What are the most effective ways to alleviate gout pain quickly. How can you prevent future gout attacks. What lifestyle changes can help manage gout symptoms long-term. What medications are prescribed for chronic gout management.

Understanding Gout: Causes and Symptoms

Gout is a common form of inflammatory arthritis that affects millions of people worldwide. It occurs when there’s an excess buildup of uric acid in the blood, leading to the formation of urate crystals in joints, particularly the big toe. These crystals cause intense pain, swelling, and inflammation.

Contrary to popular belief, gout isn’t exclusive to older, wealthy men. In fact, it’s the most prevalent type of inflammatory arthritis, affecting approximately 4% of Americans. Various factors contribute to its development, including genetics, environment, and lifestyle choices.

Key Symptoms of Gout

• Severe joint pain, often in the big toe
• Swelling and redness in affected areas
• Warmth around the joint
• Limited range of motion

Immediate Relief Strategies for Gout Attacks

When a gout flare-up occurs, the pain can be excruciating and debilitating. Fortunately, there are several methods to obtain quick relief. It’s important to note that if your pain is severe, sudden, or worsening, consulting a healthcare professional is crucial before attempting home remedies.

Over-the-Counter Pain Relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help alleviate gout pain and reduce inflammation. These medications may take up to 24 hours to provide full relief. Additionally, topical rubs containing capsaicin or other soothing ingredients can offer localized pain relief when applied to affected areas.

Ice Therapy for Gout

Applying ice to the inflamed joint is a simple yet effective natural remedy for reducing gout-related inflammation. This method can also help numb the pain in the affected area. How should you apply ice for gout relief. Apply an ice pack wrapped in a thin towel to the affected joint for 15-20 minutes at a time, several times a day.

Hydration: A Key Factor in Gout Management

While not providing immediate relief, proper hydration plays a crucial role in managing gout. Adequate water intake may help flush uric acid crystals from your system. Recent research suggests that drinking sufficient water during the 24 hours preceding a gout attack could decrease the likelihood of recurrent flare-ups.

Prescription Treatments for Severe Gout Pain

In cases where over-the-counter treatments and home remedies prove insufficient, prescription medications may be necessary to manage severe gout pain. These options should be discussed with a healthcare provider.

Prescription Anti-Inflammatories

Medications such as Indomethacin and Colchicine are potent anti-inflammatory drugs specifically prescribed for gout. These medications can provide more robust relief compared to over-the-counter options.

Corticosteroids for Gout

A short course of corticosteroids, like prednisone or methylprednisolone, can be highly effective in managing severe gout symptoms. While long-term use of corticosteroids can lead to side effects, short-term use is generally considered safe under medical supervision.

Long-Term Management of Chronic Gout

For individuals suffering from chronic gout, a comprehensive long-term treatment plan is essential to prevent future attacks and manage the condition effectively. This typically involves a combination of medication and lifestyle modifications.

Medications for Chronic Gout Management

Several prescription medications are available for long-term gout management. These drugs are designed to lower uric acid levels in the body, thereby reducing the risk of future gout attacks. It’s important to note that these medications are usually started after a gout attack has subsided to avoid exacerbating the current flare-up.

Dietary Modifications for Gout Management

While modern medicine has advanced our understanding of gout, dietary choices still play a significant role in managing the condition. Certain foods can influence uric acid levels in the body, potentially triggering or exacerbating gout symptoms.

Foods to Limit or Avoid

• High-purine meats (organ meats, game meats)
• Seafood rich in purines (anchovies, sardines, mussels)
• Alcoholic beverages, especially beer
• Sugary drinks and foods high in fructose

Gout-Friendly Diet Choices

• Low-fat dairy products
• Complex carbohydrates (whole grains, fruits, vegetables)
• Plant-based proteins (beans, lentils, nuts)
• Water and other non-sweetened beverages

How can dietary changes impact gout management. By reducing the intake of high-purine foods and increasing consumption of gout-friendly options, you can help lower uric acid levels in your body, potentially reducing the frequency and severity of gout attacks.

Lifestyle Modifications for Gout Prevention

In addition to dietary changes, several lifestyle modifications can significantly impact gout management and prevention. These changes, when implemented consistently, can help reduce the risk of future gout attacks and improve overall health.

Weight Management

Maintaining a healthy weight is crucial for gout management. Excess body weight can increase uric acid production and decrease the body’s ability to eliminate it efficiently. Gradual, sustainable weight loss through a balanced diet and regular exercise can help reduce the frequency of gout attacks.

