What Are Gout Treatments And Home Remedies
When gout is mild, infrequent, and uncomplicated, it can be treated with diet and lifestyle changes. However, studies have shown that even the most rigorous diet does not lower the serum uric acid enough to control severe gout, and therefore medications are generally necessary. When attacks are frequent, uric acid kidney stones have occurred, tophi are present, or there is evidence of joint damage from gout attacks, medications are typically used to lower the uric acid blood level.
Medications for the treatment of gout generally fall into one of three categories: uric-acid-lowering medications, prophylactic medications , and rescue medications to provide immediate relief from gout pain.
Urate-lowering medications are the primary treatment for gout. These medications decrease the total amount of uric acid in the body and lower the serum uric acid level. For most patients, the goal of uric-acid-lowering medication is to achieve a serum uric acid level of less than 6 mg/dl. These medications also are effective treatments to decrease the size of tophi, with the ultimate goal of eradicating them. Uric-acid-lowering medications include allopurinol , , probenecid, and pegloticase .
Gout home remedies
Home remedies for an acute gout attack include drinking plenty of water. Over-the-counter NSAIDs , such as ibuprofen and naproxen sodium , can be used when there are no contra-indications, such as decreased kidney function or stomach ulcers.
Signs Of Gout In Knee
ankle, swelling and tenderness in a joint, usually in the middle of the night, Men are three times more likely than women to develop gout.GoutOverviewHere are 6 signs that you may have gout or pseudogout: Hot joints Swollen joints Red joints Painful joints Infected-looking joints Tophi under the skinUric acid crystals are found in joint fluid The appearance of uric acid crystals in joint fluid is a classic sign of gout that doctors expect to find, warmth, fingers and back where even the weight of a sheet or clothing is intolerable, fingers and back where even the weight of a sheet or clothing is intolerable, Noticeable discoloration in the joints they may become deep red or even purple at onset, such as the ankle, Mix baking soda and water and drink it this is the fastest way to neutralize the uric acid, But other joints and areas around the joints can be affected, wrist and elbow, and change color through the attack, ankles, severe attack of pain, hips, redness and maybe even tenderness in the joints, Triggers
What Is The Prognosis Of Gout
Gout is a chronic condition. Left untreated, patients may suffer from recurrent painful and disabling acute attacks of gout. Joint damage and other complications of gout may occur. However, excellent treatments for gout are available, and most patients respond very well to gout treatment with a good prognosis.
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Treatment For Knee Gout Symptoms
As mentioned earlier, moving swiftly to neutralize the acidic reaction as early as possible is the best course of action both as gout treatment and gout prevention. There are several suggestions that can be implemented:
- Mix baking soda and water and drink it this is the fastest way to neutralize the uric acid. This can help to dissolve the crystals that have already formed and also work to keep the uric acid that hasnt crystallized in solution
- Soak towels in warm water and Epsom salts and wrap the knee then alternate with towel-wrapped icepacks
- Eat fresh celery, apples, cherries, and bananas these are strong antioxidants and alkalizing foods
- Drink clean filtered water 8oz every half hour until all knee gout symptoms have completely disappeared
Genes And Family History
Research over the past decade has increasingly identified a link between a genetic predisposition and high uric acid levels. For example, in a 2012 study, researchers looking at a large number of peoples unique genomes found that patients with gout often shared a similar variation on a gene that affects kidney function. A 2018 study further identified several genes that influence how the body gets rid of uric acid.
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Purines And Uric Acid
The crystallized uric acid that causes gout pain is created by the breakdown of a substance called purines. Purines are part of every cell that make up all plant and animal food sources. Purines are also produced by the human body itself.
Some foods, namely proteins like meats and beans, are higher in purine content that others. One way that high levels of uric acid accumulate in the blood is by eating these types of foods. Another way is by consuming drinks and foods that are made with a generous amount of high fructose corn syrup.
However, the true problem is that the kidneys are temporarily not able to balance the pH of the body chemistry as they normally do. Kidney function can become impaired for a number of reasons in addition to consuming certain types of foods toxic environmental chemicals in the air and water, stress hormones, dehydration, skin contact with toxic substances, physical over-exertion, and others.
When the kidneys are overloaded, the uric acid may not be properly processed and excreted. Normally, uric acid is produced and used by the body as a protective antioxidant, but when over-abundant, its corrosive nature can become problem.
