How Gout Treatment Prevents Disease Progression
Fortunately, in part because of its long history, gout is one of the most well-understood and most medically treatable forms of arthritis. The progression of gout is preventable by starting appropriate treatment as soon as possible, Dr. Meysami says. Uric acid-lowering agents, such as allopurinol , can decrease uric acid levels and prevent gout attacks.
During flares, gout patients can take NSAIDs or corticosteroids to calm the attack. Local steroid injections may also be given. A medication called colchicine is also often used to stop acute attacks, but its given now at a much lower dose in order to avoid side effects, including stomach upset.
After a flare ends, long-term treatment can begin. Almost all people with gout will need medication to control their urate, Dr. Fields says. To get a good outcome, people with gout need to get their blood urate level below 6.0 mg/dl and keep it there. By doing that, the body will gradually pull the urate crystals out of their joints, and the flares can stop. Tophi will also gradually disappear.
Medications called xanthine oxidase inhibitors limit the amount of uric acid your body produces. These include allopurinol and febuxostat . Colchicine, which decreases the inflammatory response to gout, may also be given along with allopurinol at the start of long-term treatment after a flare subsides.
Fact: Food Can Play A Role In Gout But Its Not As Important As Genetic And Other Factors
Youre more likely to develop gout if you have high levels of uric acid in your body, and your love of certain foods and drinks can raise that risk. Organ meats and alcoholic beverages are high in purines, chemicals that increase or promote high uric acid in the body. Red meat, shellfish, certain seafood , and drinks high in fructose have the same effect.
However, its a common mistake to think that diet alone triggers gout and therefore, treating gout with diet changes alone can manage it. Research increasingly shows that gout is more influenced by genes and family history than diet. A 2018 study published in the journal BMJ found diet has much less influence on urate levels in your blood when compared to inherited genetic variants.
Most people first experience a gout flare after habitually eating foods rich in purine and notice relief when limiting or eliminating these foods, so it is understandable why individuals would feel that food is the main reason why gout happens, says Melissa Ann Prest, DCN, MS, RDN, spokesperson for the Academy of Nutrition and Dietetics.
It may be the case that in people who are genetically predisposed to gout, eating a lot of high-purine foods could trigger a gout attack. And minimizing your intake of these foods could help with your overall gout management. But most people with gout need to take medication to lower their uric acid levels diet alone wont help get them to a healthy level.
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Gout Can Go Awayor Return Again And Again
Gout attacks almost always result in stabbing pain, redness, and swelling in a joint. In men, about 50% of first-time gout attacks involve a big toe joint.1 Other commonly affected joints include the instep, heel, ankle, and knee.2
See Gout Symptoms
After the first gout attack, the condition can affect people differently:
- Some people will go months or even years without having another gout attackor very rarely, they may never have another one again.
- Other people will begin to experience gout attacks regularly. Eventually, these flare-ups may become frequent and longer-lasting. Chronic gout can lead to permanent joint damage and result in disability. Thankfully, early and appropriate treatment of the underlying cause of gouthigh levels of uric acid in the bloodcan prevent joint damage.
Experts cant predict who will have a one-time attack versus chronic gout. If youve had an attack, its worth your time and effort to make changes that can help you avoid another painful flare-up.
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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.
How Can An Attack Of Gout Be Treated
The management of an acute attack of gout is very different from the prevention of subsequent attacks.
Treatments used for prevention, such as allopurinol can actually make things worse if given during an attack, and so need to be held back until the attack has resolved for several weeks.
There are a number of measures that can help resolve an attack of gout. See Table 2 for summary of treatment strategies for acute gout. One principle is that treatment for an attack of gout should be instituted quickly, since quick treatment can often be rewarded with a quick improvement.
If an attack of gout is allowed to last more than a day or so before treatment is started, the response to treatment may be much slower.
Table 2: Medications to treat acute attacks of gout
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Video: An Exercise To Reduce Pain In The Top Of The Foot
This video demonstrates an exercise that can help reduce pain in the top of foot.
This exercise video is suitable for most people, but is not tailored to any specific condition, characteristic or person.
Get advice from a GP or health professional before trying it, especially if:
- you have any concerns about your health
- you are not sure if the exercises are suitable
- you have any pre-existing health problems or injuries, or any current symptoms
Stop the exercise immediately and get medical help if you feel any pain or feel unwell.
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Using Epsom Salt While Taking A Bath
Epsom salt has been used as an alternative medicine for decades. It is mandatory to remember that you must not drink or consume epsom salt in any form. The only way to use it is to add 1-2 cups to warm water while taking a bath. Apparently, it will be absorbed by the skin and directly affect the inflammation thanks to high levels of magnesium. If you consume plenty of foods rich in magnesium, there is no need to use both of these remedies. But, if you want soft skin, you may want to try epsom salt.
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What Happens At Your Appointment
The GP may ask about your diet and if you drink alcohol.
They may refer you to see a specialist and arrange a blood test and scan. Sometimes a thin needle is used to take a sample of fluid from inside the affected joint, to test it.
The blood test will find out how much of a chemical called uric acid there is in your blood.
Having too much uric acid in your blood can lead to crystals forming around your joints, which causes pain.
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.
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What Are The Symptoms Of Gout
As we said, it takes time for gout symptoms to develop. Sometimes it may even take more than ten years. Heres what you should be looking for:
- Pain, warmth, swelling and tenderness usually in a big toe joint. The pain starts suddenly, and it may continue for hours. Sometimes even a light pressure on the affected area will be intolerable. Gout may affect the feet, ankles, hands, wrists and knees
- Red or purplish skin around the join.
