Treating Gout Attacks

Content

• What Types Of Doctors Treat Gout?
• Treatment
• Recurrent Gout: 2
• Interval Or Intercritical Gout
• How Is A Gout Attack Treated?
• Rheumatoid Arthritis And Gout: Whats The Difference?
• Common Misconceptions About Gout

Corticosteroids can be given as a tablet that the patient swallows or as an injection . In addition to medications for an acute attack, application of ice to the affected joint may be helpful to reduce pain. The goals of treatment for gout are fast pain relief and prevention of future gout attacks and long-term complications, such as joint destruction and kidney damage.

What does gout look like?

Symptoms of Gout
Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness. The small joint at the base of the big toe is the most common site for an attack.

Gout has an increased prevalence in some populations but is rare in others. For example, the frequency of gout is higher in populations such as the Chamorros and Maori and in the Blackfoot and Pima tribes. Many Maori and other Polynesian women have a genetic defect in renal urate handling that places them at risk for hyperuricemia and gout. However, racial differences may at least in part reflect differences in diet, which has a large influence on the clinical expression of gout. Although the pathophysiology, clinical presentation, and acute-phase treatment of gout and pseudogout are very similar, the underlying causes of the 2 diseases are very different. Many conditions and drugs have been associated with an increase in plasma urate levels, particularly metabolic syndrome.

What Types Of Doctors Treat Gout?

It’s important to discuss your symptoms with a healthcare provider. The third category of medications are those used during attacks of acute gout to decrease pain and inflammation. Both colchicine and NSAIDs can be used during an acute gout attack to decrease inflammation and pain. Corticosteroids such as prednisone, methylprednisolone , and prednisolone , also can be used during an acute gouty flare. However, the total dose of steroids is generally limited due to potential side effects such as cataract formation and bone loss.

A period of time when there are no symptoms at all, followed by other acute severe attacks. A sudden onset of joint pain and swelling that goes away after five to 10 days . Some people have one episode and never have any other problems with it. Others have several episodes along with lasting joint pain and damage.

Treatment

It is sometimes referred to as the “disease of kings,” because people long have incorrectly linked it to the kind of overindulgence in food and wine only the rich and powerful could afford. In fact, gout can affect anyone, and its risk factors vary. Patients may need medications to lower their elevated blood uric acid levels that predispose to gout. Sometimes it can be hard to pinpoint which of these factors is behind your gout attacks. Keeping a diary is one way to track your diet, medications, and health to help identify the cause of your symptoms.

Gout usually affects the big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins. UCSF provides comprehensive evaluations and advanced care for all forms of arthritis, including gout. Our team includes doctors from several specialties, including rheumatology, orthopedic surgery, dermatology and plastic surgery.

As noted above, starting allopurinol or febuxostat can trigger a flare of gout. This can be prevented by slowly increasing the dose of these medicines, and by taking a low daily dose of colchicine. Talk to your provider about how to prevent a flare, and be aware that if this happens, it is not an allergic reaction. A CT scan, ultrasound, MRI and/or joint fluid aspiration will be done to assess for crystals that are proof-positive of a gout diagnosis. The more risk factors a person has, the greater the risk for developing gout.

When Should Patients Seek Treatment For Gout?

Gout leads to attacks, or flares, that appear suddenly with hot, red, or swollen joints. Sometimes the joints look like they are infected, even though they are not. Obesity, insulin resistance, high cholesterol, heart disease, hypothyroidism, and kidney disease can be associated with gout. Episodes of gout have been noted after injury or surgery, sometimes involving infection or the use of contrast for x-rays. Physical fitness seems to help with prevention of gout.

How can I flush uric acid naturally?

In this article, learn about eight natural ways to lower uric acid levels. 1. Limit purine-rich foods.
2. Eat more low-purine foods.
3. Avoid drugs that raise uric acid levels.
4. Maintain a healthy body weight.
5. Avoid alcohol and sugary drinks.
6. Drink coffee.
7. Try a vitamin C supplement.
8. Eat cherries.

Losing weight may help lower uric acid levels and reduce the risk that you will experience future gout attacks. Having too much uric acid in the blood is a condition called hyperuricemia. Certain foods, medicines, and lifestyle factors can cause high uric acid levels in the blood, triggering a gout attack. For sudden gout attacks and flare ups, your physician may recommend certain over-the-counter pain relievers.

During an attack, joints become stiff, red, hot and tender. Gout can affect any joints in the body including the feet, arms and legs. In some families, inherited factors play a role in a person’s risk for developing arthritis. If a parent or other close relative has been diagnosed with arthritis, it is important to share this history with a health care provider.

The condition results from deposits of needle-like crystals of uric acid in the connective tissue and joint spaces. Uric acid is a byproduct of the breakdown of waste products in the body. When the body increases its production of uric acid or if the kidneys do not eliminate enough of it from the body, levels build up and cause gout.

A therapist can help design an exercise program to meet a person's specific needs. Gout occurs most commonly in the big toe because uric acid is sensitive to temperature changes. At cooler temperatures, uric acid turns into crystals. Since the toe is the part of the body that is farthest from the heart, it’s also the coolest part of the body – and, thus, the most likely target of gout. Prescription-strength NSAIDs, such as indomethacin , may also be used in severe gout to treat pain and inflammation.

People with gout may also experience kidney stones and damage to their kidneys. Reducing inflammation during an acute gout attack will provide pain relief. Uric acid is produced when your body breaks down purines, which are substances naturally found in your body, as well as in protein-rich foods.

Needle-like uric acid crystals are best viewed with a microscope. Inflamed lumps of tissue may form in the joint with repeated bouts of gout or in prolonged cases. Rheumatoid arthritis , which occurs when the body releases too many inflammatory chemicals . Recurrent gout People with recurrent gout experience flare-ups, or attacks, several times a year. If these attacks aren’t treated, they can cause permanent joint damage. Many people with gout avoid exercise because they fear it will make the inflamed joint worse.

Common Misconceptions About Gout

The medical name for pseudogout is calcium pyrophosphate deposition disease . The physical therapist should be aware that any patient with a history of gout, hyperuricemia, and/or a septic joint presentation should be refered for medical evaluation prior to treatment. In patients with gout, modifiable risk factors such as obesity, diuretic use, high-purine diet, and alcohol intake should be addressed. Medications such as nonsteroidal anti-inflammatory drugs , colchicine, and/or corticosteroids may be used.