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.
Managing Symptoms Of Gout
Medications are available to help you manage symptoms of gout. These include nonsteroidal anti-inflammatory drugs, such as indomethacin , ibuprofen , and naproxen . Side effects of these medications can include bleeding, stomach ulcers, and stomach pain. If your symptoms dont respond to these medications, your doctors may recommend other drugs to stop an attack and prevent future attacks.
Colchicine can reduce gout pain, but side effects may include nausea, diarrhea, and vomiting.
Corticosteroids such as prednisone also reduce inflammation and pain. These prescription medications can be taken orally or injected into your joint. Side effects include mood changes, elevated blood pressure, and water retention.
There are medications that block the production of uric acid and others that help your body remove uric acid, such as allopurinol and probenecid, respectively.
What Are The Medical Treatments For Gout
Gout is a very painful condition. Pain relievers and anti-inflammatory medications are the mainstay of treatment for gout. Nonsteroidal anti-inflammatory drugs , colchicine , and corticosteroids are used to decrease joint inflammation.
Other medications such as probenecid and allopurinol , are used for managing the underlying metabolic derangement that causes hyperuricemia and gout. These medicines decrease the elevated levels of uric acid in the blood.
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Are Patients Being Overlooked
Dr. Fields says the back pain of an attack could be mistaken for something else and treated as such. But what the patient really needs is medication to lower their uric acid level.
Even though a doctor may know the patient has gout, they may assume the back pain is from a herniated disc or osteoarthritis, he explains. They have to do imaging or a biopsy to find the uric acid deposits in the spine.
Spinal gout is rare, but it may be worth talking to your doctor about if you have back pain and a history of gout. You should be even more suspicious if you use diuretics, have high blood pressure or are obese. Early diagnosis and treatment with uric acid-lowering drugs can prevent the need for surgical intervention.
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:
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Treating Gout With Medications
Certain medications reduce the pain and inflammation of gout attacks, such as anti-inflammatory drugs , colchicine, and corticosteroids. Other medications decrease the level of uric acid in the blood and prevent the deposit of uric acid in joints , the kidneys , and in tissue , helping to prevent further attacks and complications. These drugs include allopurinol, febuxostat, lesinurad, and probenicid.
Pseudogout Symptoms & Signs
Pseudogout is a type of arthritis . Pseudogout has this name because its cause and symptoms resemble those of true gout, but gout is related to the presence or urate crystals. Pseudogout is related to aging and is linked to degenerative arthritis.
Signs and symptoms of pseudogout can include
- sudden, intense joint pain,
- red or purple skin around the affected joint, and
- severe joint tenderness .
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Could Your Back Pain Be Gout
If you have ever had back pain, you know how difficult it can be to pinpoint the cause. From bone spurs to overworked muscles to slipped discs, theres no shortage of ailments that could be at the root of your aching lumbar.
And heres one more. Over the last 10 years, rheumatologists have documented more cases of gout appearing in the spine. So if you are one of the 8 million Americans with this inflammatory form of arthritis and you have unexplained back or neck pain, tingling sensations down your arm or leg, or numbness theres a small chance the culprit could be your gout.
How Is Gout Diagnosed
If your doctor suspects gout, they may take a sample of fluid from the joint with a thin needle and send it to a laboratory for tests. Urate in the fluid might be seen with a microscope.
A blood test may also show elevated levels of uric acid . While it’s not usually used to diagnose gout, an x-ray may be used for people with gout that comes back to assess how much damage has been done to the affected joint.
Often, the diagnosis of gout is obvious, especially if you have had gout before. If you have not had gout before, or you are not sure what is causing your symptoms, see your doctor.
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What Increases Your Chances For Gout
The following make it more likely that you will develop hyperuricemia, which causes gout:
- Being male
Treatment During A Flare
You never want to start a long-term gout treatment during an acute flare-up. Starting uric-acid lowering medications such as allopurinol, Uloric, or Krystexxa during an acute flare-up will worsen the attack and lead to more debilitating symptoms. For that reason, it’s best to get the initial flare-up under control prior to initiating chronic therapy.
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What Are Symptoms Of Gout
The large joint at the base of the big toe is the most common site for a gout attack, however, any other joint can be affected. Most commonly, other joints affected are the ankles, knees, wrists, fingers, and elbows.
Patients with gout attacks suffer a rapid onset of pain in the affected joint followed by swelling, redness, and severe tenderness. Some experience pain so intense that even the light touch of a bed sheet on the joint is excruciating. These painful attacks can last from hours to several days. In cases of chronic inflammation, the attack may last for weeks. Unfortunately, patients with gout are at risk for repeated attacks of gouty arthritis.
Differences Between Ra And Gout
Both diseases cause redness, swelling, and pain in the joints. Both can cause serious disability and disrupt your quality of life.
However, a close look at initial signs and which joints are involved will clearly differentiate these two diseases. The best way to know whether you have RA or gout is to make an appointment with your doctor for a diagnosis.
Specific signs that distinguish the diseases:
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Treatment Options For Gout In Hands
There is no one-size-fits-all solution to treating gout in hands. Each case must be treated individually with the goal of helping to reduce pain and prevent future flare-ups.
Fortunately, there are various medications and drugs which can alleviate the pain and swelling. Other medications can also help with rebalancing the levels of uric acid in the body.
However, one of the most effective ways to mitigate the occurrence of flare-ups entails making lifestyle changes as follows:
- Avoiding foods high in fructose corn syrup-sweeteners, as well as foods with a high concentration of purines. Instead, increase your consumption in fruits, vegetables and grains.
- Exercise on a regular basis with an eye on maintaining an adequate level of weight according to your height and age.
