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Gout last how long: How long does gout last? What to know

by alexxlab

Gout – NHS

Gout is a type of arthritis that causes sudden, severe joint pain. See a GP for treatment to help during an attack and to stop further attacks.

Non-urgent advice: See a GP if you have:

  • sudden severe pain in a joint – usually your big toe, but it can be in other joints in your feet, hands, wrists, elbows or knees
  • hot, swollen, red skin over the affected joint

These are symptoms of gout.

An attack of gout usually lasts 5 to 7 days, then gets better. It may not cause lasting damage to joints if you get treatment immediately.

Ask for an urgent GP appointment or call 111 if:

  • the pain is getting worse
  • you also have a very high temperature (you feel hot and shivery)
  • you also feel sick or cannot eat

These symptoms could mean you have an infection inside your joint and need urgent medical help.

What happens at your appointment

The GP may ask about your diet and if you drink alcohol.

They may refer you to see a specialist (rheumatologist) and arrange a blood test and scan. Sometimes a thin needle is used to take a sample of fluid from inside the affected joint, to test it.

The blood test will find out how much of a chemical called uric acid there is in your blood.

Having too much uric acid in your blood can lead to crystals forming around your joints, which causes pain.

Treatment to reduce pain and swelling

Attacks of gout are usually treated with a non-steroidal anti-inflammatory (NSAID) like ibuprofen.

If the pain and swelling does not improve you may be given steroids as tablets or an injection.

Do

  • take any medicine you’ve been prescribed as soon as possible – it should start to work within 2 days

  • rest and raise the limb

  • keep the joint cool – apply an ice pack, or a bag of frozen peas wrapped in a towel, for up to 20 minutes at a time

  • drink lots of water (unless a GP tells you not to)

  • try to keep bedclothes off the affected joint at night

Treatment to prevent gout coming back

Gout can come back every few months or it may be years. It can come back more often if it’s not treated.

If you have frequent attacks or high levels of uric acid in your blood, you may need to take uric acid-lowering medicine.

Important

It’s important to take uric acid-lowering medicine regularly, even when you no longer have symptoms.

Things you can do to prevent gout coming back

Making lifestyle changes may mean you can stop or reduce further attacks.

Do

  • get to a healthy weight, but avoid crash diets – try the NHS weight loss plan

  • eat a healthy, balanced diet – your doctor may give you a list of foods to include or limit

  • have some alcohol-free days each week

  • drink plenty of fluids to avoid getting dehydrated

  • exercise regularly – but avoid intense exercise or putting lots of pressure on joints

  • stop smoking

  • ask a GP about vitamin C supplements

Don’t

  • do not have lots of sugary drinks and snacks

  • do not eat lots of fatty foods

  • do not drink more than 14 units of alcohol a week, and spread your drinking over 3 or more days if you drink as much as 14 units

Things that can trigger a gout attack

You might get an attack if you:

  • have an illness that causes a high temperature
  • drink too much alcohol or eat a very large, fatty meal
  • get dehydrated
  • injure a joint
  • take certain medicines

Get treatment immediately if you feel an attack starting.

Who gets gout

Gout sometimes runs in families.

It’s more common in men, especially as they get older.

You might have a higher chance of getting gout if you:

  • are overweight
  • drink alcohol
  • have been through the menopause
  • take medicines such as diuretics (water tablets), or medicines for high blood pressure (such as ACE inhibitors)
  • have high cholesterol, high blood pressure, kidney problems, osteoarthritis or diabetes
  • have had surgery or an injury

Complications of gout

It’s rare to get lots of attacks (chronic gout), but if you do, it can damage your joint.

Chronic gout can also cause tiny white lumps, called tophi, to appear under your skin, usually on your ears, fingers or elbows.

This is where urate crystals form under your skin. They can be painful.

You can get kidney stones if your uric acid levels are very high, so you’ll need treatment to reduce the levels.

Information:

Social care and support guide

Read our guide to care and support if you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they’re ill, elderly or disabled (including family members)

Video: gout

This video explains how gout affects the body, and what treatments are available.

Media last reviewed: 16 November 2020
Media review due: 16 November 2023

Page last reviewed: 09 October 2020
Next review due: 09 October 2023

How long does gout last? What to know

Gout is a chronic condition. A flare-up of symptoms can last a few days if a person gets treatment and up to a couple of weeks if they do not.

Gout is an inflammatory disease that causes flare-ups of symptoms that come and go. The time between flare-ups varies depending on the person and their response to treatment.

There is currently no cure for gout. However, lifelong treatment and lifestyle adjustments, such as dietary changes, can help people manage the condition.

In this article, we look at how long gout flare-ups typically last and explain how to treat and prevent them.

Gout is a form of inflammatory arthritis. The condition involves flare-ups of symptoms, which are periods during which the symptoms emerge or worsen. There is no cure for gout, and the condition can worsen over time without proper treatment.

