During an acute gout episode, a person's first priority will be to alleviate the immediate pain and other symptoms. Once that is done, steps should be taken to prevent future gout attacks.

Without treatment and prevention, gout can become chronic, leading to repeated episodes of intense gout pain and possibly permanent damage to the affected joint(s).

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Treating a Gout Flare-up

The immediate goals for treating a gout flare-up are to reduce intense pain, swelling, warmth, and redness. With proper treatment, gout pain and other symptoms can be under control within 24 hours and completely gone within a matter of days.

    Ice. A soft cool compress applied to the affected joint can help relieve discomfort.

    Avoid pressure. Avoid contact with anything. Anything that touches the affected joint may cause a sharp increase in pain.

    Rest. It is usually painful to use the affected joint, and resting it will help alleviate pain, swelling, and other symptoms.

    Elevation. Elevate the affected limb to help reduce swelling. If the foot is affected, sit down with the foot resting on a footstool or lie down with the foot propped up on a pillow.

    Over-the-counter medication. Over-the-counter anti-inflammatory medications, such as ibuprofen and naproxen, can relieve pain, particularly if pills are taken as soon as the patient perceives the gout attack coming on.13 A doctor should be consulted regarding the adequate dosage. Aspirin should be avoided, since it can impair the kidneys' ability to filter out uric acid, making gout symptoms worse.

    Prescription pain relievers. When over-the-counter pain relievers are not sufficient, prescription painkillers such as codeine, hydrocodone, and oxycodone may be prescribed for short-term relief of acute pain.

    Colchicine. A prescription drug called colchicine is very effective at stopping an acute gout attack. Evidence shows that gout pain, swelling, and inflammation decrease when colchicine is taken within the first 12 to 24 hours of an attack, along with a second, smaller dose an hour or two later.

    Colchicine should be taken only as directed. Many people taking colchicine experience gastrointestinal side effects, such as vomiting or diarrhea.

    Corticosteroids injections. A doctor may inject the inflamed joint with steroids to relieve the pain. This treatment is particularly useful for people with sensitivities to certain medications. Repeated corticosteroid injections, however, can have side effects.

    Surgery. Gout cannot be treated with surgery. However, if untreated gout leads to the development and buildup of tophi, surgery to remove the tophi may be warranted.

Gout is usually so painful that a person cannot ignore it and will take steps to treat it. Once the symptoms of a gout attack are under control, a person can take steps to lower the uric acid levels in the blood and prevent another attack.

References

  1. Schlesinger N. Management of acute and chronic gouty arthritis: present state-of-the-art. Drugs. 2004;64(21):2399-416. Review. PubMed PMID: 15481999.
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