pain of the affected joints. For instance, you can apply ice compression techniques to alleviate the pain. Moreover, you need to avoid drinking alcohol and stay hydrated.

Ibuprofen

Medications from physicians will also be useful for treating pain from gout. Anti-inflammatory drugs like ibuprofen will prevent the pain from an acute gout attack. But, you must take the drug early to achieve the result.

Colchicine

Similarly, colchicine is another drug to stop gout pain. Make sure that you have taken it within the first few hours of the attack. Take a colchicine table thrice a day to find the effective result. After a week, you can take two tablets a day. However, you must consult a physician before taking any drug.

Both these drugs are effective in treating acute gout conditions, and their actions are different. However, healthcare specialists mostly prefer colchicine to alleviate acute attacks, as it works fast and patients do not have adverse reactions.

Cortisone shot

Cortisone is a potent anti-inflammatory steroid medicine working immediately to reduce the intensity of gout pain. It is easy to take cortisone orally. However, there are some common side effects of taking it. Researchers have found that cortisone injected into the affected joint can give a faster and better result. For instance, to treat severe gout conditions of your feet and big toes, you can choose Cortisone injection.

The healthcare specialist will rely on ultrasound technology to inject the needle into your joint. This technology will make the result much accurate.

Consult your doctor before taking a cortisone injection for immediate gout pain relief. Do not delay in having this injection. You will find the result within the shortest time.

PRP injections

In some special cases, doctors prescribe PRP shots for their gout patients. These anti-inflammatory injections will provide you with a highly beneficial effect. Especially, when your joint has osteoarthritis and other degenerative conditions, these PRP injections will be highly effective.

Nevertheless, some researchers have claimed that PRP injections are less effective than cortisone. While you have a risk from cortisone shots, PRP is the alternative.

Arthritis like gout causes damage by breaking down tissue, which helps in the proper cushioning of joints. That is why you feel pain while the bones have friction against each other together. Due to arthritis, your joint lining may also have inflammation.

PRP shots promote the restoration of the damaged tissues within the shortest time. By using blood platelets from your body, PRP treatment providers ensure natural healing.

Creams

Regular intake of oral medications will surely lower your uric acid buildup. But, you will still feel swelling and severe pain in gout-affected parts. That is why you can use special creams to alleviate pain from gout. The right application of the cream will be effective in decreasing the level of pain.

There is another advantage of using topical creams for your gout pain. You can avoid any potential side effects because these creams are not harmful. On the contrary, drugs may have adverse effects. Moreover, some drugs react with other medications, and you have at least some risks from them.

Change your lifestlye

To control your gout flare-ups, you have to reduce your uric acid. Your lifestyle may need some adjustments. Lose your weight, reduce alcohol intake, and have a proper diet.

Try to avoid foods containing a high level of purines. Sardines, prawns, anchovies, and some meats are risky for you. Moreover, foods and drinks with high fructose sugar will be valuable to you. Frozen foods, canned foods, and other yeast-based foods may also cause a problem. Do not drink sugar-sweetened beverages every morning. Low-fat dairy products, Vitamin C, and other vegetarian diets are safe for gout.

Conclusion

These are some preventive steps for gouts. But, for immediate gout pain relief, you can rely on modern treatments. The best treatments will give you comfort, and you can keep away from the gout symptoms.

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