Gout Attacks
If you are a new gout sufferer and just landed on this page, you probably are searching to find out how long a gout attack lasts. Whereas we veteran gout sufferers know all too well that gout attacks and gout pain may last from days to weeks depending on how serious it is. The answer isn’t so simple.
Gout attacks are typically excruciatingly painful for the first 12 to 24 hours. Afterward, you have prolonged daily incremental improvement until the pain subsides completely. That’s if you don’t jump to treat right away with colchicine or some other home remedy of your choice that you probably read on this website.
The average gout attack lasts three to seven days. A gout attack, on the other hand, may be quite stubborn and last for weeks in some people.
Heck, I’ve heard of one man who was confined to his bed for the majority of two months! If gout is not treated, expect frequent gout attacks for varying periods of time.
What to Expect with Gout
Gout is a type of arthritis caused by uric acid buildup in the joints. It is distinguished by sudden and severe joint pain. It is characterized by sudden, excruciating joint pain. However, it may also affect the joints of the fingers, elbows, wrists, or knees. It typically affects the joint at the base of the big toe.
With treatment, a gout attack typically lasts three days, but it might last up to fourteen days without it. If untreated, you’re more likely to experience fresh episodes more frequently, which may exacerbate pain and even harm your joints.
You’ll feel excruciating joint pain during a gout attack. After the initial discomfort subsides, you might continue to feel discomfort. Additionally, the joint will typically be swollen and red, and your range of motion there may be restricted.
You may have frequent gout attacks, which could lead to chronic gout and permanent joint damage. You may also develop small, white, painful lumps beneath your skin. Urate crystals have formed in this location.
Anti-inflammatory drugs, steroids, or colchicine are typically used to treat gout, but there are some lifestyle changes that may shorten the severity of an attack, such as:
- avoiding alcohol at least two days a week
- being healthy in terms of weight
- consuming two liters or more of water each day
- giving up smoking
- taking supplements like NutriGout or vitamin C
- exercising consistently (be careful not to put excess pressure on joints)
Managing your Gout Symptoms
Ibuprofen (Advil, Motrin), an anti-inflammatory medication, should be taken as soon as a flare-up occurs. You can buy this medication over the counter. If you have a history of gout, make sure you are always taking anti-inflammatory medication. If you have an episode, you can take medication as soon as the symptoms appear.
Within three days, the anti-inflammatory medication should start working. Meanwhile, the following home remedies may be of assistance:
- Drink a lot of water.
- Rest the affected foot and elevate it.
- Avoid rubbing your bedclothes against the joint at night, as this may irritate it.
- Apply an ice pack to the joint for up to 20 minutes to keep it cool.
Consult your doctor if the episode has not subsided after three days. They may prescribe steroids in the form of tablets or injections.
Your doctor will probably want to perform a blood test to measure the level of uric acid if you experience flare-ups frequently. Allopurinol (Zyloprim, Lopurin) or febuxostat (Uloric), which may gradually lower these levels if you have a high uric acid level, may be prescribed.
Is Gout a Chronic Disease?
Gout is an example of inflammatory arthritis. Flare-ups, or times when symptoms first appear or get worse, are a feature of the condition. Gout has no known cure, and if left untreated, it may worsen over time.
Treatments are aimed at reducing the severity of symptoms during a flare-up and preventing future flare-ups. Typically, doctors strive to reduce the amount of uric acid in the blood, which contributes to gout symptoms.
Length of Flare-Ups Following Treatment
A gout flare-up typically peaks within 12-24 hours of the initial onset, according to the Johns Hopkins Arthritis Center. This period, however, will vary depending on the person’s response to treatment and overall health.
Within a few days of the flare-up, treatment should cause the symptoms to return to normal.
Duration of Flare-Ups in the Absence of Treatment
Without treatment, flare-ups typically last 7-14 days because treatment shortens their duration.
