Relieve The Pain With NSAIDs

When I got my first gout attack and was diagnosed with the disease, my doctor prescribed me NSAIDs and Coclchicine so I can walk again normally from the pain. That is the only time I used them, because I think I was limping for like 2-3 weeks when I first was diagnosed with gout. My other attacks weren’t as painful and long in duration, only lasting a few days.

So what are NSAIDs (pronounced En-sedz)?

The acronym stands for “Non-steroidal anti-inflammatory drugs” and that are many different types of these drugs. Did you know that we have been using NSAIDs to treat diseases since 1763? They are painkillers that reduce inflammation in the affected area like your toe or knee from your gout attack, working in reducing the levels of pain and are usually recommended as an initial treatment for gout. NSAIDs are also used to relieve arthritis. Steroids may be taken by mouth or by injection into the bloodstream or muscle.

NSAIDs used often to treat gout include the following:

  • Diclofenac (brand name Voltarol)
  • Indometacin (usually the first choice of physicians)
  • Etoricoxib (brand name Arcoxia)
  • Ibuprofen (you can buy this in pharmacies under brand name Advil, Motrin)
  • Ketoprofen ( brand names Orudis, Oruvail)
  • Naproxen ( brand names Naprosyn, Arthoxen)
  • Etodolac (brand name Lodine)
  • Fenoprofen (brand name Nalfon)
  • Tolmetin (brand name Tolectin)
  • Nabumetone (brand name Relafen)
  • Meloxicam (brand name Mobic)
  • Sulindac (brand name Clinoril)

Out of all the NSAIDs mentioned here, Naproxen seems to be the most recommended since it has the least side effects. Doctors will usually provide this as a first option since it is very effective at treating gout flares. Compared to other gout medications such as colchicine, naproxen is definitely preferable. Too much can be life threatening, meanwhile, naproxen has the least risk for vascular side effects. 

In one study, they compared the effectiveness of this NSAID against colchicine. They followed 399 patients all throughout England. One group consisting of 200 patients took 750mg of naproxen, then took a 250mg dose of it every 8 hours for 7 days. The second group of 199 patients took 500 µg of colchicine three times a day for 4 days.

What they found was that both groups had little difference when it came to pain relief. Both were effective at treating the gout flare. However, those who took colchicine had experienced diarrhea as a side effect of the drug. They also had more headaches and constipation. 

So the next time you have a gout flare, opt for naproxen instead. It is associated with fewer side effects and costs lower than colchicine.


Tart Cherry Extract for Gout

On a side note, Aspirin is a NSAID but not recommended for gout. Studies have shown that aspirin may raise the levels of uric acid in the blood. Corticosteroids may also be used and Prednisone is the most commonly prescribed and is often used in people who are unable to take non-steroidal anti-inflammatory drugs (NSAIDs) or colchicine. Use of NSAIDs may usually relieve the symptoms of a gout attack within 48 hours.

Actually, a  2018 study published in The Annals of Emergency Medicine concluded that there is no significant difference between corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) for short-term pain relief, long-term pain relief, time to resolution of pain, or the need for additional analgesics.

New research shows that a steroid pill may be as good as a nonsteroidal anti-inflammatory drug (NSAID) for treating painful gout.

What are the side effects of NSAIDS?

As with any drug, there are side effects that can be experienced by different individuals like nausea, vomiting, diarrhea, constipation, tiredness, headaches and can irritate the lining in your stomach which can cause bleeding in the stomach and/or ulcers especially if you are elederly. People with reduced kidney function or those with conditions such as stomach ulcers or bleeding should avoid using NSAIDs. Make sure to consult your doctor before using NSAIDs to treat gout.

Certain people will be affected by NSAIDs differently. For instance, pregnant women may not be allowed to take NSAIDs after 30 weeks since this can affect the fetus. Or if you have a child with a viral infection, they cannot take aspirin since it puts them at risk for developing Reye’s syndrome. Your doctor will assess your situation so they can provide the best drug that works best for you.

