What Do You Do During a Gout Attack?
It’s the holidays and the temptation to eat and drink anything that comes your way will be at an all-time high. Of course, you’re only human which also means you’re not perfect.
If you’re like most people, gout sufferers included, it can be easy to stumble and fall into this inviting cave of temptation.
Then, of course, comes the difficult part, when you’re sitting in your bed at 3 a.m., writhing in pain from the gout flare-up you most likely caused. How can you deal with this gout attack and relieve the excruciating pain?
At this point, you’re feeling guilty and sorry for yourself, and you’re promising yourself that this will be the last time you overindulge. Ah, it’s the classic challenge of going through the holiday season as a gout sufferer.
Well lucky for you, I’ve been around the block a few times and I’ve been a gout patient for many years. The fact that gout currently doesn’t have a cure doesn’t stop me from enjoying my holiday season with my friends and family.
In this article, I’m going to do a deep dive into how to stop a gout attack. I will be sharing tried and proven tips that have personally helped me stop gout attacks in their tracks. So, without further ado, let’s look at my top tips for stopping your horrible gout attacks.
Risk Factors That Contribute to Gout Flare-Ups
Despite the advances in our understanding of gout, experts do not fully understand why some people get gout and others do not. Nonetheless, many gout causes and risk factors are well established. Let’s look at some of the most common risk factors that can result in gouty arthritis.
- Excess Weight: According to research, people who are overweight are more likely to develop gout. Gout is also more likely to strike them earlier in life.
- Diet: Consumption of purine-rich foods and beverages, such as alcohol, sugary foods and drinks, meat, and seafood, increases the risk of a gout flare-up. Although beans, fruits, and vegetables are high in purines, studies have shown that they do not appear to increase the risk of gout.
- Intake of Alcoholic Beverages: If you drink beer, wine, or liquor, you are more likely to get gout. One to two alcoholic drinks increased the likelihood of a flare-up by 36%, according to a study of 724 people with gout.
- Sex: According to experts, men are four to ten times more likely than women to have gout. In addition, because estrogen appears to have protective effects, women’s risk of developing gout increases during menopause.
- Age: Many people first develop gout between the ages of 30 and 50, and the risk of gout increases with age. Gout affects approximately 3% of men under the age of 50 and nearly 12% of men aged 70 to 79.
- Race: According to studies, African American men are nearly twice as likely as Caucasian men to have had gout.
- Family History: Certain genes that influence kidney and gut function, according to research, increase the risk of developing gout. These genes may predispose the body to uric acid accumulation and the formation of uric acid crystals, resulting in gout.
- Medications: Certain medications may increase the likelihood of hyperuricemia and gout attacks. Diuretics, low-dose aspirin, and cyclosporine are common examples of these medications.This is not a comprehensive list. People who take medications or supplements should consult their doctor or pharmacist about how their medications may affect gout risk.
- Persistent Renal Failure: Persistent, or chronic, renal failure means that the kidneys are no longer fully functional. Gout can develop when the kidneys’ ability to flush out uric acid is impaired.
- Medical Event: A gout flare-up can be brought on by specific events that cause a change in the body’s chemistry. These occurrences can be infections, traumatic injuries, surgeries, illnesses, or even drastic weight loss.
The Warning Signs of an Impending Gout Attack
First of all, there are some warning signs of a gout flare-up attack that are associated with gout attacks. These may include a burning, itching, or tingling sensation in the joint as a warning sign.
When a gout attack occurs, your joint might feel a little stiff or a little sore. Most likely, the affected joint will be extremely painful, swollen, and red. The big toe is where the attacks usually start, but they can also happen at the elbow, wrist, ankle, or knee.
These symptoms, according to patients, typically start an hour or two before the gout flare-up actually starts. However, I’ve experienced those feelings a day or two before as well. If you experience attacks frequently, you will become familiar with your body’s warning signs.
In some cases, however, people with gout have no early warning signs that a flare is about to begin. They could simply wake up in the middle of the night with a painful joint. It hurts so much that anything that touches the joint feels so painful.
The truth is that most gout attacks tend to be severe. So much so that the patient can’t even bear the pain of your bedsheets touching the inflamed joint. To make matters worse, a gout attack can last anywhere from hours to days. And that’s assuming that it gets treated quickly.
If left untreated, a gout attack can potentially last for weeks! To best mitigate the pain, it’s best to get your gout treated within 36 hours! Some of you may also suffer from high fever and chills.
Gout Can Go Away or Keep Coming Back
Gout attacks almost always cause stabbing pain, redness, and swelling in the affected joint. About half of all first-time gout attacks in men involve the big toe joint. The instep, heel, ankle, and knee are also frequently affected joints.
After the initial gout attack, the condition can have various effects on individuals:
- Some people may go weeks, months, or even years without experiencing another gout attack. In extremely rare circumstances, they may never experience another one.