Treatment may also help to lessen the severity of symptoms. A 2014 review of colchicine discovered that those who used it were 25% more likely to report a 50% reduction in pain during a flare-up than those who received a placebo. Colchicine, on the other hand, may cause nausea, vomiting, and diarrhea.
Don’t Let Your Gout Symptoms Grow Worse
One of my readers has chronic gout stage 3 and his normal uric acid levels are usually between 3 mg/dl to 6 mg/dl. During a gout attack, his uric acid jumps anywhere from 11 mg/dl to 18 mg/dl!
You don’t want to end up like him because he can no longer walk and is stuck in a wheelchair due to all the joint inflammation. If you suffer from frequent gout attacks you must do something about it, don’t think that it might not come back, chances are it will.
Since gout is a progressive disease and if you don’t control your uric acid levels to below 5 mg/dl then you may expect more gout attacks.
If you take allopurinol, febuxostat, or another uric acid-lowering prescription drug and experience gout attacks, consult your doctor and reevaluate your uric acid-lowering therapy.
Remember that gout pain may occur when uric acid crystallizes and when it dissolves. So if you just got your first gout attack and your doctor prescribes you allopurinol, he’ll most likely also prescribe you colchicine to prevent another gout attack, for the first two weeks to avoid triggering gout flares as the uric acid crystals begin to dissolve.
Keeping uric acid levels in the safe range of under 5 mg/dl should keep gout away. Why not follow my diet plan and lifestyle change in my ebook and take the minimum allopurinol dose possible to treat your gout?
Gout and Diet
Uric acid is formed when the body breaks down a substance known as purines. Urine is then used to flush the substance from the body. Although it occurs naturally in our bodies, many foods also contain purine. A low-purine gout diet may help reduce the frequency of gout flare-ups.
Most diets are applicable to a gout diet. You are advised to follow a balanced, healthy diet. Maintaining a healthy weight is essential because being overweight increases the likelihood of gout flare-ups.
Being overweight also intensifies flare-ups and makes them more difficult to manage. Weight loss, even without limiting purine intake, has been shown in studies to lower uric acid levels.
If you have a history of gout, the following foods may help you control your uric acid levels and lower your risk of flare-ups:
- water
- coffee
- cherries
- any food that contains a lot of vitamin C
- dairy products with low or no fat
- whole grains, fruits, and vegetables are sources of complex carbohydrates
These foods should also be restricted or avoided:
- red meats, as well as fatty poultry
- dairy products that are full-fat
- white bread
- sugary snacks and drinks
- liver and kidneys
- alcohol
- Particular seafood such as tuna, lobster, shrimp, mackerel, anchovies, herring, sardines, mussels, and scallops
Effective Gout Medications
Medication to relieve pain and cut the length of the flare is part of the treatment for gout attacks.
Colchicine
Colcrys (colchicine) is one of the most commonly used medications to treat acute gout flares and prevent future flares. It is especially important for those who are unable to take nonsteroidal anti-inflammatory drugs (NSAIDs) or standard over-the-counter anti-inflammatory medication.
A healthcare provider prescribes colchicine. A number of factors, including your allergy history and kidney and liver function, will influence the dosage. Colchicine may cause a rapid and complete resolution of your symptoms if used promptly and in accordance with your doctor’s instructions.
Nonsteroidal Anti‐Inflammatory Drugs (NSAIDs)
NSAIDs like Advil or Motrin (ibuprofen) and Aleve (naproxen) are readily available because they may be bought over the counter. As a result, they are the most common treatment for acute gout flares. Indocin (indomethacin) is an NSAID used to treat gout.
Before beginning OTC NSAIDs, consult with your healthcare provider to determine if they are appropriate for you, the proper dosages, and potential side effects. You should discontinue these medications once your symptoms have subsided.
Corticosteroids
For gout flares, oral glucocorticoids such as prednisone and prednisolone may be prescribed. They work just as well as NSAIDs and colchicine. Treatment often requires taking a pill by mouth once or twice per day.
