How to stop gout flares

4 Tips for Overcoming A Gout Flare-Up

Overcoming A Gout Flare-Up

If you were to ask anyone who suffers from gout, they would tell you the worst pain to experience is a gout flare-up.

My dad suffers from gout. I can remember when I was in high school and he was initially diagnosed. He went to bed one morning feeling fine. He woke up the next morning and couldn’t even put pressure on his foot. It was baffling.

Now that I’ve been a nurse for ten years, I’ve seen some pretty intense things and seen grown men cry because they’re in excruciating pain. Still, some people have told me that gout pain rates high on their list.

So, here are four tips that I’ve compiled – from my professional experience and from my personal experience – that can help you get through a flare-up.

Take Your Meds

Remember when you were handed a prescription for pain medication or told to pick up a certain pain reliever from the drugstore? You were probably given explicit instructions on how to take those medications so as to reduce the pain.

Well, pull those instructions out or better yet, call your doctor.

Several medications are often prescribed to treat pain associated with gout:

  • •    Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.  These can be purchased over-the-counter.  They     reduce pain while also lower the inflammation at the joint.
  • •    Your physician may also order NSAIDs that require a prescription, such as indomethacin.
  • •    Colchicine can also be given at the onset of a flare-up, but is not a pain medication, per se.  According to WebMD, it is thought to “…work by decreasing swelling and lessening the build-up of uric acid crystals that cause pain in the affected joint(s).”  Colchicine is given at a small dose and titrated up, and can also be given as a daily medication to prevent gout flare-ups.
  • Corticosteroids, like prednisone, can be given as a pill or injection if the pain doesn’t respond to NSAIDs or colchicine.

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Get Your Rest

When you were diagnosed with gout, it is likely your doctor spouted off on the importance of adding exercise to your life. After all, exercise can improve the mobility of the affected joints and reduce weight, both of which are beneficial if you have gout.

So why am I recommending that you rest if you are having a flare-up of your gout?

Try to remember when your physician told you what causes gout – your pain is essentially caused because uric acid crystals are building up in your joints. When you move your joints, your joints are moving against the crystals, which is what is causing the pain.

When you are in a “normal” state, you do not have the uric acid crystal buildup. I would strongly encourage an exercise routine at that time.

When you have a flare-up, the build up will cause inflammation. Rest is crucial for the inflammation to reduce – so you have permission to have a Netflix marathon!

Apply Ice

Applying ice to the affected joint is another great way to decrease pain immediately.

This method will not cause the pain to go away indefinitely, at least not until the uric acid crystals have had a chance to resolve themselves, but they can temporarily reduce pain.

To do so, just apply an ice pack (or any frozen food) to the affected joint. It is recommended to wrap the ice or frozen food in a dish towel – this will create a barrier so that you do not place the ice directly on the skin.

Drink Extra Fluids

Dehydration can trigger a gout flare-up to occur. Why? When there are fewer fluids in the body, the amount of uric acid in the body increases. When the uric acid levels rise, the kidneys cannot keep up.

When you’re in the midst of a gout flare up, it is wise to increase your fluid intake. This includes drinking an adequate amount of water, especially when exercising or when it is hot out.

Not only can this prevent a gout flare up from occurring, but it can also help to “rinse out” the crystals from the body during a flare up.

So there you have it – four tips to get you through a gout flare-up!

References 

Arthritis Foundation (Managing a Gout Attack)

WebMD (Colchicine)

WebMD (Gout – Medications)

WebMD (Your Gout Triggers)

 

 

Author Bio:

Krystina Ostermeyer is a practicing RN who also enjoys writing about health and wellness. She has a varied nursing background and is currently working as a diabetes educator. She lives in a small town with her husband and two-year-old son. You can find more of Krystina’s writing on NewLifeOutlook.

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29 Comments

  • CV

    Reply Reply May 22, 2018

    Hi Spiro,

    I’ve followed your posts for a bit and like your angle of living a a cleaner & better lifestyle.

    For the last 10 years I have had attacks of gout on average one every 3 years in my big toe (too much beer and tuna). Currently I have no pain at all (and haven’t for a good year or so) in the toe but definitely feel a limited range of motion (and subsequently light pain/awareness) when I stretch the toe performing certain exercises (think lunges when the toe is flat to the floor and the heel is raised)

    I can notice a clear although not huge increase in mass on my right big toe compared to the left which I would attribute to gout tophi, my question is: is stretching the toe like this likely to cause induce a flare-up?

    I’d welcome any response.

    CV

    • Hard to say. If you have tophi there you want to get it checked out by a rheumatologist and see what they say. I don’t know to what degree you have tophi so I can’t give you a good answer unfortunately.