Regular Exercise

Engaging in regular physical activity offers numerous benefits for gout sufferers. Exercise can help maintain a healthy weight, improve joint flexibility, and enhance overall cardiovascular health. Low-impact activities such as swimming, cycling, and yoga are excellent options for those with gout.

Hydration

As mentioned earlier, staying well-hydrated is crucial for gout management. Adequate water intake helps flush excess uric acid from the body, potentially reducing the risk of crystal formation in joints. Aim for at least 8-10 glasses of water daily, adjusting based on individual needs and activity levels.

Alcohol Moderation

Alcohol consumption, particularly beer and spirits, can significantly impact uric acid levels in the body. Limiting or avoiding alcohol can help reduce the risk of gout attacks. If you choose to drink, opt for moderation and consider alternatives like red wine, which may have less impact on uric acid levels.

Natural Remedies and Supplements for Gout

While medical treatments remain the primary approach to gout management, some natural remedies and supplements may offer additional support. It’s important to consult with a healthcare provider before incorporating any new supplements into your regimen, as they may interact with existing medications or have contraindications.

Cherry Extract

Cherries and cherry extract have gained attention for their potential gout-fighting properties. Some studies suggest that cherry consumption may help lower uric acid levels and reduce inflammation. While more research is needed, incorporating cherries or cherry extract into your diet may offer some benefits for gout management.

Vitamin C

Vitamin C supplementation has shown promise in reducing uric acid levels in some individuals. This antioxidant vitamin may help enhance uric acid excretion through the kidneys. However, it’s essential to consult with a healthcare provider to determine the appropriate dosage, as excessive vitamin C intake can have adverse effects.

Omega-3 Fatty Acids

While not directly impacting uric acid levels, omega-3 fatty acids found in fish oil and certain plant sources may help reduce inflammation associated with gout. These essential fatty acids have broad anti-inflammatory properties that could potentially alleviate some gout symptoms.

When to Seek Medical Attention for Gout

While many gout attacks can be managed at home with the strategies discussed, there are instances when professional medical attention is necessary. Recognizing these situations is crucial for proper gout management and preventing potential complications.

Signs You Should Consult a Healthcare Provider

• Severe pain that doesn’t respond to home remedies
• Joint pain accompanied by fever or chills
• Inability to move the affected joint
• Symptoms lasting longer than 10 days
• Recurrent gout attacks
• Development of tophi (urate crystal deposits under the skin)

Why is prompt medical attention important for severe gout symptoms. Seeking timely medical care can help prevent joint damage, reduce the risk of complications, and ensure appropriate treatment for your specific condition. A healthcare provider can also assess whether your symptoms are indeed due to gout or if another underlying condition may be present.

Diagnostic Procedures for Gout

When you consult a healthcare provider for gout symptoms, they may perform several diagnostic tests to confirm the diagnosis and assess the severity of your condition. These may include:

1. Joint fluid analysis to detect urate crystals
2. Blood tests to measure uric acid levels
3. Imaging studies such as X-rays or ultrasounds to assess joint damage
4. Dual-energy CT scan to detect urate crystal deposits

Based on these results, your healthcare provider can develop a tailored treatment plan to manage your gout effectively and prevent future attacks.

Emerging Treatments and Research in Gout Management

The field of gout research is continually evolving, with new treatments and management strategies emerging. Staying informed about these developments can help you and your healthcare provider make informed decisions about your gout management plan.

Targeted Therapies

Researchers are exploring new targeted therapies that aim to address the underlying mechanisms of gout more precisely. These include drugs that inhibit specific enzymes involved in uric acid production or enhance its excretion from the body.

Immunomodulatory Approaches

Some studies are investigating the role of the immune system in gout inflammation. New treatments targeting specific inflammatory pathways may offer more effective and targeted relief for gout symptoms.

Personalized Medicine

Advances in genetic research are paving the way for more personalized approaches to gout management. By understanding an individual’s genetic predisposition to gout and their response to different treatments, healthcare providers may be able to tailor therapies more effectively in the future.

How might these emerging treatments impact gout management in the future. As research progresses, we may see more effective, targeted therapies with fewer side effects, potentially improving the quality of life for individuals living with gout. However, it’s important to note that many of these treatments are still in the research phase and may not be available for clinical use in the immediate future.

