Home Care For A Gout Flare
If your doctor has diagnosed you with gout and given you medicine for a flare-up, take the medicine as directed when you know youâre having one. In most cases, that will probably be as soon as the first signs begin.
Your doctor may prescribe nonsteroidal anti-inflammatory drugs 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 .
In some cases, you already may be taking medicine like colchicine to prevent gout flare-ups. Your doctor may have also suggested:
If you canât take allopurinol or it is not effective, your doctor may prescribe . 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 youâve been taking preventive gout medicine for a long time and youâre having flares for the first time in a while, call your doctor. They may talk to you about changing your dosage or your medicine.
What Are The Causes Of Gout
A buildup of uric acid in the body is the main cause of gout. A byproduct of the breakdown of purinesorganic chemical compounds present in food and various tissues and cells throughout the bodyuric acid is typically excreted from the body in the form of urine. A buildup, however, occurs when the body is unable to dispose of all the uric acid. This condition is known as hyperuricemia and results in the formation of uric acid crystalsmonosodium uratein the affected joints.
For some patients, this can lead to the symptoms of gout, i.e., inflammation, pain, swelling, and loss of movement in the joints. These symptoms are often severe in intensity. However, for some patients, hyperuricemia may not lead to the onset of gout, and treatment, in this case, is not necessary.
Adults over the age of 40, in particular men, are more likely to experience gout symptoms. Studies show that the disease also affects patients with the following conditions or lifestyles:
- high blood pressure, especially those that use diuretics
- organ transplants
- a diet high in foods containing purines, fructose, and alcohol
The chances of you experiencing gout also increase greatly if other members of your family have previously had the disease.
Treatment Of Foot Gout
If you suffer from foot gout, there are many different types of gout treatment approaches you can take to help lessen the flare.
Flares from foot gout can be treated using your regular gout medications. This includes NSAIDs, corticosteroids, and colchicine. These are short-term gout medications and should only be taken during a gout flare.
Then, certain medications need to be taken regularly to maintain low uric acid levels. This is called preventative medication and can include drugs such as allopurinol, febuxostat, probenecid, pegloticase, and lesinurad.
Light Exercise or Rest
This may sound counterintuitive but taking a walk during an attack might help you recover faster. For people who have had gout long enough, theyve lived through the pain and have gotten used to it.
However, if this doesnt work for you dont force it. Sit back, relax, and let your foot rest. Put it in an elevated position and place an ice pack on the affected area.
Buy a Comfortable Pair of Shoes
Find comfortable shoes that you can regularly wear preferably those that have cushioned insoles and a wide toe box. This helps support the feet and prevent contact with the toe which can feel sensitive to touch during the first few days after an attack.
In certain situations, you may need to undergo an operation to remove the liquid inside. This is especially needed if the gout has already progressed into tophi.
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What To Do For A Gout Attack
Medication may shorten a gout attack. Your doctor may prescribe medication that blocks inflammation called a nonsteroidal anti-inflammatory drug , you may also take a drug called colchicine or a strong anti-inflammatory steroid drug. Over-the-counter NSAIDs include ibuprofen and naproxen.
These drugs will reduce the pain and inflammation, but there are also home treatments that will help. Home treatment includes resting your joint, elevating your joint above the level of your heart, and using ice packs to reduce pain and swelling.
During A Foot Gout Flare
If you are experiencing a gout flare-up and are unable to reach your doctor, there are a few things you can do to help reduce the symptoms:
- At the first sign of symptoms, take ibuprofen or naproxen
- Drink plenty of water
- Rest and elevate your foot immediately
- Place cold compresses on the affected area
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Practice Mindfulness And Meditation
The good news: A gout attack is self-limited and will clear in time. In the meantime, according to the Arthritis Foundation, meditation, yoga breathing, mindfulness, and guided imagery can help you deal with the pain.
Preventing And Treating Gout
When you first come to AllCare Foot & Ankle Center with gout symptoms, we conduct a thorough examination to determine the best course of treatment. We typically prescribe nonsteroidal anti-inflammatory medications to help control symptoms and prevent further joint damage.
If youve already had or continue to have multiple gout attacks, it can lead to a variety of health complications, including the erosion and destruction of your toe joint and the development of kidney stones. This is why preventing future gout attacks is essential for your overall health and wellness, not just for relieving the pain in your toe.
