Home Treatments & Remedies For Gout Pain And Uric Acid

Content

• Who Should Diagnose And Treat Gout?
• Hot And Cold Therapy Tips To Tame Joint Pain
• Health Alert:
• Which Joints Are Involved In Gouty Arthritis, And Why Is It Most Common In The Foot?

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What is the main cause of gout?

Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat.

The red and hot joints, coupled with rapid acceleration of joint pain, strongly suggest gout, and identifying tophi, if present (see Figures 7-10) help further. 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.

Who Should Diagnose And Treat Gout?

In addition to lifestyle changes, medications play a vital role in gout treatment. There are 2 main classes of medication which lower uric acid levels, thereby reducing the risk of an attack. The first class of medications decreases the amount of uric acid that is produced in the body. These medications are called xanthine oxidase inhibitors, and they block the breakdown of purine into uric acid in the liver. The second class of medications, called uricosurics, increases the amount of uric acid eliminated from the body through the kidneys and urine.

Hot And Cold Therapy Tips To Tame Joint Pain

Some medicines are safe for people with kidney disease, and some are not. Talk to your doctor about which medicines make the most sense for you to try. Patients with a first gout episode should not start urate-lowering therapy, except if they have moderate-to-severe chronic kidney disease, kidney stones, or serum urate above 9 mg/dL.

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An important thing to remember when starting any of these medications is that they can cause an attack due to an abrupt change in uric acid levels. This is normal, and despite what appears to be a setback, the medications should not be discontinued. To minimize the risk of flare-ups, patients should continue treatment with any anti-inflammatory agents they use during acute attacks for at least 3 to 6 months after initiating maintenance medication.

Health Alert:

It typically occurs in the feet — mostly affecting the base of the big toe. It’s more likely to affect men and post-menopausal women — as well as people with diabetes, poor kidney function, and other underlying health conditions. However, for some patients, oral medications have not provided the expected relief. When that occurs, hydration therapy provides a safer alternative. In addition to NSAIDs or corticosteroids, supplementary analgesics, rest, ice application, and splinting of the inflamed joint may be helpful.

Palpable tophi develop in patients with gout and can rarely occur in patients who have never had acute gouty arthritis. They are usually firm yellow or white papules or nodules, single or multiple. They can develop in various locations, commonly the fingers, hands, feet, and around the olecranon or Achilles tendon. Tophi can also develop in the kidneys and other organs and under the skin on the ears. Patients with osteoarthritic Heberden nodes may develop tophi in the nodes. This development occurs most often in older women taking diuretics, and these can become dramatically inflamed and misdiagnosed as inflammatory osteoarthritis.

What Else Should I Ask My Healthcare Provider About Gout?

Treatment should continue for at least three months after uric acid levels fall below the target goal in those without tophi, and for six months in those with a history of tophi. Gout is a multisystemic inflammatory disease characterized by recurrent flares of intense arthritis. The usual attack of gout arthritis normally has short duration, affects one or few joints, and exhibits good response to nonsteroidal anti-inflammatory drugs, colchicine and corticosteroids.

If patients are taking urate-lowering drugs when an acute flare begins, the drugs should be continued at the same dose; dose adjustments are deferred until the flare has subsided. There is no contraindication to lowering serum urate levels during an acute flare if appropriate antiinflammatory therapy is being provided. If acute gouty arthritis is suspected, arthrocentesis and synovial fluid analysis should be done at the initial presentation. A typical recurrence in a patient with known gout does not mandate arthrocentesis, but it should be done if there is any question of the diagnosis or if the patient’s risk factors or any clinical characteristics suggest infectious arthritis.

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