Living with Gout: Coping Strategies and Support

Managing gout extends beyond medical treatments and lifestyle modifications. The chronic nature of the condition can have significant psychological and social impacts. Developing effective coping strategies and seeking support can greatly enhance your ability to live well with gout.

Emotional Well-being

Living with a chronic condition like gout can be emotionally challenging. It’s not uncommon to experience feelings of frustration, anxiety, or depression, especially during flare-ups. Acknowledging these emotions and seeking support when needed is crucial for overall well-being.

Stress Management

Stress can potentially trigger gout attacks in some individuals. Incorporating stress-reduction techniques into your daily routine can be beneficial. Consider practices such as meditation, deep breathing exercises, or yoga to help manage stress levels.

Patient Education

Understanding your condition is a powerful tool in managing it effectively. Stay informed about gout, its triggers, and treatment options. This knowledge can help you make informed decisions about your care and feel more in control of your health.

Support Groups

Connecting with others who have gout can provide valuable emotional support and practical advice. Consider joining local or online support groups where you can share experiences, tips, and coping strategies with others who understand your challenges.

Communication with Healthcare Providers

Maintain open communication with your healthcare team. Regular check-ups and discussions about your symptoms, concerns, and treatment efficacy can help ensure your management plan remains effective and tailored to your needs.

How can effective coping strategies improve life with gout. By addressing both the physical and emotional aspects of living with gout, you can enhance your overall quality of life, reduce the impact of the condition on your daily activities, and maintain a positive outlook despite the challenges posed by gout.

Gout Prevention: Strategies for Reducing Future Attacks

While managing active gout symptoms is crucial, prevention plays an equally important role in long-term gout care. By implementing preventive strategies, you can potentially reduce the frequency and severity of future gout attacks.

Consistent Medication Adherence

If prescribed uric acid-lowering medications, taking them consistently as directed by your healthcare provider is essential. These medications work over time to reduce uric acid levels in your body, and missing doses can impact their effectiveness.

Regular Monitoring

Periodic check-ups and uric acid level tests can help you and your healthcare provider track the progress of your gout management plan. This allows for timely adjustments to your treatment if needed.

Trigger Identification and Avoidance

Keep a journal to track potential gout triggers, including foods, activities, or situations that seem to precede your gout attacks. This information can help you identify and avoid personal triggers more effectively.

Gradual Lifestyle Changes

Implement lifestyle modifications gradually to increase the likelihood of long-term adherence. Small, consistent changes in diet, exercise, and hydration habits can have a significant cumulative effect on gout prevention.

Proactive Management of Comorbidities

Gout often coexists with other health conditions such as hypertension, diabetes, or kidney disease. Managing these conditions effectively can indirectly contribute to better gout control.

Why is a comprehensive approach to gout prevention important. By addressing multiple aspects of gout management – from medication adherence to lifestyle modifications – you create a robust defense against future gout attacks. This proactive approach can lead to better long-term outcomes and improved quality of life for individuals living with gout.

What is the Fastest Way to Get Rid of Gout?

Gout is a painful type of arthritis that feels similar to the pain experienced with rheumatoid arthritis, as both diseases cause inflammation in the joints. 

Gout is caused by a buildup of uric acid in the blood.

When the body cannot get rid of the excess uric acid, that buildup ends up accumulating as crystals in a joint, such as the big toe.

This creates swelling, redness, warmth, and severe joint pain in the affected area.

This condition has historically been seen as a disease that only affects old, wealthy men.

But in fact, gout is the most common form of inflammatory arthritis.

About 4% of Americans—more than 8 million people—suffer from gout.

Since gout can be caused by genetic, environmental, and lifestyle factors, anyone can get gout—even if they eat what would typically be deemed a healthy diet. 

Attacks and flare-ups of the condition can be painful.

While there is no cure for gout, there are things you can do to get relief from the pain and inflammation.

In this article, I’ll talk about ways to get fast relief from a gout attack, treatment options for these flare-ups, and warning signs that an attack may be coming.

I’ll also tell you when it’s best to talk to your doctor or another healthcare provider about gout symptoms.

How to Get Fast Relief From Gout Attacks

Gout pain can be debilitating, and can prevent you from performing routine activities—even walking or standing can hurt.

That’s because many attacks start at the base of the big toe.

Pain and inflammation in this region can make walking or standing for long periods of time excruciating. 

There are a few home remedies that may provide quick relief for a gout flare-up.

