How to Cure a Gout Attack

Gout is a complex form of arthritis that often affects men; however, women are increasingly susceptible to gout after menopause. A gout attack can occur suddenly, often waking you up in the middle of the night with the sensation that a joint or muscle is on fire. The affected joint or muscle will be hot, swollen, and so tender that even the weight of a bedsheet may seem intolerable. Fortunately, there are treatment to relieve a gout attack.^[1]

EditSteps

EditRecognizing the Symptoms of a Gout Attack

1. Check the joint for intense pain, swelling, or redness. Usually gout causes severe pain in one joint, like the base of your big toe, or joints like your ankle, wrist, or elbow. Affected joints will swell and the skin may look read or inflamed.^[2]
   
   • Any joint can be affected by gout, and sometimes two or more joints can be affected at one time.
2. Note if it is painful to walk. Putting any pressure on the affected joint will be very painful if you are experiencing a gout attack, and even the weight of a sheet or a blanket can hurt the affected joint. You may also have limited mobility or be unable to move the affected joint at all.^[3]
   
   • Sometimes, gout is mistaken for other forms of arthritis. If you are not sure if you are suffering from gout, you should get checked by your doctor to confirm your diagnosis.^[4]
3. Treat the gout attack as soon as possible. If you experience sudden, intense pain, you should call your doctor immediately. If left untreated, gout can lead to worsen pain and joint damage. You should seek immediate medical care if you have a fever and a joint is hot and inflamed, as these are signs of a possible infection.^[5]
   
   • If left untreated, a gout attack can last several days, but usually goes away completely within 7-10 days.
   • Some people only ever experience one gout attack in their lifetime, while others may experience a gout attack weeks, months, or even years after their last attack.

EditUsing Home Treatment

1. Uncover and elevate the affected limb. Remove all surrounding clothing or bedding from the limb so it is open to the air. Raise the limb by sliding a cushion under the limb. Avoid knocking around or damaging the affected limb when you elevate it.^[6]
   
2. Apply an ice pack to the limb. It’s important to keep the affected limb cool to ease any pain or swelling. Wrap an ice pack or a bag of frozen peas in a towel before applying it to the limb.^[7]
   
3. Continue to apply the ice pack for 20 minute intervals. Only apply the ice pack to your limb for 20 minutes at a time. Do not apply it directly to your skin or for longer than 20 minutes at a time as this could damage your skin.^[8]
   
   • Touch the affected limb to make sure the temperature of the affected limb has returned to normal before reapplying the ice pack.

EditUsing Medication

1. Get a prescription for anti-inflammatory painkillers (NSAIDs). Many people who suffer from gout will have a supply of NSAID tablets ready at home in case an attack occurs. The painkillers will ease most gout attacks and soothe your symptoms within 12-24 hours. There are several types and brands your doctor may prescribe, including diclofenac, indomethacin , and naproxen.^[9] Most people can take these drugs without any complications, but some side-effects may occur, including:
   
   • Bleeding from the stomach. This is more of a risk if you are over 65 years old or have a stomach ulcer. If you have either of these risks, you avoid taking these tablets and talk to your doctor about other possible medications.
   • Some people with asthma, high blood pressure, certain kidney problems, and heart failure may not be able to take anti-inflammatory painkillers.
   • If you are taking medication for other conditions, they could interact negatively with anti-inflammatory painkillers. Talk to your doctor if you are on other medications before taking the painkillers.
2. Take one anti-inflammatory painkiller at a time. Follow the dosage prescribed by your doctor and don’t take too many painkillers at once. Continue to take this medication throughout the attack and for 48 hours after the attack has finished.^[10][11]
   
3. Ask your doctor for proton pump inhibitors (PPI). NSAIDs should be prescribed together with PPIs, which reduces the risk of the NSAID causing indigestion, stomach ulcers, and bleeding from the stomach.^[12]
   
   • These medications will also protect your stomach if you have already taken aspirin and then experience a gout attack. Aspirin plus an anti-inflammatory medication will increase the risk of stomach bleeding. PPIs will help to counteract this risk.
   • Your doctor may also try interleukin-1 inhibitors (IL-1) to control pain. IL-1 may rapidly reduce pain for those who do not respond to NSAIDs.^[13]
4. Try colchicine if NSAIDs are ineffective. Colchicine is a medication that is derived from the Autumn crocus plant. It is not a painkiller, but it works to reduce the ability of the urate crystals that inflame your joint lining, thereby reducing some of the inflammation and pain during a gout attack.^[14]
   
   • Colchicine will be prescribed by your doctor and can be an effective treatment for gout if taken in the first 12 hours of the attack. But it should only be used at low doses as it can cause side effects like nausea, abdominal pain, and diarrhea.^[15]
   • Always follow the recommended dosage. For most people, this means no more than 2-4 colchicine tablets a day.
5. Talk to your doctor about corticosteroid tablets. These are a type of steroids for people that do not respond to other treatments and are unable to take an NSAID or a colchicine. A short course of steroid tablets provides relief but can’t be used long-term in high doses as they can cause side effects such as:^[16]
   
   • Weight gain
   • Osteoporosis, or thinning of your bones
   • Bruising and thinning of your skin
   • Muscle weakness
   • Increased vulnerability to infection
   • Corticosteroids can also exacerbate diabetes and glaucoma, an eye condition that can cause blindness if left untreated.
   • Do not use corticosteroids if you have impaired kidney function, impaired liver function, or a risk of heart failure.

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EditSources and Citations

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