  • Foods to avoid with gout

    Reply Reply March 21, 2018

    You have shared some great tips to overcome the gout pain from flaring up. However, I also like to add a point on making some dietary modifications to reduce the severity of gout flare ups.

    1. Eat fresh fruits and vegetables that are low in purines.
    2. Limit the consumption of alcohol
    3. Take a 10:10:80 macronutrient ratio(Protein:Fats:Carbohydrates)
    4. Include only Low GI carbohydrate foods
    5. Limit your protein from meat sources and switch to low fat dairy.

    • Spiro Koulouris

      Reply Reply March 21, 2018

      What I have been advocating since the beginning. Thanks for re-affirming!

  • Jack

    Reply Reply December 2, 2017

    For pain relief within hours cut a TransAct Flurbiprofen patch (from Reckitt Benckiser Pharmaceuticals) into 1 1/2″ wide strips and wrap around the affected joint,it works!

    • James

      Reply Reply May 2, 2018

      Had gout since 2007.Not overweight and climb mountains between episodes of gout. Gout is in one side of the family historically. One big attack per year is certain. During an attack my uric acid is around 4.5 and does not drop much when the attack has gone. This can’t be explained to me. Latest attack has been the worst yet. 6 weeks and finally clearing.

      I have been eating a lot of raw turnip,carrot and onion. Boil a big pot of this for 15 minutes when the raw stuff gets to much with potatoes. Add plenty of Black ground pepper and go easy with the salt. Blueberries. Bananas. Apples, Pineapple Melon.3 litres of water per day, every day with more during an attack. Heaps of tart cherries. 1000mg of Vitamin C supplement. Get good C not sugary stuff. Turmeric and Cherry supplements.

      No alchohol as that is a huge trigger. It’s the brewers yeast in beer I believe. Red meat is a no for any gout sufferer. Limit white meat as much as possible. White sugar to be avoided. I suspect cheese as a trigger not entirely sure but avoid it anyway as it’s 100% fat. Eating large meals is a trigger. Stop when you are full. Do not Pig out.

      Low dose aspirin and beta blockers are going to trigger gout. Gout is the work of the devil. Only a strict type of diet with good hydration and discipline is going to save you from it. Gout is assured if you do not watch your type of food intake.

  • Salim Abdus-Salam

    Reply Reply November 30, 2017

    I have been suffering from gout for about four years, mostly once a year. This year is the worst yet. I also have a third liver kidney failure that recently went from 45% 55% to 55% to 65%. I believe this is because I had just finish a 21 day fast. My doctor thought it was strange that my body would build up with UA while I was fasting. Maybe I was not drinking enough water. I wanted to fast for this gout thing but haven’t started yet. I am however drinking the cherry juice eating some fruit and veg. vinegar and water. I don’t want want to write too long. One question. Has anyone tried hemp for pain?

  • Karma

    Reply Reply November 23, 2017

    Hello Spiro,

    Thought to come here for some support… Thank you for this site. I have had gout since 2009. Female 52yo. Original gout flare 8 years ago after taking blood pressure meds. Doctors continue to deny it was gout and I had to do a battery of tests for months afterwards which came up empty. I provided all of my evidence and updates and research and my doctor then agreed it was gout. Prescribed colchicine (which made me sick) and Allopurinol which didn’t work all the time so as I Did not want to take allopurinol for the rest of my life, I decided to do it with diet. As of 2009, I have not eaten any red meat, had any alcohol, any shellfish or salmon. I was only getting gout flares once a year or so, but have had to add more foods to the “no” list based on gout attacks, such as: Asparagus, mushrooms, turkey and dried apricots ( attack was identified after isolating these items).

    A few of the gout attacks over the last couple years have been due to dehydration ( working all day out in the field without eating or drinking and then eating high sodium foods and not drinking enough water )… As I could feel, I wasn’t drinking enough water and the pain came on but it was too late to stop it.

    The attack I’m still feeling has been going for almost 4 weeks. My left foot gout started on the top of my foot moved to the outside and around to the underside so I could not walk at all. It then moved into the inside ankle bone and then the outside ankle bone and then into the big toe over 2 weeks time. During this time, I had to stay home from work, but I drink a ton of water with lemon every day and stayed on a “gout diet” of low-fat dairy including Greek yogurt, light cheese, apples, avocado, celery, milk pudding, brown rice cakes,some greens and tart cherry juice. Every time it relaxed in one area of the foot moved to another.

    It got better enough where I went to work for two weeks and then it started up again last Sunday and I’ve been off work for three days. Thank goodness that I am off for Thanksgiving Thursday and Friday and the weekend so I have four more days to get this under control! Not supposed to take Advil, but a few days during this time it was unbearable and I had to. I don’t know what else to do. I’m following a very low purine alkaline diet, drinking a ton of water, resting my foot all day, massaging it lately, and it’s just not going away. Stress does add to get out so I’m trying to remain positive and relaxed while at home… And I’m in contact with friends but need to rest and let it heal.