But if your pain is severe, sudden, or worsening, contact a healthcare professional before attempting any remedies at home.

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Over-the-counter pain relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve) can help relieve gout pain and swelling.

It may take some time for the relief to kick in—anywhere up to 24 hours. 

Topical rubs containing capsaicin or other soothing ingredients (like aspercreme, Icy Hot, etc.) can help with both pain and inflammation when applied on the swollen areas.

Apply ice to the affected joints

One of the easiest natural ways to reduce inflammation in a gout attack is by applying ice to the affected area.

Ice may also help numb the pain in the affected area.

Drink plenty of water

This won’t likely provide immediate relief, but inadequate hydration is known to contribute towards the creation of urate crystals.

Drinking water may flush uric acid crystals out of your system.

Preliminary research suggests that adequate water consumption during the 24-hour period before a gout flare can decrease recurrent gout attacks. 

Prescription Treatments

If your gout pain is unbearable even with the recommended over-the-counter treatments, prescription anti-inflammatories like Indomethacin and Colchicine may be needed.  

A short course of a corticosteroid like prednisone or methylprednisolone can also be helpful. 

While long-term use of corticosteroids can cause some problematic side effects and health issues, short-term use is generally considered safe. 

If your gout symptoms are severe and not improving with over-the-counter and home remedies, speak with a doctor or healthcare provider to see if a prescription treatment may be helpful.

Treatment for Chronic Gout

If you have chronic gout, you may need more than quick relief.

You’ll also likely need a long-term treatment plan to prevent future attacks.

Below are a few treatment options that your doctor may recommend.

Medications for gout

Usually, doctors will wait until a gout attack subsides before starting prescription medications.

This is because these drugs are designed to lower uric acid levels.

Sometimes that can cause existing crystals surrounding the joints to shift, exacerbating the flare-up.  

Once a flare-up has ended, your prescribed medication treatment plan can prevent future gout attacks.

Below are a few common medications for gout:

Diet changes

Before modern medicine, doctors assumed dietary choices were to blame for gout attacks.

They weren’t wrong: A diet that’s high in purines—chemicals that are metabolized into uric acid—can cause gout flares.

Historically, gout was referred to as “the disease of kings”  because a heavy purine diet一alcohol, organ meats, sugar一could only be afforded by the wealthy.

Common high-purine foods you may want to avoid if you have gout include:

• High fructose corn syrup: This includes snacks and sugary drinks like soft drinks.
• Alcoholic beverages: Consuming too much alcohol is dehydrating for the body and can increase uric acid levels in the body.
• Organ meats: Meats like liver and kidney are purine-rich foods that should be avoided.
• Red meat: Serving sizes of red meat should be limited. 

Following a diet low in purines can help prevent gout flares.

If you’re unsure of what you should and shouldn’t eat, discuss meal plan options with your doctor or a dietitian.

Lifestyle changes

Experts recommend that adults engage in 150 minutes of exercise per week.

This can include low-impact activities that are easy on the joints, like walking, swimming, or biking.

Engaging in regular physical activity, along with eating a healthy diet, can help you lose weight.

Since obesity is a risk factor for gout, this could also reduce your risk of flare-ups.

Gout flare-ups tend to come on suddenly.

A flare-up will usually occur in one localized area—usually the big toe, but it can also affect other joints like the ankles, knees, elbows, wrists, or fingers.

Some symptoms you may experience include:

• Joint pain
• Inflammation
• Redness
• Swelling
• Loss of mobility

When it comes to gout prevention, get to know your family’s general medical history.

Genetics plays a big role in your chances of developing gout, so it’s a good idea to get familiar with your family history of gout.  

Other risk factors include:

• Sex: Men are three times more likely than women to develop gout.

• Age: Men over 40 and post-menopausal women are more likely to develop gout.

• Weight: People who are obese are at a greater risk of developing gout.

• Medical conditions: People with high blood pressure, diabetes, insulin resistance, or heart and kidney diseases are at a greater risk of developing gout.

• Alcohol consumption: Alcohol is dehydrating. The risk of developing gout increases as alcohol consumption goes up.

If you have a family history of gout or fall into multiple risk factor groups, discuss prevention with your doctor.

A low-purine diet is typically recommended to help keep uric acid levels in your body low.

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When to See a Doctor

If you are experiencing severe gout symptoms, seek care immediately.

Gout triggers and gout attacks are different for everyone, so a physician will be able to tailor a plan of treatment and prevention that works best for you. 

