S To Take During A Gout Flare
A gout attack is one of the most painful experiences you can have. It usually doesnt give you much warning, and comes on suddenly. According to the National Kidney Foundation, gout is on the rise and affects more than 8 million American adults.
In each of our locations in Michigan, our team at Great Lakes Foot and Ankle Institute welcomes patients who are suffering from this extremely agonizing form of arthritis. Our team of knowledgeable podiatrists offer some advice for ways you can manage your gout pain during a flare-up. But first, lets cover some general information about gout.
Stage : Intercritical Gout
After a first gout flare, 75 percent of people will have a second within a year but some people can go years before another attack, says Dr. Fields. The in-between stage is where a person has already had a gout flare but is presently not having any joint pain or swelling, he says. Almost all gout patients will go through this phase, since it is the nature of gout to have flares and then quiet down for a period of time before the next flare.
Even though it may seem like nothing is happening, this is the point in which patients should begin long-term treatment. Lowering uric acid levels with medication can prevent future gout flares and long-term complications that go with them.
The Pain And Swelling Of Gout Can Be Easily Treated
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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Different Pain Intensity Is Noticed
The first thing I will reveal is that the pain you feel wont always be the same. It is the strongest during the first 12-24 hours, but after that, it will start declining, until you are finally free of it. Most people experience a gout attack which lasts between 3 days and 1 week, but as I have mentioned, this matter cannot be generalized. It is possible that your gout attack lasts for a few weeks, even 2 months! During that time, you will be trapped in a bed at home and you wont be able to go to work or to continue with your daily routine.
I also must add the fact that gout and its attacks must be treated as soon as possible. Ideally, you would use some method for prevention, but if still, an attack occurs make sure you start a treatment at the same moment. Take ibuprofen or colchicine. Stay calm and continue using some of the preventives I have revealed so far.
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If you have frequent gout attacks, make sure to find the main cause of it. As we all know, gout is a progressive disease which can be triggered by numerous factors, so always try to find the solution and use it straight away.
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Risk Factors And Determinants Of Flares
shows the association of various factors with the number of flares. Male gender was associated with a higher number of flares . We observed a trend to a lower number of flares among older individuals, i.e. the oldest age category had the highest proportion of individuals with no flares . We found that higher BMI , and greater number of GP visits were also associated with greater number of flares. Both a higher alcohol consumption as well as a history of cardiometabolic diseases were also associated with greater number of flares . A borderline association was found between the history of digestive diseases and the number of flares .
Association of various factors at baseline with the time to the first post-diagnosis flare during follow-up by a Cox proportional hazard model
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Uric Acid Is The Cause
When there is an overabundance of uric acid in the blood it is called gout. Usually, having too much uric acid in the blood is not harmful. In fact many people with high levels in their blood never know about it. When uric acid levels in the blood become extremely high, the uric acid may start to form crystals. These crystals most commonly form in the joints, especially the joints in the big toe. Your odds of experiencing the pain of gout are higher if you are overweight, drink excessive amounts of alcohol, or have a diet that is comprised of meat and fish that are high in chemicals called purines.
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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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:
Can It Lead To Any Complications
If left unmanaged, gout-related inflammation can cause permanent damage to your ankle joint, especially if you have frequent flare-ups.
Over time, lumps of uric acid crystals, called tophi, can also form around your ankle. These lumps arent painful, but they can cause additional swelling and tenderness during a flare-up.
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Definition Of Cormorbid Disorders
Traditional lifestyle and demographic factors such as alcohol use, smoking and BMI were collected from the database before the index date . In a similar way, information about the comorbidities of interest was collected. It comprised cardiometabolic diseases digestive diseases . The numbers of GP visits, referrals and hospitalizations in the year before the index date were also ascertained.
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.
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Ascertainment Of Gout Flares
All members from the cohort of incident gout were followed from start date, corresponding to 30 days after the first-ever diagnosis of gout, until the earliest occurrence of one of the following endpoints: gout flare, cancer, death, end of practice data collection or 31 December 2008, whichever came first.
The operational definition of gout flare was defined as follows: when there was a recorded prescription of colchicine or when there was a health-care visit recording gout together with at least one of the following treatment patterns within 1 week: IA aspiration, IA injection , prescription of NSAIDs or prescription of CS or adrenocorticotropic hormone . The final cohort consisted of 23857 patients: the difference with the initial cohort is patients presenting one of the censoring criteria during the first 30 days after the diagnosis of gout .
Ascertainment of flares was performed recursively adding in every new follow-up a period of grace of 30 days to the date of the flare detected in each consecutive search . The validity of our operational definition of flare was confirmed based on the manual review of a random sample of 100 computerized patient profiles .
