How Is Gout Treated
When you have a gout attack, pain relief is your first goal. Its important to call your doctor even if the pain has stopped. The uric acid buildup that triggered your gout attack may still be irritating your joints and could eventually cause seriousdamage, like joint destruction and kidney damage.
Your doctor may:
- Give you a shot of corticosteroids to ease discomfort quickly
- Prescribe a long-term medication that can prevent and even reverse uric acid buildup
- Recommend lifestyle changes or alternative treatments
Theres a lot you can do on your own to ease symptoms:
- Rest the affected joint until the attack passes and for 24 hours after the attack.
- Elevate painful joints.
- Use ice to reduce swelling.
- Relieve inflammation with NSAIDS . Avoid aspirin, which can worsen symptoms.
- Limit alcohol, especially beer and hard liquor.
- Cut back on meat and seafood, which can raise uric acid levels.
- Follow a moderate exercise program.
- Control your weight. Being overweight increases your risk for gout.
What Increases Your Chances For Gout
The following make it more likely that you will develop hyperuricemia, which causes gout:
- Being male
What Does The Future Hold For Gout
Active research is ongoing in a variety of fields related to gout and hyperuricemia. Scientists have found that high animal protein slightly increased the risk for gout. New drugs are being developed that may be more versatile and safe in treating the elevated uric acid levels in patients with chronic gout.
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If you havegout, youre all too familiar with the sudden, burning joint pain that a gout attack can bring on most commonly in the big toe.
Gout a type ofarthritis is caused by too much uric acid in the blood. Usually, having an excess of uric acid isnt harmful. In fact, many people with high levels in their blood never get gout. But when uricacid levels in your blood are too high, the uric acid may form hard crystals in your joints.
Common Myths About Gout
Drinking too much alcohol and eating too much rich food were once considered the prime suspects in causing gout. Although eating certain foods and drinking alcohol may cause uric acid levels to spike, these habits alone may not cause gout.
A recent study indicates that our DNA is a key factor in gout flare-ups. Researchers found that diet was less important than genetics in determining whether or not patients would develop high levels of uric acid.
If you suspect you have gout, make an appointment with your doctor to be tested and learn how to prevent or reduce future gout attacks.
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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 .
How Long Gout Pain Lasts
Characteristically, gout pain comes on rapidly and the joint becomes red and swollen, with the swelling reaching a peak within the first 24 hours of the attack, Dr. FitzGerald explains.
At first, gout usually affects just one joint, but can affect more than one joint, sometimes adjacent joints. Flares typically resolve on their own over the next seven to 14 days. Treating a gout flare with medications can help it resolve faster. Medications for gout flares typically include:
- Non-steroidal anti-inflammatory drugs , such as ibuprofen or naproxen
- Colchicine
- Glucocorticoids
A gout attack may occur only one or two times a year or even only a few times ever. However, gout can become chronic, leading to frequent attacks and flares that occur at least a few times a year or never completely resolve. Chronic gout can damage and deform joints and can sometimes be mistaken for other inflammatory diseases like rheumatoid arthritis.
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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.
Is It Gout Or Bunion Pain In My Left Big Toe
Hello everyone, I had my first gout attack about two years ago in my left big toe.
I had a lump on the side which my doctor told me was a bunion. Treated that attack with colchicine and Indomethicin. That cleared it up pretty quickly and I really didn’t do anything to address the gout after that.
The bunion started bothering me more and more so my foot doctor agreed to bunion surgery. When I was in recovery the doctor told me he was shocked to find a lot of uric acid crystals in my foot. He told me he removed as much as he could. Two days into recovery my big toe pain got worse and felt like gout so I took some of the old colchicine pills I had and that seemed to relieve the pain somewhat. Then two days ago, a week and a day after surgery, my ankle just got so painful I feared that was gout also.
I called my foot doctor and he prescribed me indomethacin after taking that for a day my ankle pain lessened and went away. I am continuing the indomethacin for a few more days. I am going to have to change my diet, slow down on beer, and get on allopurinol.
Does anyone think my toe and ankle could have been gout attacks after surgery?