    I’ve tried apple cider vinegar and water which is horrible tasting, and hard to get down, so since Tart cherry and lemon are just as good, I’m using those. I’ve also had celery seeds on hard-boiled eggs as celery seed is supposed to reduce inflammation. I cannot take baking soda due to high blood pressure so I’m doing everything else. Sorry this is so long, but I needed to relay what I’m doing so people can comment about something I’m perhaps missing that I could add to my routine to help. Thanks and hope everyone is doing well.

    • Spiro Koulouris

      Reply Reply November 23, 2017

      Hi Karma!

      Thank you for telling us your story!

      Do you check your uric acid levels at least twice a year? If they are high even with disciplined dieting, you may have no other choice but see your doctor and go on medication to manage it. If kidneys are not working at their full capacity then dieting will do nothing for you, you will get flare-ups. Unless you screwed up and ate a food in the past few days that is a gout trigger. Sounds like you are doing everything that you can.

      • Betty Abbou

        Reply Reply April 12, 2018

        Thank you for sharing. This is good info

  • Lani

    Reply Reply November 5, 2017

    Hello,
    I suffer from gout. I usually get flares and attacks after very emotionally stressful days, or after surgery. I recently had surgery on my left knee. My left ankle flared so bad I sobbed. Last week I had ankle surgery, again my left foot swelled and was beet red.

    My question is will I have attacks after every surgery? I am scheduled for shoulder surgery in December (My horse knocked me down and into a brick wall, then ran over my legs and tripped and sat on me)

    My Dr gives me Allopurinol and Indomethacin. I have colchicine on hand for emergencies.

    Thank you

    • Spiro Koulouris

      Reply Reply November 6, 2017

      Hi Lani!

      Ouch! Hope you are feeling better! Yes surgery can wildly affect uric acid and can cause a gout attack. If you suffer an attack, colchicine will work best for quick relief from pain and inflammation. Good luck!

  • Dan S

    Reply Reply November 3, 2017

    Hi Spiro, I just had one of the worst attacks in my ankle. I was bed ridden for 2 weeks, and after finding your website and following some home remedies I am now in the clear. Im just wondering, given you stick to your strict diet as best you can, how often do you have gout flare ups, and if you still have them, how bad are they given the effort you put into your diet etc? Thanks so much for your help. D

    • Spiro Koulouris

      Reply Reply November 5, 2017

      Hi Dan!

      I haven’t had any flare ups for years now. So far so good, sometimes I’ll get a sore foot from putting too much pressure on my feet like walking long distances or running. This is the price your joints pay from having previous gout attacks unfortunately.

      • Dan s

        Reply Reply November 7, 2017

        Thanks Spiro,

        Could you let me know, typically what supplements and home remedies you take on a daily basis.

        At the moment my typical day consists of apple cider vinegar and colchine. Do you take anything else on a daily basis.

        I also try to drink 3 litres of water a day, minimum

        • Spiro Koulouris

          Reply Reply November 8, 2017

          Hi Dan!

          I take a couple apple cider vinegar capsules daily, vitamin D since I live in the northeast, vitamin B12 for energy boost, NutriGout for kidney and liver cleansing and my Tart Cherry Extract for uric acid control. The rest is all diet Dan.

  • Girlie T

    Reply Reply October 12, 2017

    Hi,
    My Mom was diagnosed 3 years ago and was initially given allopurinol. She had an adverse reaction to it – rashes, specifically all over her scalp. Another medication caused palpitations so now she’s on a control diet. No pork and loads of avocados. Fingers crossed, it’s been good.

  • rayan

    Reply Reply September 6, 2017

    I am gout sufferer for almost a year now.
    I am battling with gout since then until now, during my expirement on battling gout I came across some food and remedies that would help:

    1-black cherry extract, I took six a day.
    2-glucsomine and MSM, I took two a day.
    3-two table spoons of apple cider vineger
    4-baking soda 1/2 teaspon, 3 times a day
    5-drink plenty of water

  • Shauna White

    Reply Reply August 1, 2017

    Thanks for the tips!
    Very Very useful and well informed. I hope I will write like you someday. Keep writing.

  • Footlumps

    Reply Reply July 27, 2017

    I’ve been having regular serious gout attacks virtually every few weeks for the past six months. I have been on a strict diet and am on Allopurinol and test my uric acid level almost every day which shows that the Allopurinol is working. However, even though I’ve been on the strictest diet and medication for months here I am in the early stages of yet another severe attack and I have no idea why. I’ve done all the right things and my diet is abnormally strict due to suspected food allergies, so what is going on, and why? Constant gout is destroying my life.