If you experience any serious symptoms like itching, rashes, swelling, black stool, trouble urinating, headache, middle back pain, blurred vision, fatigue, or unexplained weight gain, get help from your doctor right away. More severe side effects from NSAIDs can include difficulty breathing, swelling of the face or throat, slurred speech, or weakness on one part of your body. 

NSAIDs are meant to be taken for a short period of time. Be careful if you are prescribed to take them for longer than 10 days. Ten is the maximum time you can take OTC NSAIDs for pain. And, they should only be taken at the lowest possible dose. Those who take NSAIDs long term are at risk for serious side effects like renal failure, stroke, heart disease, eye damage, and peptic ulcer. 

Long term NSAID use can also make your existing diseases worse. So if you have a condition such as high blood pressure or heart disease, be very careful. Taking NSAIDs for at least three months is already considered chronic NSAID use.

If you have to take NSAIDs that long, make sure you undergo regular blood tests. This is to check whether everything is working properly and that your organs are not damaged from the drug. NSAIDs aren’t the only drug option for treating chronic pain. Talk to your doctor about it as they might be able to provide much safer options. 

When used effectively and in the appropriate doses, NSAID drugs may be very effective against gout attacks. I’d like to hear from your experiences, please don’t forget to add your comments.

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    23 replies to "Gout and NSAIDs"

    • […] NSAIDs may reduce the risk of Alzheimer’s disease but not the overall risk of dementia by reducing inflammation. […]

    • […] but certain medications used to treat a flare often lead to long-term risks to your bone health. Corticosteroids and colchicine are examples of drugs that can affect the bones resulting in bone thinning, […]

    • Abdul Aziz

      The key to controlling gout is blood iron levels – which is why pre-menopausal women rarely suffer from it. Start donating blood as that really helped me.

    • […] A disease of the joints due to an excess of uric acid in the blood. In gout, crystals of uric acid are deposited in a joint, resulting in swelling and pain. Treatment of arthritis is dependent upon the kind. Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) may help alleviate symptoms. […]

    • […] may prescribe colchicine or NSAIDs to get rid of the pain and inflammation and put you on long term uric acid management drug like […]

    • […] you visit a doctor, most likely he will treat you with NSAIDs like corticosteroids which will either be injected in the affected joint or given for you to take orally to get rid of […]

    • […] anti-inflammatory drugs (NSAIDs): NSAIDs are an anti-inflammatory medication that can be available over the counter (Motrin, Advil and […]

    • Ioannis S.

      My name is Ioannis and I am from Greece. My profession is Anesthesiologist (MD). I found your site extremely helpful because a close friend of mine suffers from gout. He is 65 years old, active (busy lawyer) and slightly obese. Is in treatment with the usual allopurinol and small dose of colchicine daily. Possibly will pass to febuxostat. In severe crisis uses an increased dose of colchicine plus rest, ice etc. In the past (maybe 10 years or so) a rheumatologist gave him, among the other usual drugs, and a small dose of injectable nandronolone (50mg/once a month). Although is reasonable to me that he felt better (anabolic effects), he also had no more crisis. He stopped the anabolic steroid (because of the fear of the steroid itself and the usual talking about it) and things return as it is. Some times had even cortisone (injectable) with no results. Not wanting to take more of your precious time, I would like to ask you about your thoughts in some problems. Initially the good results in mood, power, bones and anti inflammatory properties of small doses of nandronolone are known (obviously and the side effects). Is it possible that the anabolic effects counteract the catabolic effects that lead to excessive uric acid followed by arthritis and gout? Is it possible that the tendons and bone strengthening leads to some kind or relief ? During my search at PUBMED I found almost nothing (except things like “prolonged starvation leads to gout crisis”).

      Thank you for your time and thoughts.

      Sincerely yours,
      Ioannis S., MD

      • Spiro Koulouris

        Hi Gianni!

        All steroids or NSAIDs as they call them do is stop the pain, I don’t think it raises or decreases uric acid in the blood. If your friend felt pain with his gout then it’s common to prescribe cortisone and/or other steroids to rid of the pain.