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Why Does Gout Affect The Big Toe
According to the American College of Foot and Ankle Surgeons, gout is most common in the big toe joint because uric acid is sensitive to temperature changes. The foot is farthest from the heart and is the coolest part of the body, so that big toe joint can be a canary in the coal mine when it comes to gout.
How Can A Gout Attack Be Prevented
Diet plays a key role diet in gout prevention: Since foods can directly set off gout attacks, patients with gout should receive counseling as to which foods are more likely to induce attacks. Losing weight is often also helpful. However, as important as diet is in gout, for most people with gout diet, and even weight loss, are not enough, and medications will be needed to get to their uric acid goal.
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The Role Of Medication In Prevention Of Gout
Table 3: Medications to pevent attacks of gout
Standard medications in preventing gout attacks
i. Colchicine : using the matches analogy discussed above1, using colchicine can be seen as dampening the uric acid matches. Colchicine does not lower the bodys store of uric acid, but it decreases the intensity of the bodys inflammatory reaction to these crystals. Recent studies have shown that at least one mechanism of colchicines action is by acting to prevent a cascade of reactions that lead to the production of interleukin 1-beta, which is an inflammatory protein , which is important in gouty inflammation.8
ii. Allopurinol: This agent is presently the most commonly used drug for the prevention of gout. Allopurinol blocks the enzyme xanthine oxidase, which blocks the breakdown of purines, thus decreasing the bodys total amount of uric acid. Allopurinol is effective in preventing gout no matter what the mechanism of the elevated uric acid was. Whether a person is making too much uric acid, or has difficulty excreting it via the kidney, allopurinols decrease in uric acid production leads to the same goal: a decreased total body uric acid.
Table 4: Reasons to use medication to lower uric acid
Replies To Gout In Pictures
- Medina WeeklyFebruary 13, 2020
i have had gout for a couple of years in my big toe.i do try to eat healthy,one thing i have found works for me is drinking the pom juice,plain and mixed ,cherry,blueberry.2 days without my juice and i get a painful reminder.
- SamSeptember 1, 2019
Ive had gout for almost 15 years. Usually it hits the big toe area. One day I got a stiffness in my left knee. Within 2 days the knee was inflamed. Took naproxen to calm the swelling & pain. Then within one week my right knee also got attacked. FYI, the worst place to get gout is the knee. It literally knocks you on your back. If you are unlucky as me to get it in both knees same timewell I hope you have a high pain threshold. I am now 3rd week on my back. Swelling down but stiff as heck. Cannot walkI have to use a wheelchair. Urinate in a portable urinal because getting to the toilet is torture. I dont eat so not to have to go to the toilet. Basically you are crippled.
- MaryMarch 27, 2019
I have just been diagonised with gout in my left knee I have never had it before just wondering if once you have it will it always be there
First of all, a few prednisone 10 mg tablets will give a person relief within a day. Colchicine usually takes a day or two and has bad side effects. Like one guy stated genetics plays more of a roll in gout flairs than diet according to latest research. Hope this helps
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What Else Should I Ask My Healthcare Provider About Gout
Consider asking your healthcare provider:
- What is causing the gout?
- Do I have any joint damage?
- What can I do to prevent future attacks?
- Can any gout medications help me?
- How long will I need to take gout medications?
A note from Cleveland Clinic
Gout is a painful form of arthritis. Extra uric acid in your body creates sharp crystals in the joints, leading to swelling and extreme tenderness. Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks.
Last reviewed by a Cleveland Clinic medical professional on 11/15/2020.
References
Signs Your Pain Is Likely Gout And Not Something Else
If you develop sharp sudden pain in a single joint or a couple of joints, if the pain is so debilitating that it is hard to walk or wear shoes, and if you have risk factors for gout , theres good reason to suspect gout as the culprit. However, its important to see a doctor for a thorough exam and proper diagnosis.