We recommend the following to help prevent future gout flare ups:
- Drink plenty of fluids
- Limit or avoid alcoholic drinks
- Reduce meat, poultry, and seafood in your diet
- Consume more low-fat dairy products for protein
- Lose weight, if necessary
The common symptoms of gout arent something you should ignore, and we can help you get it under control. Give us a call at our Arlington or Dallas offices, or request an appointment online today.
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My First Attack Of Gout
When I had my first attack of gout, I did an Internet search in an effort to understand what it was. The one thing I was unable to find was a day-by-day description of what the disease is like. I decided to record what happened to me during the first seven days of the attack. Since the initial onset, I have altered my dietgreatly increasing the amount of water I drinkand I have made more of an effort to eat less meat by increasing my fruit and vegetable intake.
Even though this article offers some insight to the symptoms of the disease, it is not meant to replace a doctor’s advice. Nor is it an indication that your gout symptoms will be the same as mine. If you have an attack, you should see your doctor as soon as possible.
Which Joints Are Involved In Gouty Arthritis And Why Is It Most Common In The Foot
As with all other known types of arthritis, Gout has particular joints it tends to attack, and the foot is its most common location. Gout especially favors the bunion joint, known as the first metatarsophalangeal joint , but the ankle, midfoot and knee are also common locations, as is the bursa that overlies the elbow.
The bunion joint is the first joint involved in 75% of patients and is ultimately involved in over 90% of those with this condition. . It is thought that this joint is especially involved in gout because it is the joint that receives the highest pounds per square inch of pressure when walking or running.
Late in gout, if untreated, multiple joints can be involved, including the fingers and wrists. The shoulder joint is very rarely involved by gout and the same is true of the hip.
Figure 5: Location of Gout Attacks
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How To Treat A Gout Flare
Different medications can be used to address gout, but when youre in the midst of a gout flare, the number-one goal is pain management. Because the pain is so severe, its really important to try to bring it under control quickly, says Dr. Saag.
Even though gout is caused by uric acid buildup, now is not the time to start a drug thats specifically designed to lower uric acid levels.
Instead, your doctor will likely prescribe a higher dose of a non-steroidal anti-inflammatory drug , such as naproxen, or a steroid medication like prednisone. Your doctor might also inject a steroid directly into the affected joint, or, if the pain is bad enough, start you on an intravenous version of it, says Dr. Saag.
Colchicin is another medication that is sometimes used to manage gout flares. This drug is not a traditional pain reliever, since it doesnt seem to relieve pain caused by other conditions. According to a Cochrane Review, about 40 out of 100 people who use colchine during a gout attack rated their pain 50 percent lower than those who took a placebo, but theres also a high risk of side effects like vomiting, nausea, and diarrhea, especially when taken at high doses.
If youve had gout flares before and are now seeing a new provider or are being treated in the emergency room, be sure to tell the doctor about the treatments youve previously tried during an acute episode and how well they worked for you.
What Increases Your Chances For Gout
The following make it more likely that you will develop hyperuricemia, which causes gout:
- Being male
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Should I Walk With Gout
Due to the pain and discomfort of a gout attack, it is always best to stay seated, elevating your feet if at all possible, until the flare-up passes.This may take a minimum of 4 hours, If you must walk during an attack, it is best to use a cane to help keep full pressure off the foot, and to provide extra stability.
How Does Diet Impact Gout
Though diet isnt the only factor that leads to gout, it can play a role. To know why, its important to understand what causes gout in the body .
Gout occurs when an excess of uric acid in the body crystallizes in the joints, most commonly in the big toes, fingers, wrists and knees. These sharp crystals cause sudden swelling and are the source of the pain associated with a gout attack.
Uric acid is produced naturally when the body breaks down purines. Most purine is produced inside the body, though purines are also contained in some foods. Normally, uric acid doesnt cause problems because the body is able to secrete it easily through urine. However, some people produce too much uric acid or are unable to secrete enough of it. In these cases, the result is gout.
Though the body produces uric acid naturally, making gout largely unavoidable, consumption of foods rich in purines can exacerbate the problem. In fact, one study found that high purine intake was associated with five times greater risk of recurrent gout attacks .
In addition to foods rich in purine, those with gout should also avoid foods with lots of added sugars and refined carbs. Though more research needs to be done, reducing glycemic index seems to correlate with lower uric acid levels .