- Others will start to have gout attacks on a regular basis. These attacks could eventually develop into more frequent and protracted ones. Chronic gout may result in disability and permanent joint damage. Fortunately, joint damage can be avoided by promptly treating the underlying cause of gout, which is a buildup of uric acid in the blood.
Experts are unable to predict who will experience a one-time attack versus chronic gout. If you’ve had an attack, it’s worth your time and effort to make changes that will help you avoid a painful flare-up in the future.
Make Sure to Have These Handy!
If your doctor has diagnosed you with gout and prescribed medication to treat a flare-up, take the medication as directed when you notice one. In most cases, that will be as soon as the first signs appear.
What you need handy at home is some colchicine and/or some ibuprofen like Advil or Motrin. I tell my doctor to always prescribe me colchicine and have it ready during a gout attack. That’s because you don’t want to be stuck with your doctor being away during the holidays or away on vacation.
If you’re taking allopurinol or febuxostat as a long-term uric acid-lowering therapy, you’re probably taking a specific dose every day. As a result, you’re probably always carrying that medication with you.
Colchicine, a well-known gout medication, is an exception to this rule. The medication is stopped once the gout symptoms have subsided.
Colchicine is effective when taken within 12 to 24 hours after your gout attack. Colchicine can cause major gut problems if taken in a high dose. Keep in mind that it is critical to adhere to your doctor’s recommended dosage. For most people, this means taking no more than two to four tablets a day.
Got no colchicine? Then ibuprofen is a must since it’s available at your local pharmacy over the counter. Take it to take the sting out of your pain; it makes it much easier to move around while you wait for your doctor to prescribe you remedies such as colchicine and NSAIDs.
Your doctor might give you a prescription for nonsteroidal anti-inflammatory drugs (NSAIDs), such as celecoxib, indomethacin, meloxicam, or sulindac. They may also advise you to take NSAIDs that are available over the counter, such as naproxen or ibuprofen.
Your doctor may advise steroids or other anti-inflammatory drugs like the previously mentioned colchicine. Of course, the type of medical advice given will be dependent on your your medical history.
Tolerance and Medication
These medications may still be effective even though you may experience flare-ups. You might experience an attack during the first few months of treatment as your body gets used to the medication. If this occurs, your doctor most likely also gave you a medication to take.
Call your doctor if you’ve been taking preventive gout medication for a while and you’re experiencing flare-ups for the first time in a while. They might discuss adjusting your medication or dosage with you.
Depending on the severity of your gout, they may even give you additional advice and medication. Whatever you do, do not take aspirin since it can affect your uric acid level by worsening your attack.
Minimizing Pain Without Medications
Medications are by far the most effective way to alleviate the agonizing symptoms of a gout attack. However, taking medications frequently entails visiting a doctor, receiving a recommendation and prescription, and then going to a local pharmacy to obtain said medication.
These are obviously not the kinds of activities you want to engage in while experiencing a gout attack. Fortunately, I am going to share some home remedies I personally use to bring some relief to my gout symptoms.
To be clear, these probably won’t give you the immediate relief that you want. But, they do help you maintain your sanity during a flare-up. Best of all, you don’t even need to leave your house or order anything from your local pharmacy.
Here are some of my go-to tricks I use when at home:
- Ice/Cold Packs: If your pain isn’t too severe, try applying cold compresses or packs to the joint to reduce inflammation and discomfort. Wrap the joint in a thin towel and apply ice to it for up to 20 minutes several times throughout the day. Avoid applying ice to your hands or feet if you have nerve problems caused by diabetes or another condition.
- Allow the Joint to Rest: Gout can cause swelling and pain, particularly in the feet, hands, knees, and ankles. Although this is a natural reaction when experiencing a gout flare-up, you should try not using your affected joint for a while. It’s best to rest it until the pain subsides. You’re unlikely to want to move it much anyway. Elevating the affected joints is one method of reducing swelling. This forces blood and fluid away from the joint and toward the heart.An ice pack with elevation can also be used to alleviate gout symptoms. These two remedies are part of the RICE method (rest, ice, compression, and elevation).
- Drink Plenty of Water: Your uric acid levels increase further when your body is dehydrated. To help keep those levels normal, drink plenty of water. Increased fluid consumption can stimulate the kidneys to release excess fluid, reducing swelling in gout patients.Other clear fluids to consider include broths and herbal teas. Of course, people should avoid purine-rich beverages such as alcohol and soda. Anyone with congestive heart failure or kidney disease, on the other hand, should consult their doctor before increasing their fluid intake.
- Get Tested for Sleep Apnea: Gout can be exacerbated by untreated sleep apnea. Sleep apnea is a sleep disorder that causes the body to take in less oxygen while sleeping, which in turn causes the body to produce more purines. A continuous positive airway pressure (CPAP) machine or other device that increases oxygen intake while sleeping is typically used to treat sleep apnea.
- Drinking Lemon Water: A 2015 study discovered that drinking 2 liters of water per day with the juice of two freshly squeezed lemons reduced uric acid in gout patients. The researchers concluded that drinking lemon water helps to neutralize uric acid in the body, thereby lowering levels.