Dr. FitzGerald cautions that issues unrelated to gout can cause an angry, inflamed joint. Gout may be confused with several other conditions that can cause similar symptoms, including:
- Pseudogout
- An infected joint
- Bacterial skin infection
- Rheumatoid arthritis
- Psoriatic arthritis
Pseudogout is caused by a different kind of crystal, calcium pyrophosphate. A flare of pseudogout can resemble gout, but it more often affects your wrist and knee, and is unlikely to involve the big toe. Like gout, pseudogout is also considered a form of inflammatory arthritis. Its more likely to affect people over the age of 40 and those who have a thyroid condition, kidney failure, or disorder that affects calcium, phosphate, or iron metabolism, according to the Cleveland Clinic.
Its also possible to have gout without the classic presentation of red, hot, sharp, burning, sudden pain in the big toe, foot, ankle, or knee. Some patients may have joint pain that is less acute.
People can also have high levels of uric acid but not develop symptoms of gout.
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When To See A Doctor
Gout occurs without warning. Anyone experiencing intense pain on the big toe, followed by warmth, tenderness, redness or discoloration, should immediately seek medical attention.
If a person does not receive treatment for gout, it can lead to joint damage over time, including bone erosions and arthritis.
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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Differences Between Men And Women
Sex differences play a role in which joints are affected:
- In men, about 85% of gout flare-ups affect joints in the lower extremities. About 50% of first-time gout attacks involve a big toe joint.8
- In women, a gout attack is most likely to occur in a knee.10 In addition, women may be more likely to get gout in the upper extremities.9
While women are less likely to get gout, they are more likely to have multiple joints affected by gout.13
Why Does My Big Toe Hurt Suddenly
When we think of gout, we might think of Renaissance-era royalty and indulgent feasts. But gout is still very much with us in the 21st Century. Gout is actually a type of arthritis that can affect any joint in the body. But it often strikes first in the form of sudden pain in your big toe. Heres a look at what causes gout, how to treat and prevent it, and why our big toe is so susceptible.
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What Does A Gout Attack Look And Feel Like What Would A Foot Or Toe With Gout Look Like
When gout occurs, the joint tends to be extremely painful and is warm, red and swollen . The inflammation that is part of a gout attack is systemic, so that fever and chills, fatigue and malaise are not uncommonly part of the picture of a gout attack.
Figure 6: Toe with Acute Attack of Gout
Gout attacks can occur in joints that look normal, or in joints that have easily visible deposits of uric acid. These deposits are called tophi and can be in numerous locations, but especially on the feet and elbows. In Figure 9, the little finger of the right hand is bandaged since fluid was just removed from it, which demonstrated innumerable uric acid crystals.
Figure 7a: Tophi on Foot
Figure 7b: Tophus Over Achilles’ Tendon
Figure 8: Tophus on Elbow
Figure 9: Tophi on Hands
Figure 10: Large Tophus of Finger
While some gout attacks will solve quickly by themselves, the majority will go on for a week, several weeks, or even longer if not treated. Since gout attacks are usually quite painful and often make walking difficult, most gout sufferers will request specific treatment for their painful condition.
Could That Ache In Your Big Toe Be Gout
Gout is a complex form of arthritis most common in men, though post-menopausal women are also susceptible. We explain the symptoms and provide tips to reduce your risk.
You wake in the night with the sensation that your big toe is on fire. The joint at the base of your toe is so swollen and tender that even the weight of the sheet feels too painful to endure.
You may be experiencing an attack of gout: sudden severe pain, redness and tenderness, often located in the joint at the base of the big toe. Gout is caused by the accumulation of urate crystals in a joint. Urate crystals form when your body produces too much uric acid or when your kidneys excrete too little uric acid. When uric acid builds up in the blood, needle-like urate crystals form in a joint or surrounding tissue, causing pain, inflammation, and swelling.
This complicated form of arthritis can affect anyone, though it is most common among men. The symptoms of gout are intense and almost always occur suddenly, without warning.
- Acute joint pain. Although gout often affects the large joint at the base of the big toe, it can also affect other joints in feet, ankles, knees, hands, and wrists. The pain is most severe in the 12 to 24 hours following the onset of the attack.
- Lingering discomfort. Usually, the sudden pain of an attack subsides within a day, but joint discomfort may linger for as long as several weeks.
- Inflammation. The affected joint is swollen, tender, and red.
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