How Long Does A Gout Attack Last

What Increases Your Chances For Gout

HOW LONG DOES A GOUT ATTACK LAST?

The following make it more likely that you will develop hyperuricemia, which causes gout:

Being male

Using certain medications, such as diuretics .

Drinking alcohol. The risk of gout is greater as alcohol intake goes up.

Eating or drinking food and drinks high in fructose .

Having a diet high in purines, which the body breaks down into uric acid. Purine-rich foods include red meat, organ meat, and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout, and tuna.

Signs And Symptoms Of Gout

Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers.

Signs and symptoms of gout include:

severe pain in one or more joints
the joint feeling hot and very tender
swelling in and around the affected joint
red, shiny skin over the affected joint

Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.

Almost everyone with gout will experience further attacks at some point, usually within a year.

Read more about the complications of gout.

What Are Future Possible Treatments Of Gout

Fortunately, present medications are successful in the vast majority of gout patients. But some patients cannot tolerate our present arsenal of gout medications. For others, these agents are not sufficiently effective. Therefore, new treatments are continually being sought. Some of the more promising include anakinra, rilonacept, canakinumab, BCX4208 and arhalofenate.

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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.

What Are The Signs And Symptoms Of Gout

Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.

Symptoms in the affected joint may include:

Pain, usually intense

Medications For Acute Gout

Non-steroidal anti-inflammatory agents and COX-2 inhibitors are the mainstay of therapy of acute attacks of gout in patients who have no contra-indication to them. These medications include such agents as naproxen , ibuprofen , celecoxib , indomethacin and many others. These agents reliably decrease the inflammation and pain of gout. However, patients with ulcers, hypertension, coronary disease, and fluid retention must be careful with these agents, even for the short courses needed to resolve a gout attack. The doses of non-steroidal anti-inflammatory agents needed to resolve a gout attack are on the higher side, since full anti-inflammatory effect is needed. See examples of dosage in Table 2. Over-the-counter dosage levels, for example, ibuprofen at 200mg, two tabs three times a day, are often insufficient.

Corticosteroids, such as prednisone and methylprednisolone , are anti-inflammatory agents that are quite effective against gout attacks. Anti-inflammatory steroids are very different in action and side-effects as compared to male hormone steroids. Anti-inflammatory steroids have long-term risks, such as bone thinning and infection, but their risk for short-term therapy is relatively low. These agents can raise blood pressure and blood sugar, so can be a problem for those with uncontrolled hypertension or uncontrolled diabetes mellitus.

S To Care For Yourself During A Gout Attack

There are some steps you can take at home to help ease the pain of gout, encourage kidney function, and lower the levels of uric acid thats triggering and worsening your flare-up:

Increase your fluids, especially water
Dont resist the urge to urinate
Rest, elevate, and ice your painful joints
Take an anti-inflammatory pain medication like ibuprofen or naproxen
Use epsom salt soaks
Take any prescribed medicines that decrease your uric acid levels
Eat foods and supplements that lower uric acid, such as magnesium, sour cherries, ginger, and celery
Stay away from alcohol, shellfish, and red meat, which cause your body to make uric acid

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The Four Stages Of Gout

Gout is best understood by seeing it as having four phases or stages :

Stage 1: High uric acid

Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.

Stage 2: Acute flares

This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.

Stage 3: Intercritical periods

These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.

Stage 4: Advanced gout

This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .

Figure 1: Stages of Gout

Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the “bunion joint,” represent a gouty tophus.)

Figure 3: Progression of Gout

When Asked How Long Does Gout Last Most People Would Say A Few Days To A Few Weeks

HOW LONG DOES A GOUT ATTACK LAST

How long does gout last? Your symptoms, treatment, and diet all come into play.

A gout attack can cause sudden and very severe joint pain. It frequently starts in the joint of a big toe and may wake you up at night. Even having a sheet resting on your toe can be painful. A gout attack can make you miserable. It may last from three days to up to two weeks. Taking medication usually helps reduce the pain and may shorten the attack. But even without medication, a gout attack usually goes away within ten days.

Once you have had an attack of gout, you need to start treatment to prevent another attack, because gout often comes back. Without treatment, you can expect another attack within two years. People with frequent attacks can develop a type of long-term gout that does not go away. It can cause painful lumps in or near joints and can cause damaging deformity of a joint. The good news is that treatment works well. Gout is very controllable for most people.