Treatments focus on reducing symptom severity during a flare-up and preventing future flare-ups. Doctors typically aim to reduce the amount of uric acid in the blood, which contributes to gout symptoms.

According to Johns Hopkins Arthritis Center, a gout flare-up typically reaches its peak within 12–24 hours of the initial onset. However, this period will vary depending on the person’s response to treatment and their general health.

Treatment should lead the symptoms to return to normal within a few days of the flare-up.

As treatment shortens the duration of flare-ups, they typically last for about 7–14 days without it.

Treatment can also reduce symptom severity. A 2014 review of colchicine found that people using this treatment were 25% more likely to report a 50% reduction in pain during a flare-up than those receiving a placebo. However, colchicine can cause side effects, such as nausea, vomiting, and diarrhea.

Common symptoms during a gout flare-up include:

  • intense joint pain with a sudden onset
  • pain in one joint at a time, which may increase as the disease progresses
  • painful, discolored, and swollen joints

The Centers for Disease Control and Prevention (CDC) note that gout is most common in the big toe but that it also frequently affects other joints, such as the knee, ankle, and other toes.

Treatment can reduce the severity and duration of a flare-up, but people can also take steps at home to manage the symptoms.

Diet can affect the symptoms of gout.

The CDC, the Arthritis Foundation, and the American College of Rheumatology recommend eating a diet low in purines. This means avoiding:

  • red meat
  • organs
  • certain types of seafood
  • alcohol

The DASH diet and Mediterranean diet are both good options for avoiding high purine foods.

The DASH diet primarily involves fruits, vegetables, whole grains, and lean meats, while the Mediterranean diet is rich in vegetables, whole grains, fish, and unsaturated fats.

Anyone who experiences an episode of gout symptoms for the first time should speak with a doctor. The doctor can help the person determine the best course of treatment, which is likely to include dietary changes and home remedies.

It is worth contacting a doctor if the recommended treatments are causing side effects or not working. In these cases, doctors can adjust the treatment plan accordingly.

A person with gout should also talk with their doctor if their gout flare-up is lasting longer than usual or the symptoms are worsening.

Gout flare-ups are painful episodes that can last for 1–2 weeks. Timely treatment can reduce the duration of a flare-up and the severity of the symptoms.

People with gout can take steps to prevent flare-ups, such as avoiding foods that are high in purine. Doctors can work with a person to determine an effective treatment plan that allows them to manage the disease over time with medications and lifestyle adjustments.

what is this disease, causes, symptoms, signs, diagnosis, treatment, diet

The essence of gout

Causes

Symptoms

Diagnosis

Treatment

Diet

Gout is a metabolic disease characterized by the deposition of crystals of uric acid or sodium monourate in various organs and tissues (mainly in the joints and/or kidneys). This is a fairly common disease that, according to medical statistics, occurs in one person out of 1000 in Russia and two out of 100 in Europe and the USA.

The peak incidence of gout in men is at the age of 40-50 years, they get sick 15-20 times more often than the fairer sex. Gout in women usually develops over the age of 60, during the onset of menopause. The reason is that estrogens accelerate the excretion of uric acid by the kidneys, so after a decrease or complete cessation of their production, the likelihood of the disease increases dramatically.

Essence of gout

This disease is based on a violation of the metabolism of purine bases and the accumulation of uric acid and its derivatives (acid urate salts) in the peripheral blood, which is medically called hyperuricemia. Normally, its concentration in the blood is not more than 420 µmol/L.

However, the very fact of an increase in the concentration of uric acid in the blood serum does not indicate the presence of this pathology: it occurs in 4-12% of the inhabitants of our country, among whom the vast majority have no idea what gout pain is. Hyperuricemia occurs in a number of other diseases, namely diseases of the cardiovascular system, blood, kidney pathology and oncology.

Uric acid crystals in the presence of risk factors are deposited first in the joints, leading to the development of aseptic (“sterile”) inflammation. With the progression of the disease and the lack of proper treatment, this process gradually affects the kidney tissue, resulting in a gradual decrease in renal function.

Interestingly, crystals can be deposited in the joints when the serum concentration of this compound is 360 µmol/l and higher (that is, this indicator may be normal in some patients). During an acute attack, this laboratory marker can drop even lower, so a doctor’s examination and a comprehensive examination are important for making a diagnosis. Treatment of patients with gout is part of the duties of a rheumatologist.

Causes of gout

Primary gout, like most other diseases, develops when a hereditary predisposition is combined with a certain lifestyle. Genetically determined may be a decrease in the number or absence of enzymes that metabolize sodium monourate, resulting in the development of hyperuricemia.

Risk factors that increase the likelihood of developing this disease include a sedentary lifestyle and resulting overweight or obesity, excessive consumption of red meat, beer (which contains uric acid precursor compounds), tea, coffee, chocolate, and certain legumes.