The alternative that nature has provided is to allow the excess uric acid to crystallize in a joint far from the vital organs to protect them this is the fundamental point to understand when the question, what is gout? comes up.
What Are The Symptoms Of Gout In The Knee
The main symptom of gout in the knee is pain and discomfort in the surrounding area. Keep in mind that gout is often unpredictable, regardless of the joint its affecting. You might go weeks or even months without any symptoms, only to wake up with a burning pain in your knee.
In some cases, gout starts out in one of your big toes before moving on to other areas, such as your knee. Over time, these flare-ups may last longer than previous episodes.
Other symptoms you might feel from gout in your knee include:
- tenderness
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Gout Frequently Flares In Your Knee But You May Not Always Know That Your Knee Pain Is Due To Gout Heres How To Tell Since Prompt Treatment Can Reduce Your Risk Of Complications
Knee pain can be a common symptom of several types of arthritis, as well as many other conditions or injuries. If your knee stiffness is accompanied by a burning pain and is warm to touch, you may have a gout flare in the knee.
Though gout is most often associated with the big toe, gout tends to flare in areas that already have arthritis, says Robert Keenan, MD, a rheumatologist with Articularis Healthcare in Summerville, South Carolina. Although gout can strike in many different joints, as a general rule, gout works its way up the body. If its not treated, it works its way up from the big toe, through the ankle, to the knee, and then to the lower spine and so on.
Gout can affect both knees, but typically is felt more strongly in one knee say, where you may have arthritis wear-and-tear to begin with.
Learn more about what causes gout in the knee, as well as ways to treat the pain and prevent it in the future.
What Causes Gout In The Knee
Gout develops when the body has high levels of uric acid, a normal waste product. This is known as hyperuricemia.
Uric acid is normally excreted through the body via the kidneys, but in some people, levels can remain high and uric acid can start to accumulate and crystallize in various joints. When these uric acid crystals affect the joint in the knee, it can cause gout symptoms in the knee, making the knee joint red, swollen, and hot to the touch. The buildup of uric acid can also impair the knee joints full range of motion, which can make it difficult to walk.
A number of factors can influence your risk for gout.
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What Is The Latest Research On Gout
Research is being done on using medications that block a chemical signal known as interleukin-1 to treat gout flares in patients who do not respond to other therapies. Anakinra and canakinumab are two medications that block interleukin-1. They are currently used for other conditions and are under investigation for use in gout flare-ups.
There is ongoing research in using a specialized CT scan known as a dual energy CT scan to diagnose gout. There is also a great deal of research investigating the various uric acid transporter genes that are responsible for uric acid metabolism.
How To Prevent Knee Gout
A general rule in medicine is that prevention is the best form of treatment, as never developing the condition through proper preventive measures will save you from distress as well as expensive medical bills. The following are recommendations to follow to prevent the development of gout:
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Mohan Garikiparithi got his degree in medicine from Osmania University . He practiced clinical medicine for over a decade before he shifted his focus to the field of health communications. During his active practice he served as the head of the Dept. of Microbiology in a diagnostic centre in India. On a three-year communications program in Germany, Mohan developed a keen interest in German Medicine , and other alternative systems of medicine. He now advocates treating different medical conditions without the use of traditional drugs. An ardent squash player, Mohan believes in the importance of fitness and wellness.
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A Rare Cause Of Knee Pain In Gout Patients: Tophi Of Patella
Ayhan AKIN1, Rahime NC2, Özlem AKAN1, Seçil DEMRDAL1, Korhan BAYRAM1
1Department of Physical Medicine and Rehabilitation, Katip Çelebi University Atatürk Training and Research Hospital, zmir, Turkey2Department of Dermatology, Katip Çelebi University Atatürk Training and Research Hospital, zmir, Turkey
Keywords: Gout, patella, tophi
Acute Attack Pain Management
Home remedies. Reducing inflammation during an acute gout attack will provide pain relief.
- Ice. Apply ice to the affected area to reduce swelling. Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice. Apply ice for about 20 minutes at a time.
- Elevate. Frequently raise and keep the affected area above the level of the heart.
- Rest. Move the affected area as little as possible while symptoms are present.
