It’s 3 a.m. and suddenly you’re awake, with sharp stabbing pain coming from your toe. It hurts so much that just having the sheet over your foot is painful.
This is the harsh reality of what happens during an attack of gout.
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Gout is a condition that has plagued people for centuries and currently affects millions of Americans, mostly men. It's caused by the build-up of uric acid in the body, which crystalizes in joints and can cause episodes of inflammation and mild to intense pain.
Fortunately, there are several measures that can help ease your pain and get you through a gout attack:
1. Take pain medications.
Over-the-counter pain medications can help you through an attack, particularly anti-inflammatory options like ibuprofen or naproxen (Aleve). Ask your physician which option and dosage is best for you.
2. Take your prescription drugs.
If you've had a gout attack before, your physician may have prescribed drugs to treat future attacks, such as:
- A strong painkiller such as such as codeine, hydrocodone, and oxycodone
- A corticosteroid, either taken orally or given as an injection into the affected joint
- An oral medication called colchicine, which is specifically for gout and has been shown effective in reducing pain and inflammation if given in the first 24 hours of an attack
3. Apply ice to the affected joint.
If you can tolerate the pressure of an ice pack, cold therapy can offer pain relief by decreasing inflammation and dulling pain signals.
4. Elevate the joint.
If your foot is affected, prop it up on a pillow or footstool. In fact, the RICE (rest, ice, compression, elevation) protocol—except for compression, which is too painful—can help ease a gout attack.
5. Take it easy.
Rest the affected joint and keep pressure off it until pain eases. Have roomy slippers on hand, so you can keep your feet warm and comfortable until the attack passes.
6. Stay hydrated.
Drinking water throughout the day will aid in flushing the uric acid from your system. Aim for 8 glasses a day.
For severe cases of gout, your physician may recommend corticosteroid injections into the affected joint, which can be useful for those with sensitivities to other medication options.
While this is rarely needed, surgery may be recommended to remove tophi, which are small white growths that occur under the skin where uric acid has crystalized.
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There are also important measures you can take to prevent a future gout flare-up, including avoiding food and the drinks high in purines.