Notably, NSAIDs and colchicine may be better options if you have frequent gout flares to limit steroid-associated toxicity, which may include elevated blood sugar and blood pressure, increased appetite and weight gain, mood changes/anxiety, insomnia, and decreased bone mineral density.
To relieve inflammation and pain, corticosteroids may also be injected directly into the affected joint.
Kineret
Kineret (anakinra) is an IL-1 receptor antagonist that inhibits chemical messengers to prevent inflammation. It is typically used to treat rheumatoid arthritis. It has been demonstrated to be just as effective as standard first-line gout medications (colchicine, NSAIDs, and glucocorticosteroids).
A 100- or 200-milligram injection, given by your doctor once daily for five days, has been shown in studies to significantly lessen the severity of your gout symptoms, making it a viable option for the treatment of acute gout flares.
Most side effects are mild and go away on their own. Possible negative effects include:
- Redness or bruising at the injection site
- Increased risk of infection
- Headache
- Fever or chills
- Stomach pain
- Nausea
- Vomiting
- Diarrhea
- Joint pain
Although the Food and Drug Administration (FDA) has not given the drug approval to treat gout in the United States, anakinra is used to treat gout in Europe. If conventional medications don’t work, your healthcare provider may have you use Kineret off-label.
Allopurinol
Allopurinol is used to treat and prevent gout in the long term. When taken on a regular basis, it may help prevent gout attacks and joint damage.
Allopurinol reduces the amount of urate in your blood. As a result, it is sometimes referred to as urate-lowering therapy (ULT). When your urate level is low enough, new crystals stop forming and existing crystals dissolve slowly.
All of the crystals may dissolve after a few years. If this occurs, the crystals will no longer cause joint damage or gout attacks as long as you are taking allopurinol.Because it may take a long time to dissolve the crystals, you may experience more gout attacks while this is taking place. This is more likely if your urate levels are already elevated or if you’ve had gout for a long time.
If this occurs in your case, it does not imply that the allopurinol is not working.
Who Can Take Allopurinol?
Allopurinol is frequently recommended as the first-line treatment for gout. It may prevent future attacks and joint damage if prescribed by your doctor as soon as you are diagnosed.
Allopurinol is usually prescribed if blood tests show that your urate level is high enough for urate crystals to form, especially if one or more of the following conditions apply:
- Urate crystals may be seen on your skin. These are tophi, which are firm white lumps
- You have gout attacks on a regular basis
- Gout has caused joint damage in you
If you meet the following criteria, you may be denied allopurinol or given a lower dose:
- have ever experienced an allopurinol allergic reaction
- possess thyroid issues
- are presently experiencing a gout attack
- have issues with your kidneys or liver
How is Allopurinol Taken?
One tablet of allopurinol is taken each day. It is usually best to take it right after eating, and the tablet needs to be dissolved in water and then ingested. The more water you consume throughout the day, the more urate your kidneys may remove from your body.
Your allopurinol dosage may change over time depending on how much urate is present in your body. Your doctor will perform blood tests every two to four weeks to check your urate levels until they are confident that the dose you are taking is sufficient to lower the level of urate in your body. If you have kidney or liver problems, you may need to stay on a lower dose.
To avoid further gout attacks, your doctor may advise you to wait until after an attack has passed before starting allopurinol. If this is not possible, it may begin when your inflammation is not severe.
Allopurinol does not alleviate the acute pain associated with gout attacks. It is, however, a long-term treatment to eliminate the urate crystals that cause gout attacks.
To control your urate levels, you will most likely need to take allopurinol for the rest of your life. You should continue taking allopurinol even if you have:
- You are having more gout attacks, or it initially does not seem to help the pain and inflammation.
- You no longer have gout attacks – discontinuing treatment may cause urate crystals to form again, resulting in more gout attacks.