How K Health Can Help

Did you know you can access online urgent care with K Health?

Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes. 

K Health’s AI-powered app is based on 20 years of clinical data.

Frequently Asked Questions

What is the best thing to drink if you have gout?

Water. Drinking plenty of water is best if you have gout. Other beverages recommended for gout patients include milk, tart cherry juice, and coffee—all in moderation.

Does walking on gout foot make it worse?

If you have a current flare-up, it is best to stay off the affected foot to avoid further trauma to the joints. However, once a flare-up subsidies, you should still be able to participate in low-impact activities like walking or swimming. Regular physical activity is encouraged for your health and gout prevention.

What is the best thing for gout in the big toe?

If you have a gout flare-up on the big toe, rest and elevate your foot. You can try home remedies such as applying ice, taking over-the-counter pain medications, and drinking lots of water to help provide relief. If the pain is severe or worsening, contact your doctor.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions,
and medical associations. We avoid using tertiary references.

• Treatment Options for Gout. (2017).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624445/

• Gout. (n.d.).
  https://www.arthritis.org/diseases/gout

• Gout. Epidemiology of gout. (2010).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3046529/

• Gout and hyperuricaemia in the USA: prevalence and trends. (2019).
  https://pubmed.ncbi.nlm.nih.gov/31168609/

• Gout. (2010).
  https://www.cdc.gov/arthritis/basics/gout.html

• Alcohol quantity and type on risk of recurrent gout attacks: An internet-based case-crossover study. (2014).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991555/

• Nonpharmacological Management of Gout and Hyperuricemia: Hints for Better Lifestyle. (2015).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125106/

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How to cure gout on the legs [effective SWT method]

Gout is the deposition of uric acid salts in various tissues of the body, most often in the joints and cartilage. With gout of the legs, physiotherapy, especially the SWT method, significantly improves well-being.

“Gout <…> gave birth to hell itself,” wrote I.A. Krylov. Of course, the nature of the occurrence of this disease is different, but nevertheless it delivers a lot of “hellish” troubles to its carriers.

The disease is especially common among Caucasians and occurs in 50 men and 10 women out of a thousand. In order for gout not to lead to serious complications, it needs to be diagnosed and treated in time.

1. Causes and symptoms of gout

2.
How to treat gout in the legs

2.1. Prevention of gout on the legs

Causes and symptoms of gout

Gout belongs to the group of arthritis. Arthritis refers to any disease of the joints. The term “gout” is used when talking about the deposition of uric acid salts in various tissues of the body, most often in the joints and cartilage. What is causing this process?

Uric acid is a product of the breakdown of purines, special substances that are produced in our body, and also get to us with food. We get a large amount of purines when we eat fatty meat and fish (herring, sardine, cod), organ meats (sausages, sausages), fast food. And also when we drink alcohol (especially beer and grape wine), unnatural juices, sweet carbonated drinks, coffee. In this case, a huge amount of uric acid is synthesized in the body, and the kidneys cannot cope with its excretion. Another cause of gout is when the body produces a normal amount of this acid, but the kidneys are unable to remove it due to any pathologies.

Salts of uric acid (urates) are deposited in joints, especially small ones, gradually destroying them. Salt deposition is most susceptible to injured joints. The joint of the big toe (popularly called the “big bone on the leg”) becomes the object of the lesion due to the fact that we wear uncomfortable, narrow shoes. Gout can also lead to the formation of kidney stones, which in turn can lead to kidney failure, which in some cases can be fatal.

Symptoms of gout may include:

• acute joint pain (especially after heavy meals or large amounts of alcohol). Sometimes the sensations are so unbearable that it hurts even from the fact that a sheet lies on the arm or leg. The pain begins to torment at night, passes during the day, and then returns again. This may take several days or even months;
• redness and swelling of the joint;
• increased temperature in the joint area up to 39–40°C;
• fever;
• general weakness.

If the attacks are repeated again and again, then, for example, gout of the toe can go to other joints, making them painful and inactive.

Gout is considered a disease of the elderly, but due to the fact that a modern person consumes a lot of fats and alcohol, in particular beer, this leads to a “rejuvenation” of the pathology. The disease is chronic, that is, it cannot be completely cured. But in order to avoid serious consequences, one should resort to therapy that will stop or slow down the process of destruction of the joints.