    • Ed

      Reply Reply August 17, 2017

      What strict diet are you following? You’ll need to give up meat and fish. Especially fish for me. Once I did that and started drinking plenty of water my attacks stopped.

  • Gout Got Gout

    Reply Reply July 22, 2017

    Eat everything in moderation and don’t forget your morning pill. Have had Gout for years.

  • Darren Hignett

    Reply Reply July 7, 2017

    I completely disagree with the tip to apply ice. I keep hearing how keeping the joints warm helps with blood flow and to remove the crystals and that saunas are good for arthritis related illness.

    • Footlumps

      Reply Reply July 28, 2017

      Yes that does make sense, but in my experience I simply can’t tolerate my foot in even slightly warm water. It just sends it throbbing with pain. Likewise ice water is more than I can take. For me what helps is just cold water from the tap in a big plastic bowl, enough to completely submerge my foot, and I just keep that on the floor near me to use when I feel the need.

      I find that about a half hour at a time every so often seems to help the pain somewhat and I’ve sometimes even fallen asleep with my leg hanging off the edge of the couch with my foot in the water and stayed like that for a couple of hours which is about as long as I can sleep between painkillers during an attack.

  • Krishna Cheedella

    Reply Reply July 6, 2017

    Hi,

    Thank you very much for the tips. These helped me a lot. I would like to add that drinking 8 to 16 glasses of water every day is a must. It helps flush out uric acid out of the body.

    And the most important thing to control uric acid, in fact any disease is to have positive thoughts all of the time. Positive energy can keep you in great health. My uric acid is off the charts but gods grace I m in great health because I believe God keeps me healthy and happy. Push out negative thoughts and keep making happy thoughts all the time. That’s the key.

    Thanks and regards,

    Krishna Cheedella

  • Jason

    Reply Reply July 6, 2017

    Good article except I have to violently disagree with “Apply Ice”. Cold on an inflamed gout joint causes it to contract. Contraction causes your muscles, tendons and other flesh in general to press against the uric acid crystals more, similar to your exercise comment. Picture holding a handful of pins and needles. Now mentally increase your grip on the needles until they start to hurt a good amount. Applying cold is like closing your grip even further causing more damage.

    I learned this through practical experience when my physiotherapist recommended cold for my gout. This is the standard lesson in Physio school for an inflamed joint. When I tried it things got much worse following the example above.

    ON a different note I have found the hydration comment the most important. Drinking quite a bit more than you are comfortable with helps quite a bit.

    Cheers!

  • Hector m. Lopez

    Reply Reply July 6, 2017

    Thank you very much for your professional
    Help and the tips… ( Very useful ) superb.

  • Andrew DeMario

    Reply Reply July 6, 2017

    Why overcome flareups when you can get rid of gout for good? I have beat gout. I am a senior citizen, not overweight, and exercise daily. I had gout for 8 years and it progressively got worse. I was determined to get rid of it, i.e., dissolve all UA crystals, and never get an attack again, and never take any medication in the process. I succeeded. I am now free of gout for 18 months when I was getting a severe attack once a month before. I took drastic measures. For one year I quit all booze, became a lacto/ovo vegetarian, drank a minimum of 1/2 gallon of water each day, stopped eating honey and all added sugars (especially fructose) and took 1/2 teaspoon of baking soda in 6 ounces of water every night before I went to bed. I now eat any and all forms of meat and fish and fats and don’t believe that sort of food to be gout causing at all. I stopped with the baking soda six months ago, but still drink water copiously. In my opinion, booze and sugar are the enemy and always have been.

    • Footlumps

      Reply Reply July 28, 2017

      Personally I believe much of what you say to be true. Certainly fructose is a culprit. But when you think about it logically you can’t help but see connection between a more “natural” diet and better health. I believe genetics play a part too.

      The high rate of alcoholism, anemia, diabetes and associated conditions among the native populations of Mexico and North America are in my opinion closely linked to the sudden recent dietary changes brought on with the abrupt availability and consumption of unnatural foods in the population.

      To me it makes sense that for people accustomed to thousands or even millions of years of certain food sources there must surely be consequences if there is a massive and abrupt disruption or alteration in food such as that experienced by native American populations in only the last couple of hundred years. Sudden exposure to refined sugar, widely available alcohol and unnaturally processed foods to a population would almost certainly have adverse effects.

      For all of us this evolutionarily sudden disruption in food sources is tantamount to cultural suicide whoever you are. We should all look back at what our own individual genetic cultures were used to before globalization made everything available to everybody everywhere all the time.

      I would be very interested in knowing things like what Roman physicians reported when Rome’s armies became international migrants, or what happened when Vikings from Europe settled permanently in North America.

      This article is very interesting: http://www.goutandyou.com/gout-and-the-tsimane-tribe/

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