- Peeling and itching of the skin when the swelling goes down.
- Lingering discomfort. After the pain starts to subside, you might still feel some joint discomfort for a few days or a few weeks
- Lumps might develop under the skin around the joint due to the built up of uric acid crystal.
- Symptoms might appear as a result of an illness or trauma
Goat attacks usually:
- Develop over a few hours.
- Last 3-10 days.
- Become more frequent if left untreated. In this case, the attacks will probably last longer and affect other joints
However, you should know that symptoms may vary. Some people might not experience gout attacks, but feel the pain nearly all the time. This is called chronic gout.
If you dont get proper help, gout might lead to joint, tendon and tissue damage. Your doctor usually will prescribe you nonsteroidal anti-inflammatory drugs, colchicines or corticosteroids.
However, anti-inflammatory drugs have side effects like stomach pain, bleeding, and ulcers. Corticosteroids might lead to mood changes and increased blood sugar and high blood pressure.
To Treat An Acute Attack
To stop a gout attack, your doctor will give you medicines. These are usually pills like colchicine, NSAIDs , or a steroid medicine. Sometimes it’s treated with a steroid shot. The sooner you get started on medicines, the sooner your symptoms will start to get better.
To ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another anti-inflammatory medicine can also help you feel better. Using ice on the sore joint may also help.
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How Can I Self
The methods of managing an acute attack of gout differ from the ongoing methods for managing gout. If youve been diagnosed with gout, youll benefit in the long term from making healthy changes to your lifestyle, such as:
- maintaining a healthy body weight. If you do need to lose weight, make sure your weight loss is gradual as crash diets can increase uric acid levels
- drinking alcohol in moderation and avoiding binge drinking
- drinking plenty of water, and staying hydrated
- avoiding, or eating in moderation, foods that are high in purines. Talk with a dietitian for tips and advice
- exercising regularly aim to complete at least 30 minutes of physical activity most days of the week
- working closely with your GP to prevent further attacks and actively manage your condition.
The Pain And Swelling Of Gout Can Be Easily Treated
IBJI
October 17, 2012 | Blog
Gout is actually a form of arthritis that commonly affects the big toe in men. It may cause a sudden burning pain in one of your joints, or stiffness and swelling in one or more joints. Attacks of gout can happen repeatedly unless it is treated. Eventually, gout attacks can cause long-term damage to your tendons, joints, and soft tissues.
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What Is The Most Important Information I Should Know About Allopurinol
You should not use allopurinol if you are allergic to it.
Tell your doctor if you have ever had:
- kidney disease
- if you are receiving chemotherapy or
- if you have a gene variation called HLA-B*58:01 allele .
Tell your doctor if you are pregnant or breastfeeding.
Do not give this medicine to a child without medical advice.
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What Foods To Avoid
Many of the foods you want to avoid are meats and seafood. Meats such as chicken, pork, beef, or lamb are usually okay in moderation however, if you find they cause symptoms you will want to avoid them altogether. Salmon, as part of a gout diet, is also usually tolerated well in moderation.
- Yeast:beer, nutritional yeast, large amounts of bread, others
- Game meats: venison, veal, bison, others
- Organ meats: liver, tongue, tripe, others
- Fish: including sardines and anchovies
- Other seafood: shellfish, roe, others
- Sugary drinks: sodas, fruit juice, others
- Sugar substances: honey, nectar, high-fructose corn syrup, others
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How To Manage Gout Attacks
- Medically reviewed by
Gout attacks, also called flares or flare-ups, can come on suddenly and be extremely painful. During a gout attack you may have pain, swelling, and/or redness in your affected joint.Gout attacks can last anywhere from a few hours to several days. When you have acute gout, you may only have attacks once or twice a year. When you have chronic gout, attacks happen more regularly, with shorter breaks in between attacks.There are things you can do to manage your symptoms during gout attacks. The main goal of treatment during an attack is to decrease joint pain and swelling. If you already take a medicine to lower uric acid at the time of an attack, you should continue your regular treatment. If you do not already take a medicine to lower uric acid at the time of an attack, you should not start treatment during an attack, but rather start treatment afterwards, on your doctors advice.Some ways to manage gout pain and swelling during an attack are:
If the pain during a gout attack does not get better at all within 48 hours, call your doctor to ask about other treatments you can try.Treatments are also available to prevent gout attacks from happening in the first place. Having gout attacks more often can increase your chances of having even more attacks in the future, so controlling the condition from the start is important. Talk to your doctor about whether medicines to prevent gout attacks are right for you.
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For Ligament Cartilage And Joint Tears
Ligament, cartilage and joint tears in your knee will need to be addressed by your doctor.
After imaging diagnostics and a clinical assessment, your doctor will let you know if your treatment will include physical therapy and anti-inflammatory medication, or if youll need to undergo surgery to repair the injury.
Recovery from knee surgery can take some time. It may take anywhere from 6 months to a year to resume your normal activities.
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Easy Ways To Apply Heat Treatment In Gout
Besides medicines, there are specific other treatments that you can try to get relief from the pain of gout. Hot compression is perfect for any arthritis pain. As gout is also a type of arthritis, you can try hot compression for this. But, you should always consult your doctor about this.
Now, why hot compression is useful for treating gout pain? Once you apply heat to the aching muscles and joints, it relaxes that area and reduces the inflammation and swelling. Besides, heat application can increase lubrication at those stiff muscles and joints to reduce pain. The main reason for gout is the crystallization of uric acid at your joints. When you do hot compress, it provides comfort to these areas, and you feel relieved. There are different ways to apply heat treatment. Have a look-
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 doesnât 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.
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