Of course, committing to a lifestyle change and sticking to it is much easier said than done. Many people try to manage their gout in hands on their own for months or even years before seeking treatment by a doctor.
Many do not seek treatment at all, which is a huge shame since gout in hands is a practically curable condition.
Gout in hands is a very serious medical condition. If you feel you may be suffering from many of the symptoms mentioned above, go seek an appointment with your nearest doctor immediately to get a gout diagnosis.
When To Contact A Doctor
Anyone who suspects that they may have gout should contact a doctor for a diagnosis. Other conditions that may cause similar symptoms will also likely require treatment. Gout and other forms of arthritis that go untreated can cause joint damage.
People with a diagnosis of gout should attend regular appointments with a doctor. During these, they should mention any worsening of symptoms, new symptoms, or concerns about other conditions that may occur alongside gout.
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What Is The Prognosis Of Pseudogout
The outlook of pseudogout is generally very good. Aggressive treatment of the inflammation can lead to complete resolution of the inflammation, pain, tenderness, and loss of joint function. While this can last for weeks, the inflammation of resolves within days with proper treatment.
Recurrent attacks of pseudogout and chronic joint inflammation can lead to injury to the affected cartilage and bone.
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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.
Gout In The Thumb: Is Your Thumb Pain A Sign Of Gout
CreakyJoints discusses gout in the thumb and methods of treatment according to experts including HSS rheumatologist Theodore R. Fields, MD, FACP.
Considered a type of arthritis, gout is very common, however the thumb is quite an unusual place for gout to make its first appearance, said Dr. Fields. Gout can occur in any joint in the body, but the most common spot for a first flare of gout is at the bunion joint of the big toe, followed by the mid-foot, then the ankle and the knee. Theres some thought that gout in the lower extremity, and especially the big toe, may happen earlier than in other joints because of pressure from walking, he explained. In the first toe, it has been postulated that it being the coolest part of the body, you get more gout since we know that gout crystals are more likely to come out of solution in cooler temperatures.
Read the full article at CreakyJoints.org.
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Is Thumb Pain Due To Gout Or Something Else
Many gout attacks are so painful that they are not subtle or easy to miss. However, not all gout flares present in the same way . Answering yes to most of these questions could help determine that your thumb pain could be from gout in your thumb:
- Have you experienced sudden shooting pain in your thumb?
- Does this pain last for a day to a week or two and then subside or lessen?
- Do you notice redness and swelling around either thumb joint?
- Is your thumb back to normal after the pain and swelling goes away?
- Have you been experiencing sudden pain in your foot, ankle, or other joint prior to your thumb pain, especially with redness, heat, and swelling?
While the pain of a gout attack is distinct, other forms of arthritis could be to blame for thumb pain, including rheumatoid arthritis or psoriatic arthritis.
Most Common Gout Attack Sites
The most common site for a gout attack is what is known as the bunion joint on the big toe. It is typically the first joint affected by gout. As gout worsens, the ankle, mid-foot, knee, and elbow can become common sites of gout attacks. Uric acid crystals can also collect in soft tissues and form lumps called tophi, most typically on the hands, fingers, elbows, and ears.
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Lets Talk More About Tophi
Sometimes, after repeated severe gout attacks, uric acid crystals collect beneath the skin and form small white or yellow lumps called tophi. They are typically found in soft tissue around the affected joints on the elbow or on the exterior part of the ear. Fortunately, tophi can be dissolved with treatment. When left untreated, they can gradually destruct bones and cartilage, leading to discomfort and immobility.
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When To See A Doctor
You should see a doctor at the first sign of a gout attack.
Gout attacks can be treated and you can prevent it from spreading to other joints in the body, so you want to catch it early if possible.
If your gout is particularly painful, or you start recognizing tophi bumps, then go see a doctor immediately.
When You Get Burning Pain In The Base Of The Thumb It Could Be From A Gout Flare Here Are More Signs Your Thumb Joint Inflammation Could Be Gout And How To Treat Your Thumb Pain
Stiff joints in the hand can be a symptom of several types of arthritis. But if you also have burning pain, such as at the base of the thumb, you could be having a gout flare in the thumb.
Thumb pain caused by a gout attack can be especially debilitating because we use our thumbs so often. Every time you pick up your phone, grab a doorknob, or grasp a mug, your gout-inflamed thumb is forced to move at a joint where uric acid crystals are causing severe inflammation and extreme pain.
Most commonly, gout pain in any joint is more intense than that of pain from other kinds of arthritis, such as rheumatoid arthritis, says Theodore Fields, MD, Attending Rheumatologist at Hospital for Special Surgery and Professor of Clinical Medicine at Weill Cornell College of Medicine in New York City.
Gout flares are usually associated with signs of active inflammation, including redness, heat, swelling, and pain. Gout in the thumb can occur at the middle joint or at the joint where the thumb meets the hand.
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How Will Gout Affect Me
Attacks can vary from person to person. Some people only have an attack every few years, while others have attacks every few months.
Without medication attacks tend to happen more often and other joints can become affected.
Having high urate levels and gout for a long time can lead to other health problems, including:
- narrowing of the arteries – which can lead to an increased risk of stroke or heart attacks or other heart problems
- osteoarthritis, which occurs when the urate crystals and hard tophi cause joint damage.
- an increased risk of developing kidney disease or worsening of the condition if you already have it
- kidney stones
- an increased risk of some cancers, especially prostate cancer
- mental health problems, including depression
- underactive thyroid
- erectile dysfunction in men.
If you take medication to lower your urate levels, and have a healthy diet and lifestyle, most of the damage and complications caused by gout can be stopped.
Treatments for gout are incredibly successful. There are two main parts to treating gout, which are:
- treating the acute attack
- treatments to prevent future attacks.