        Of course if tendons and bones are strengthened you will experience relief to a certain point cause gout slowly wears down your tendons, cartilage and bones. See my post on NSAIDs and also advise your friend to exercise, ask him if he is willing to try out yoga and light strength exercises to build up his bones, tendons and eat a proper diet to rebuild cartilage and tendons like foods high in:

        Vitamin B3
        Amino acids
        Vitamin C
        Vitamin E
        Vitamin B12

        Make sure he loses weight and changes his lifestyle habits to more healthy living.

        Thanks for your question.

    • Sue m.

      was just today told I have gout. My doctor prescribed some powerful meds. But have a friend who controls her attacks through diet alone and I will attempt to do the same. Thanks to all of you who have offered helpful suggestions.

    • […] it much easier to walk around while you wait to visit your doctor to prescribe you colchicine, NSAIDs or provide you with other advice and medication depending on the severity of your gout. Whatever […]

    • […] from the bark of the willow tree and its active ingredient is salicylic acid. It is part of the NSAIDs family but is different from most other NSAIDs in the way they […]

    • Lucinda

      I had gout attacks and a bad 1 that wont go away I tryed the medication for it 2 of them still not better had this 3 months now I can’t do walking or any daily activities inside or outside cuz of my gout attacks I have arthritis to in my big toe let me tell ya its like hell this is I can’t sleep.please help me if you have any idea what I need to do sincerely Lucinda.

      • Spiro Koulouris

        Hi Lucinda!
        It sounds live you have severe gout, so I think you should follow your doctor’s advice, get a 2nd opinion as well. All I can tell you is to drink only water and nothing else for now. Cut your meat intake completely until you feel better and eat lots of vegetables, fruit, whole wheat breads and pasta, whole grain rice. Complex carbohydrates burn clean so your kidneys won’t work too hard in breaking them down. Try and eat for now about 10% of your daily calories as fat like eggs, milk, cheese, butter and so on. Do not drink any alcohol whatsoever or sugary drinks like colas and fruit juices. Try and keep your sugar intake to a maximum of 25 grams a day if you can. It sounds hard believe me but discipline is key to success in everything you do in life, wouldn’t you agree? I hope things improve for you soon!

    • John

      Spiro, thanks for the blog and info. I’ve been getting gout for a long time; however, it had been years since my last attacks but over the last three months I’ve had three episodes. I’m also a diabetic so watching my food intake as you can imagine. Ibuprofen used to work very well but not so much any more. I’ve tried NSAIDS recently, Indomethacin in particular. I’m only on my second day and hoping for the best. I drink a ton of water already but upping that as well. Thanks again for the blog. I’ll be sure to provide an update on how the Indo works.

      V/r, John

      • Spiro Koulouris

        Fight the good fight John and don’t forget to alter your diet as well! Watching what you eat can do wonders for your gout too!

    • […] Sciences” by Srivastava, et al, concluded that chamomile caused cell reactions like to that of NSAIDs drugs. Consuming chamomile tea may not be as effective as applying it topically on the skin of the […]

    • […] NSAID and comes in a variety of names we all are familiar with like Advil, Motrin and Nurofen. Compared to other NSAIDs its potential for causing serious side effects like stomach ulcers, heart […]

    • […] Your doctor then will most likely prescribe you either allopurinol, colchicine, phobenecid or NSAIDs to get rid of uric acid before it crystallizes and causes you a painful gout attack. It is very […]

    • […] during rest and during movement. You could basically compare the results to those people taking NSAIDs. Bromelain does this by helping excess fluid drain from the area of the muscle injury having a […]

    • […] due to its interaction with leukotrienes providing relief from a gout attack working the same way NSAIDs do whereby the flavonoids and polyphenols work together and act as COX2 inhibitors decreasing pain […]

    • […] Relieve the pain of gout with NSAIDs […]

    • […] Non-steroidal anti-inflammatory drugs and gout […]

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