How to treat gout in the legs

Since the Middle Ages, gout has been called the “disease of kings”, since it was the holiest persons who had the opportunity to indulge themselves in plentiful meals and were prone to gluttony. Therefore, first of all, to control gout, you need to reconsider the diet. You should reduce the consumption of meat and meat offal, refuse fatty foods, beans and fish caviar, beer, wine and, if possible, other alcoholic beverages. Patients with gout are usually prescribed dietary table number 6. It is recommended to drink at least 2 liters of fluid per day. Mineral waters such as Borjomi, Narzan, Essentuki will be useful.

In acute attacks of gout, it is recommended to apply ice to the inflamed area, make compresses with dimexide. The use of painkillers and anti-inflammatory drugs that do not contain steroids is shown.

Please note!

American scientists have established the relationship between calcium and ascorbic acid deficiency in the body and the development of gout. Therefore, as a treatment and prevention of the disease, it is necessary, in agreement with the doctor, to take these substances.

Physiotherapy significantly improves the well-being of the leg with gout. One of the most advanced and high-tech treatments for gout is shock wave therapy. When the affected tissues are exposed to a shock wave of a certain frequency, the following occurs: microcrystals of salts and connective tissue seals are loosened, blood flow increases tenfold, which in turn leads to the absorption of salts and tissue restoration.

In particularly severe cases, surgical methods are used to remove deposits of uric acid in the joints. But, in order to avoid this, it is necessary to carry out the prevention of arthritic diseases, such as gout of the foot.

Prevention of gout on the legs

In order for the joints of your legs to retain mobility and performance until old age, you should pay attention to the following preventive measures:

• lead an active lifestyle, walk more, do exercises in the morning;
• give up bad habits;
• eat more grains, vegetables, fruits, boiled or steamed meats and fish;
• drink more plain water;
• for preventive purposes, take a blood test to determine the content of the most important vitamins and minerals. If necessary, supplement the diet with a mineral-vitamin complex.

If you still experience gout, do not rush to despair. The main thing – do not postpone the solution of the problem “for later”, contact the specialists. A reliable assistant in the fight against the disease will be the method of shock wave therapy (SWT) we have already noted. You will find some of the most affordable prices for procedures at the Health Plus Medical Center. Even the elderly can receive effective and affordable treatment here. Procedures at the Health Plus Medical Center are performed without anesthesia in a course of several sessions of 10-15 minutes each, the number of which depends on the severity and duration of the disease. Qualified specialists will help you maintain a healthy state of the body.

Effective treatment of gout

Higher medical education. She graduated from the First Medical University named after academician I.P. Pavlov in 2015, in 2016 she completed her internship in the specialty “neurolology”. The internship, as well as the next 2.5 years of work, took place in the city hospital #26 at the department of general neurology. In clinical practice, patients with pain syndromes were extremely common. Based on the experience of senior colleagues, supported by settled, and in some way promoted by authoritative experts, ideas about the causes of pain, I built the treatment on a standardized scheme: painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), vitamins, sometimes I had to resort to more potent drugs ( antidepressants, anticonvulsants). Exercise therapy was also prescribed, but within the framework of the hospital and with a short hospital stay, many patients did not even have time to reach the exercise therapy room, and therefore the visit to physiotherapy exercises was postponed to the outpatient stage (patients arrived or not, I can’t say). Over time, patients returned again, but subsequent exacerbations were worse, poorly responded to drug treatment. In the routine of work, I didn’t really ask myself the question “why?”, There are standards, there are well-established treatment regimens, there are MRI reports and hernias, which were transferred to the hands of neurosurgeons if our “treatment” no longer helped. One day, a patient was admitted to the department with severe pain, in a forced position. For 4 days the drugs did not relieve the pain, he slept kneeling on the floor with his head on the bed. We couldn’t send him for an MRI as he couldn’t lie flat because of the pain. On the 4th day it became easier, the patient went to the study. I expected to see at least a large hernia there, or an inflammatory lesion of the vertebrae, but … there were not even protrusions on the MRI !!!
The patient was discharged citing muscle spasm. And I have some questions.
During my maternity leave, I became interested in the causes of back pain. Gradually, moving from the repetition of anatomy and physiology to the clinical manifestations of diseases, I moved on to methods of treatment. And it turned out that drugs are not the first line of treatment. I reached the methods of physical rehabilitation, to kinesitherapy. When the time came to return to work, I began to understand that in the previous conditions I would not be able to fully help patients suffering from pain.