Lifestyle Changes Are Key to Reducing Gout Symptoms
Maintaining healthy uric acid levels is always preferable to taking prescription drugs. The truth is that if you do not control your uric acid levels, you will eventually be in permanent pain. That’s because those nasty crystals will chip away at the bone and cause permanent joint damage. Believe me, you don’t want to go there!
In conclusion, a gout attack may last anywhere from a day to several weeks depending on what stage you are in, diet, lifestyle, and treatments all come into play. To learn more about how to stop a gout attack, make sure to read this post.
About Lifestyle Changes
Dietary changes, for example, may help support healthy uric acid levels, the chemical that deposits in joints and causes gout. However, for the majority of people, dietary changes alone are insufficient to prevent gout.
Medication is usually required to reduce uric acid levels sufficiently to stop attacks. Still, changing your diet may help you have fewer gout flare-ups.
In the past, medical professionals would frequently give their patients a list of foods high in purines and advise them not to eat those foods. That hasn’t been demonstrated to be particularly useful by itself.
More recently, experts have begun to reconsider diet. Instead of attempting to determine which specific foods to avoid, the emphasis is on maintaining a healthy diet and attempting to lose weight if you are overweight or obese.
Simply losing weight may reduce uric acid levels. It is also beneficial to drink plenty of fluids. However, avoid sugary drinks and alcohol, which may raise uric acid levels.
Quick Lifestyle Habit Changes To Make Now
The lifestyle suggestions below may help you avoid a gout attack. As a bonus, they may also help prevent some complications of gout such as kidney disease and heart disease.
- Drink in moderation and avoid purine-rich foods: Gout patients should avoid purine-rich foods such as fatty meats and shellfish. Limit your alcohol consumption, especially beer, because it may raise your uric acid levels.The good news is that certain foods, such as cherries, coffee, and vitamin C-rich foods, may help prevent gout attacks.You should also drink plenty of water as part of any healthy diet. This is especially important if you have gout because staying hydrated may help flush out uric acid and prevent the formation of uric acid crystals.
- Reduce the amount of stress in your life: Stress may cause a gout attack or worsen the symptoms of an existing gout attack. While it is impossible to eliminate all of your stress, there are a few things you may do to help reduce it. When you have a gout attack, reducing your stress may help you focus on something other than the pain.
- Exercise on a regular basis: Physical activity is an important part of living a healthy lifestyle, and it may help prevent future gout attacks. One of the many advantages of exercising with gout is that it helps you lose weight (if you need to). Being overweight or obese increases your risk of gout, but if you already have gout, maintaining a healthy weight may help you avoid a gout attack. Exercise may also help you manage stress more effectively.
- Get plenty of rest and sleep: When you have gout, you need to get plenty of rest and sleep. Getting enough sleep—aim for about 8 hours every night—may help you manage stress and feel better overall. Getting enough rest may also help when you have a gout attack. A gout attack can be excruciatingly painful, and you may find it difficult to move. During a gout attack, resting the affected joint might help you manage your symptoms.
- Consider using herbal and dietary supplements: Some herbal and dietary supplements may help with gout. Turmeric, which may be used to treat a variety of inflammatory conditions other than gout, may aid in inflammation reduction. Bromelain, which is found in pineapple stems, may also help with gout.The efficacy of these supplements for gout needs to be studied further. Herbal supplements may interact with other medications you are taking, so if you’re interested in trying them, talk to your doctor before taking them.
Conclusion
Gout flare-ups may be managed in terms of pain intensity by adopting a healthy lifestyle, which may also help to prevent future flare-ups.
If you do experience a flare-up, rest and ice the affected joint while taking over-the-counter anti-inflammatory medication as soon as your symptoms appear. If symptoms do not go away after three days of treatment or if you are experiencing these symptoms for the first time, consult your doctor.
Anyone experiencing their first bout of gout symptoms should consult a doctor. The doctor may advise the patient on the best course of treatment, which may include dietary changes and home remedies.
If the recommended treatments are causing side effects or are not working, it is worthwhile to consult a doctor. In such cases, doctors may modify the treatment plan.