Study design and ascertainment of gout flares.
Why Do Gout Attacks Occur
The simplest explanation is due to high levels of uric acid. If the level is 5 mg/dl or higher, you can expect a gout attack. Some people can even record extremely high levels of the aforementioned acid and it may reach up to 18 mg/dl. If this occurs, you can expect a permanent joint inflammation so wheelchairs are mandatory!
The main point here is that you must keep your uric acid level at 5 mg/dl or lower. Thats why it is important to have regular tests in order to determine if the therapy actually working. If it is, then there is no need for you to feel scared. There wont be a gout attack. On the other hand, if the uric acid level is too high, you will have to start a new therapy. I dont have to tell you that the test is performed by a doctor who will measure the uric acid level and the elimination of its crystals in the joints. If they are not eliminated on time or in proper amounts. The therapy will have to be increased, all in order to protect you from pain and gout.
Keep in mind that gout is a progressive disease, meaning that it will advance all the time. If you dont get used to it, you will expose yourself to more frequent gout attacks, which are definitely something worth avoiding!
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Take Your Gout Medication Regularly
In addition to the strategies described above, a doctor will usually recommend taking a prescription medication, such as allopurinol, that is proven effective in preventing gout attacks.
Allopurinol and other medications that lower the uric acid can have several benefits, including reducing gout flares, improving function and quality of life, increasing productivity at work, decreasing sick-days from work, and reducing gout-associated cost. Like most drugs, the long-term use of prescription gout medications carries a small potential of side effects and health risks.9 You should discuss the potential benefits and risks with your provider.
How Is Gout Treated
Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
- Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
- Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food , may help prevent future attacks. Changing or stopping medications associated with hyperuricemia may also help.
- Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
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How Long Does Gout Last
Discover here how long your gout attack can last for and who is at risk of longer gout attacks. Then discover how to prevent them.
Generally speaking, an attack of gout can last anywhere from 3 to 21 days, sometimes even longer. 7 to 10 days could be the average for most people.
But a lot depends on how quickly it is diagnosed, how quickly treatment is started, the type of treatment used, and its location in the body.
But there are also other determinants for how long a gout attack can last. For example, gout may last longer in:
- folks with certain underlying medical conditions
- and even some medications
The big toe is the most common location for gout, but you can also get gout in the knee, the ankle, hand, and so on. Basically any location where uric acid crystals can accumulate
You see, the common denominator in gout is high uric acid blood levels a condition called hyperuricemia. This condition can then lead to the formation of uric acid crystals in the joints. Its generally assumed that high uric acid is anything over 6 mg/dl. However, it has been known for some people to have levels over 9.0 mg/dl and not suffer from gout. Equally, gout has been known in patients with levels as low as 6 mg/dl. Much depends on the individual. But, as a general rule of thumb, maintaining your levels below 6 mg/dl is a good target.
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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How Long Does Gout In The Ankle Last
Gout flare-ups can last for several hours at a time, but you may feel pain in your ankle for days or weeks. Some people only have one flare-up in their life, while others have them several times a year.
Keep in mind that gout is a chronic condition, meaning it lasts for a long time and requires ongoing management. Dietary changes and medications can make a big difference, but youll also be at risk of having a flare-up.
Keep in mind that it can also take some time to find the right combination of diet changes and medication that works for you. Dont be discouraged if things dont seem to be improving right away.
What Is The Fastest Way To Get Rid Of Gout
- Nonsteroidal anti-inflammatory drugs : These can quickly relieve the pain and swelling of an acute gout episode. They can shorten the attack, especially if taken in the first 24 hours.
- Corticosteroids: These drugs can be taken by mouth or injected into an inflamed joint to quickly relieve the pain and swelling of an acute attack. Corticosteroids usually start working within 24 hours after they are taken.
- Colchicine: An anti-inflammatory medicine that works best if taken within the first 24 hours of a gout attack.
Medications for reducing uric acid levels: These are usually prescribed after an acute attack ends to reduce uric acid levels in the body to prevent future attacks.
- Colchicine: Regular and low doses of colchicine may be given along with other medications below to prevent flare-ups.
- Allopurinol: It reduces uric acid production in the body.
- : It reduces uric acid production in the body.
- Probenecid: It acts on the kidneys to help eliminate uric acid.
- Pegloticase: This is a medication that is injected every 2 weeks. It reduces uric acid quickly and used when other medications fail.
Lifestyle and home remedies to treat acute gout and can prevent recurrent attacks:
- Limiting or avoiding alcohol consumption and drinks sweetened with fructose
- Limiting intake of foods high in purines, such as red meat, organ meats, and seafood
- Drinking plenty of fluids
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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.