Unlike primary, secondary gout can develop as a complication of other diseases or medications. The most common causes of gout are chronic renal failure, which slows down the excretion of uric acid in the urine, some autoimmune diseases and anticancer therapy.

Symptoms of gout

Gout is a chronic progressive disease that progresses through a series of successive stages. This disease is incurable today, however, adequately selected therapy can slow down its progression and the development of complications, gout attacks develop much less frequently, which makes it possible for a person to live a normal life.

The following periods of gout are distinguished:

  1. Asymptomatic hyperuricemia. At this stage, an elevated level of uric acid is determined in the patient’s blood, but there are no clinical signs of the disease yet.
  2. Asymptomatic hyperuricemia with deposition of uric acid crystals in the joints, but without clinical manifestations of the disease.
  3. Accumulation of uric acid in the joints with attacks of acute arthritis, for which there is a characteristic localization – in the vast majority of cases, gout on the leg affects one metatarsophalangeal joint. An attack of arthritis develops, as a rule, at night and is characterized by extremely intense pain. In the literature, it is described as “pain from clamping the press” or “pain, as if a dog had dug into the leg.” Even the touch of a thin sheet to the affected joint leads to unbearable suffering. In addition to pain, outwardly you can see a pronounced swelling of the joint, hyperemia, the skin over it becomes shiny. An attack of gout lasts about 3-7 days, after which the condition gradually normalizes.

The next exacerbation may develop several months or even years after the first, during the interictal period the patient may feel completely healthy. However, over time, in the absence of treatment, the duration of remission will decrease, and exacerbations will develop more often. If in men the disease most often involves one metatarsophalangeal joint on the foot, then in women often signs of gout can be found on the joints of the hands, polyarthritis often develops with the involvement of various groups of joints.

Chronic tophi form is the latest stage of gout, characterized by the presence of tophi or gouty nodules (foci of accumulation of uric acid, visible during visual inspection), signs of chronic arthritis, and the presence of bone erosions.

In addition to joint damage, sodium monourate crystals are deposited in the kidney tissue with the gradual development of nephrolithiasis and chronic pyelonephritis. As the disease progresses, the excretory function of the kidneys decreases and chronic renal failure develops with a long list of complications.

Gout diagnostics

In the first two stages of the disease, before the onset of clinical manifestations, it is impossible to make a diagnosis after a visual examination. Uric acid in gout is the main laboratory marker that allows you to suspect or exclude this disease. However, it does not have 100% sensitivity and specificity: a large number of people with hyperuricemia do not have gout, and in patients, especially immediately after the next attack, its level may be within the normal range.

In turn, an attack of gout is so characteristic that after the patient describes his condition, no doctor has any doubts about the diagnosis. Difficulties arise with atypical localization of arthritis. In this case, instrumental methods are used for diagnosis (X-ray or ultrasound examination), from laboratory markers, the examination is supplemented by an assessment of the level of acute phase proteins, a proteinogram.

Treatment of gout

Unfortunately, today there is not a single drug that could not only cure this disease completely, but also take it under control. Medicines for gout can be divided into those that lower the level of uric acid in the blood and those that relieve pain during an attack.

Antihyperuricemic agents include Probenecid, Sulfinpyrazone, Azapropazone and Allopurinol, the latter being the most commonly used. The goal of treatment is to reduce the level of uric acid in the blood by a factor of two, which can significantly slow down the progression of the disease and reduce the risk of complications.

During an attack of gout, drugs should relieve pain as much as possible, as the leading symptom of an aggravation of the disease. For this purpose, non-steroidal anti-inflammatory drugs are used, and Indomethacin has the maximum efficiency.

In addition to drug therapy, extracorporeal hemocorrection, physiotherapeutic methods, spa treatment are used.

Gout diet

Diet in this disease plays a leading role, since limiting the use of certain foods helps to significantly reduce the production of monosodium urate.

The leading aspect of the diet is to reduce the consumption of red meat and offal (liver, lungs, heart), fish, alcoholic beverages, legumes and certain vegetables (asparagus, eggplant, cauliflower). Eating these foods in large quantities in itself can provoke another attack.

Taking a large amount of high-carbohydrate foods with gout is inevitable, because most protein foods are banned. In moderation, it is permissible to eat eggs, cereals, lean fish, poultry meat. However, in this case, the risk of weight gain or even obesity increases, which again provokes the progression of this disease. Therefore, it is important for patients to monitor their physical activity, walk at a fast pace for at least 30 minutes a day, do exercises, swimming is the best sport.

Patients, among other things, should limit the use of table salt and increase the amount of fluid consumed up to 3 liters per day (in the absence of contraindications).

Gout is a chronic incurable disease. However, a timely visit to a rheumatologist, compliance with all recommendations for lifestyle modification, weight control, pharmacotherapy, diet and regular medical examination can significantly improve the quality of life, reduce the frequency of exacerbations and complications.

The author of the article:

Ovsepyan Naira Gevorgovna

rheumatologist, online consultations

work experience 31 years

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