- Minimize Stress: Gout symptoms can be exacerbated by stress, so getting enough sleep can help people feel less stressed. While it is not always possible to eliminate all sources of stress, the following suggestions may be of assistance. If the pain does not prevent you from moving, you can try exercising. Try requesting time off from work. Reading a favorite book or journaling. Also, meditating can be incredibly fun and beneficial too!
- Losing Weight: As with most foot and ankle issues, it’s crucial to keep a healthy weight. There is less pressure on your lower extremities the lighter you are. Losing a few pounds can help people with gout symptoms feel less swollen and can also lessen the severity of other conditions like plantar heel and diabetic foot problems.
- Drink Coffee: Some people believe that drinking coffee reduces the risk of developing gout. According to a 2016 review and meta-analysis, those who drank more coffee were less likely to have gout. This may be because coffee can lower uric acid levels. We’ve also discussed gout and coffee.A 2019 study found that coffee consumption reduces the risk of gout and may do so without lowering serum uric acid levels. However, just because the study found a link between higher coffee consumption and a lower risk of gout does not mean that coffee is to blame.
- Consuming a Well-Balanced Diet: A well-balanced diet rich in nutrient-dense, minimally processed foods can help lower uric acid levels and reduce the risk of gout flares.Plant-based diets can be especially beneficial for gout patients. Many fruits and vegetables are high in antioxidants, which can aid in the reduction of inflammation.
- Avoiding Meats High in Purine: Purines are abundant in organ meats such as kidneys and liver, as well as game meats such as venison and wild-caught birds.
- Seafood and fish: Crab, shrimp, and other shellfish can aggravate gout flare-ups, but trout, anchovies, and mackerel can also raise uric acid levels. However, oily fish, such as salmon, have excellent health benefits and contain lower levels of purines than other fish, so eating them in moderation can be beneficial.
- Spices and Minerals: A variety of minerals and spices, which can be found in your kitchen cabinets or as supplements at your local pharmacy, can help to reduce inflammation and gout pain.For immediate relief, ginger paste can be consumed. Its ability to lower serum uric acid levels has been demonstrated in numerous credible studies.Magnesium is a fantastic mineral that works similarly to ginger in that it reduces inflammation.Similar benefits of neutralizing acid can be obtained by adding turmeric or lemon juice to your beverage.
- Complex Carbs: Individuals suffering from gout should consume more whole grains, fruits, and vegetables, as well as less refined carbohydrates such as cakes and white bread. Avoid high-fructose corn syrup-containing foods and beverages and limit your intake of naturally sweet fruit juices.
Treatment Options for More Severe Cases of Gout
In severe cases of gout, doctors may recommend surgery. If gout causes severe pain, a major abnormality, or a severe infection at the site, a person may be a candidate for surgery.
Gout surgery options include:
- Joint Fusion: Surgeons may fuse a joint together to stabilize it if chronic gout causes significant tissue damage.
- Joint Replacement: Surgeons can replace affected joints with artificial structures after removing the affected joints.
- Tophi Removal: Tophi can be removed by a surgeon in cases of severe discomfort, abnormality, or infection.
Some Additional Tips
You got no colchicine AND no ibuprofen? Ooff! Make sure to rest that joint as much as possible until the pain lessens. Use some cold compresses or cold packs and place them on the affected joint to lessen the inflammation for about 20 to 30 minutes several times a day.
Drink lots of water, drinking more water will stabilize your uric acid levels, flushing the excess. Aim for 8 to 16 cups of water daily. Make sure to read my post on the water to understand its many benefits for us gout sufferers.
Watch what you eat, which entails staying away from all gout-prohibited foods like organ meats, seafood, and alcohol, particularly beer. Limit your intake of meat as much as you can and avoid foods or drinks high in high fructose corn syrup or purines.
I also suggest if you’re going to walk, walk with a cane, to keep pressure off your affected joint. I’ve done this before and helps tremendously. There are many other home remedies listed in many different posts on my website that you can check out as well.
Whatever the case may be, make sure to let your doctor know as soon as you can, and if this is the first gout attack, you’re going to need to visit your doctor to run some blood tests and suggest a urate-lowering therapy.
If your symptoms don’t somewhat improve within 48 hours, then it’s best to call your doctor and may suggest a different treatment.
Get a Proper Gout Diagnosis
If you experience sudden, severe joint pain, consult your primary care physician, who may refer you to a specialist. You might need to see a specialist because gout symptoms are broad and can be mistaken for other inflammatory conditions.
Gout is typically diagnosed under the supervision of specialized doctors who specialize in gout patients, such as rheumatologists, though your primary doctor may also be able to diagnose you. Your doctor will conduct a thorough physical examination and discuss your symptoms with you.
Your doctor may order specific tests in addition to a physical examination and evaluation of your symptoms, such as blood work to determine the level of uric acid in your blood and imaging tests like X-rays, MRIs, and ultrasounds to take images of and more closely examine the affected joints.