- Over-the-counter non-steroidal anti-inflammatory medicines. If the gout attack is mild, anti-inflammatory drugs available without a prescription may relieve pain. Because there are serious side effect of using non-steroidal anti-inflammatory drugs even the over-the-counter strength be sure to check with your doctor before taking them.
Prescription medications. Your doctor may recommend a prescription-strength non-steroidal anti-inflammatory medicine such as indomethacin.
Colchicine is also given to reduce inflammation during an acute gout attack. This drug has recently been approved by the Federal Drug Administration for treatment of gout. Like all medications, colchicine has side effects that you will need to discuss with your doctor.
Your doctor may also prescribe corticosteroids for acute gout attacks. These are strong anti-inflammatory medications that can be taken either in pill form, intravenously, or injected into the painful joint. Cortisone may improve the severe inflammation very quickly.
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How Can I Manage My Gout And Improve My Quality Of Life
Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.
For gout in particular:
- Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines , and limit alcohol intake .
CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.
What Are The Risk Factors For Gout
Risk factors for gout include:
- being male
- taking medications that increase water excretion by the kidneys
- being overweight
- eating a diet with a lot of meat, offal and shellfish
- having kidney disease, high blood pressure, diabetes or abnormal levels of fat and cholesterol in the blood
- drinking a lot of alcohol, especially beer, port or spirits
- going on a crash diet or fasting
- being of Maori or Pacific Islander origin, which can predispose a person to high uric acid levels
Gout is more common in men than in women, and among women it’s more common after menopause. It’s more likely to occur in older people, but can affect anyone.
It can also affect people with certain types of blood disorder and people in treatment for cancer.
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Arthritis / Acute Gout Attack
Gout is a form of arthritis, hence it causes pain and discomfort in the joints. A typical gout attack is characterized by the sudden onset of severe pain, swelling, warmth, and redness of a joint. The clinical presentation of acute gouty arthritis is not subtle with very few mimics other than a bacterial infection.
The joint most commonly involved in gout is the first metatarsophalangeal joint , and is called podagra. Any joint may be involved in a gout attack with the most frequent sites being in the feet, ankles, knees, and elbows.
An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack takes approximately 7-14 days.
An accurate and colorful discription of a gout attack was elegantly written in 1683 by Dr. Thomas Sydenham who was himself a sufferer of gout:
The Role Of Medication In Prevention Of Gout
Table 3: Medications to pevent attacks of gout
Standard medications in preventing gout attacks
i. Colchicine : using the matches analogy discussed above1, using colchicine can be seen as dampening the uric acid matches. Colchicine does not lower the bodys store of uric acid, but it decreases the intensity of the bodys inflammatory reaction to these crystals. Recent studies have shown that at least one mechanism of colchicines action is by acting to prevent a cascade of reactions that lead to the production of interleukin 1-beta, which is an inflammatory protein , which is important in gouty inflammation.8
ii. Allopurinol: This agent is presently the most commonly used drug for the prevention of gout. Allopurinol blocks the enzyme xanthine oxidase, which blocks the breakdown of purines, thus decreasing the bodys total amount of uric acid. Allopurinol is effective in preventing gout no matter what the mechanism of the elevated uric acid was. Whether a person is making too much uric acid, or has difficulty excreting it via the kidney, allopurinols decrease in uric acid production leads to the same goal: a decreased total body uric acid.
Table 4: Reasons to use medication to lower uric acid
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What To Do During An Attack
You should:
- take any medication you’ve been prescribed as early as possible after you notice an attack this should start to have an effect within two or three days
- rest and raise the limb
- avoid knocking or damaging the affected joint
- keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
- ensure you’re well hydrated
Apply the ice pack to your joint for around 20 minutes. Don’t apply ice directly to your skin and don’t apply it for more than 20 minutes at a time because this could damage the skin.
If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.
Who Should Diagnose And Treat Gout
The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases. Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a provider near you, visit the database of rheumatologistsexternal icon on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout.
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When To Contact A Doctor
People who are experiencing symptoms they think might be due to gout should seek guidance from a doctor.
Gout tends to progress and worsen over time. However, early treatment can often help control gout and reduce the risk of severe complications, such as joint damage.
People with gout can also develop infections, which they need to treat as soon as possible. Those who have diabetes are more likely to develop infections with gout.
A person should seek emergency medical care if signs of infection are co-occurring with symptoms of gout.