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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

What Is The Fastest Way To Get Rid Of Gout

Medications for acute gout attack: These medications are usually prescribed to treat an acute attack 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

Also Check: Early Signs Of Gout In Big Toe

Get Tested For Sleep Apnea

Untreated sleep apnea can increase the risk of gout.12,13 Sleep apnea is a sleep disorder that causes the body to take in less oxygen while sleeping, which in turn causes the body to produce more purines.12,14 Sleep apnea is typically treated with a continuous positive airway pressure machine or other device that increases oxygen intake while sleeping.

How Is Gout In The Knee Diagnosed

If you think you might have gout but havent been diagnosed, try to see a doctor while youre having symptoms. Gout is easier to diagnose when youre in the middle of a flare-up, especially one thats causing swelling, redness, and other visible symptoms.

During your appointment, your doctor will likely ask you several questions about your diet, any medications you take, and whether you have a family history of gout. This can help to rule out other potential causes of your symptoms, including an infection or rheumatoid arthritis.

Your doctor may also order a blood test to check your uric acid levels. Some people have high levels of uric acid and dont develop gout. Others have typical uric acid levels but still develop gout. As a result, your doctor will want to do some other tests as well.

An X-ray, MRI, or CT scan of your knee can help to eliminate other possible causes of joint inflammation. Depending on your exam, your doctor may also order an ultrasound to check for the presence of crystals in your knee.

Finally, they might do a joint fluid test. This involves taking a small sample of joint fluid from your knee with a small needle and looking at it under a microscope for any uric acid crystals.

Based on the results of your exam and tests, they may refer you to an inflammatory arthritis specialist called a rheumatologist for treatment.

Also Check: What Can You Do For Gout In Your Knee

Management Of Knee Gout Flares

The definite diagnosis of gout is made by needle aspiration of the joint fluid, which is studied to detect urate crystals. The aspirate from the knee joint contains crystals, even during the asymptomatic stage after an acute attack. Treatment should include lifestyle modifications to decrease the production of uric acid, weight management, and reductions in the intake of alcohol.

Local ice packs are used to decrease the signs of inflammation. For acute episodes, NSAIDs are used as the drug of choice, but joint aspiration can also relieve the pain. To decrease the inflammation, corticosteroid injection can be administered directly into the joint, and allopurinol and colchicine can be used to decrease inflammation. The patient is given a urate-lowering therapy in cases of recurrent gouty attacks, when there is evidence of joint damage, very high uric acid levels, and renal problems.

References:

Soloway, S. . Tophaceous gout in a knee with total joint replacement. JCR: Journal of Clinical Rheumatology, 17, 48.

Ko, K. H., Hsu, Y. C., Lee, H. S., Lee, C. H., & Huang, G. S. . Tophaceous gout of the knee: revisiting MRI patterns in 30 patients. JCR: Journal of Clinical Rheumatology, 16, 209-214.

Schlesinger, N., Schumacher, R., Catton, M., & Maxwell, L. . Colchicine for acute gout. Cochrane Database of Systematic Reviews, .

The Role Of Physical Activity In Prevention Of Gout

Along with diet, physical activity can help with weight loss, and gout has been associated with being overweight.7 in patients with well-established gout, especially if X-rays have demonstrated joint damage in the foot, a low-impact exercise program is reasonable. An exercise program combined with diet in gout can reduce risk for attacks.7 If an attack seems to be coming on in the lower extremity, patients are well-advised to try to get off their feet, since impact seems to worsen gout attacks. Clues to an attack of gout coming on include local swelling, heat, redness, and tenderness in a joint, especially in the foot, ankle, or knee. Some patients have fever and chills as the first warning that an attack of gout is coming on.

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What Happens At Your Appointment

Why Does Gout Attacks Last For Weeks?

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.

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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Who Is Affected By Gout

Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.

People are more likely to get gout if they have:

Obesity, or a lot of extra weight.

You are also more likely to develop gout if you:

Consume a diet high in animal proteins
Consume a significant amount of alcohol
Are on water pills .

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Information on GoutPal is provided by a gout patient to help you understand gout and related issues. Gout information is provided by a layman, with no medical training or qualifications. It should not be used for diagnosing or treating any health problem or disease. The information is given to help you understand your doctor’s advice and know what questions to ask. It is not a substitute for professional care. If you have an actual or suspected health problem, you should consult your doctor.