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Home Remedies For Gout Flares
While you taking medication to fight the pain and inflammation during a gout flare, there are a few other simple gout home remedies you can use to ease the discomfort. Rest is important try to keep the impacted joint higher than your heart. Ice may also be helpful, because it brings down swelling. Research shows that ice is particularly soothing for gout if youre dealing with a different type of arthritis, a heating pad may be a better choice.
Some people also say that eating cherries or drinking tart cherry juice helps during a gout flare. While studies have shown that cherry lovers may be less likely to have frequent gout flares, its not clear whether loading up on this fruit during an attack will make an immediate difference. Cherries may be helpful because theyre rich in antioxidants, and tart cherries may help lower uric acid levels .
What Causes Gout In The Foot
For most people, 50% of all Gout cases begin with an initial attack in the bunion joints of the big toes. But why is this?
One hypothesis is that it may simply be a result of gravity, with the acids naturally flowing down and then settling into the farthest joints of the lowest extremities: the big toes.Another hypothesis is that because the feet and toes are farthest body appendages away form the heart, it is therefore a cooler part of the body due to circulation, making their joints more conducive to the formation of acid crystals. This correlates to gout being more prevalent in many colder climates.Over time gout may also attack other joints in the body, though generally one joint at a time, including the metatarsals, which are the long bones on the tops of the feet, the tarsals, which are the seven bones within the ankle, and in rare occasions, the heels
Above: Gout presenting with redness and inflammation in the ankle joint
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Whats The Outlook For People With Gout
Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.
Symptoms Of Gout Flares
Gout is a type of arthritis that flares and subsides, especially at first. Common symptoms of a gout flare include:
- Intense joint pain that comes on suddenly, often in the middle of the night
- Most commonly affects the big toe can occur in other toe joints, ankle, knee, and more
- Typically strikes one joint at a time more can be affected as the disease progresses
- Affected joint is swollen, painful, warm to the touch, and red
- Pain from a flare can last up a week or two with long periods of remission in between
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Is Orange Juice Good For Gout
Orange Juice and Gout RiskMany sugar-sweetened juices can increase your risk for gout, but naturally-sweetened juices like orange juice may also be a gout risk trigger.
Injured joints seem to make better spots for uric acid to collect, and can lead to a gout attack that can last for weeks. A traumatic event can start a small inflammatory response, which may then precipitate a gout attack in that joint, Dr. Vanittalie says. When uric acid levels remain high, uric acid crystals accumulate in your joints and cause damage. If youre prone to high levels of uric acid, strive to remain properly hydrated by drinking the optimal amount of water based on your activity level. When youre dehydrated, uric acid builds up in the blood that cannot be diluted and efficiently released through the kidneys. Dehydration also slows metabolism to the point of weight gain, which can cause or exacerbate gout.
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Ways To Manage Gout Pain
May 8, 2019
Gout is one of those ailments you hear a lot about as you age. It is a very common form of arthritis, and its not picky about who it attacks. Gout is characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in the affected joints and it most often attacks the big toe joint. Gout will often flare up in the middle of the night and cause men and women to writhe from the sudden pain. Many of Dr. Vervilles patients describe the pain as a feeling that their toe is on fire. Other symptoms may include:
- The skin is warm to the touch
- Lingering discomfort in the affected joint
- Swelling and redness at the site of the pain
- Limited range of motion in the affected joint
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Causes Of Gout Flares
Gout, a type of inflammatory arthritis, happens when levels of uric acid a normal byproduct of metabolic reactions in your body become too high, says Kenneth Saag, MD, professor of medicine in the division of clinical immunology and rheumatology at the University of Alabama at Birmingham. When this substance cant be sufficiently dissolved and excreted in the urine, it starts to crystallize, and those crystals deposit themselves in joints where they cause severe inflammation.
Certain risk factors, such as having a family history/genetic predisposition or having chronic kidney disease, can affect the development of gout over time. Taking certain medications , a high alcohol or sugar intake, or eating high-purine foods can trigger a gout flare. Read more about what causes gout here.
If youre new to gout, your doctor will need to confirm the diagnosis, as it can sometimes masquerade as other ailments that impact the joints . Your doctor will likely use a needle to remove some fluid from the swollen joint, then examine it under a microscope to confirm that it contains uric acid crystals.