How can you manage gout pain effectively. What are the most effective strategies for alleviating gout attacks. Which lifestyle changes can help prevent future gout flares. How does proper diagnosis and treatment impact gout management. What role do medications play in controlling gout symptoms. How can diet modifications help reduce gout pain. Why is ongoing care crucial for managing gout long-term.

Understanding Gout: A Common Form of Inflammatory Arthritis

Gout is a prevalent type of inflammatory arthritis characterized by sudden, intense pain in joints, particularly the big toe. It occurs when there’s an excess of uric acid in the body, leading to the formation of uric acid crystals in joints and surrounding tissues. These crystals trigger inflammation, resulting in painful gout attacks or flares.

Gout attacks can be excruciating, often starting abruptly and lasting for days or weeks. Between flares, individuals may experience periods of remission with no symptoms. However, without proper management, repeated gout attacks can lead to a more severe condition called gouty arthritis.

Key Symptoms of Gout

• Intense joint pain, often in the big toe
• Swelling and redness around affected joints
• Warmth or heat in the affected area
• Limited range of motion in the joint

Are gout symptoms always the same for everyone? While the big toe is commonly affected, gout can occur in various joints, including ankles, knees, and fingers. The severity and duration of symptoms may vary from person to person, emphasizing the importance of personalized treatment approaches.

Causes and Risk Factors of Gout

Gout is primarily caused by a condition called hyperuricemia, where there’s an excess of uric acid in the body. Uric acid is produced when the body breaks down purines, substances found naturally in the body and certain foods. When uric acid levels become too high, crystals can form and accumulate in joints, leading to gout attacks.

Common Risk Factors for Gout

1. Gender: Men are more likely to develop gout than women
2. Obesity: Excess weight increases the risk of gout
3. Medical conditions: Heart disease, high blood pressure, diabetes, and poor kidney function can contribute to gout development
4. Diet: Consuming foods high in purines (e.g., red meat, organ meats, certain seafood) and fructose can increase risk
5. Alcohol consumption: Especially beer and spirits
6. Medications: Certain drugs, particularly diuretics, can raise uric acid levels

Does having hyperuricemia always lead to gout? Interestingly, not everyone with high uric acid levels develops gout. However, addressing hyperuricemia is crucial for those diagnosed with gout to prevent future attacks and complications.

Diagnosing Gout: The Importance of Proper Assessment

Accurate diagnosis of gout is essential for effective management. Gout can mimic other forms of arthritis, making it crucial to consult a healthcare professional, preferably a rheumatologist, for a proper diagnosis.

Diagnostic Methods for Gout

• Physical examination of the affected joint
• Medical history assessment
• Blood tests to measure uric acid levels
• Joint fluid analysis to detect uric acid crystals
• Imaging tests (X-rays, ultrasound, or CT scans) to rule out other conditions

Can gout be diagnosed during remission periods? Gout is typically diagnosed during an active flare when symptoms are present. However, if you suspect you have gout, it’s essential to seek medical attention even between flares to discuss your symptoms and potential management strategies.

Comprehensive Treatment Approaches for Gout

Effective gout management involves a combination of medical treatments and self-management strategies. The primary goals are to alleviate pain during flares, prevent future attacks, and reduce the risk of complications.

Medical Treatments for Gout

1. Pain management during flares:
   • Nonsteroidal anti-inflammatory drugs (NSAIDs)
   • Colchicine
   • Corticosteroids
2. Preventive medications:
   • Uric acid-lowering drugs (e.g., allopurinol, febuxostat)
   • Probenecid to improve uric acid excretion
3. Treatment of underlying conditions

How long does it take for gout medications to work? The effectiveness of gout medications can vary. Pain relief medications typically work within hours to days, while preventive medications may take weeks or months to show full benefits. Consistency in taking prescribed medications is crucial for optimal results.

Lifestyle Modifications: Key to Long-term Gout Management

In addition to medical treatments, lifestyle changes play a vital role in managing gout and preventing future attacks. These modifications can significantly impact uric acid levels and overall health.

Essential Lifestyle Changes for Gout Management

• Maintain a healthy weight
• Follow a gout-friendly diet
• Stay hydrated
• Limit alcohol consumption
• Exercise regularly
• Manage stress

Which dietary changes are most effective for gout management? While individual responses may vary, reducing intake of purine-rich foods (e.g., red meat, organ meats, certain seafoods) and limiting alcohol and sugary beverages can help lower uric acid levels. Incorporating low-fat dairy products, whole grains, and vegetables may also be beneficial.

6 Effective Strategies for Managing Gout Pain

Dealing with gout pain can be challenging, but several strategies can help alleviate discomfort during flares and prevent future attacks. Here are six effective ways to manage gout pain:

1. Immediate Pain Relief Techniques

When a gout attack strikes, quick action can help reduce pain and inflammation:

• Apply ice to the affected joint for 20-30 minutes several times a day
• Elevate the affected limb to reduce swelling
• Use over-the-counter NSAIDs as directed by your healthcare provider
• Rest the affected joint and avoid putting pressure on it

Is heat therapy recommended for gout pain? While ice is generally preferred during acute gout attacks to reduce inflammation, some individuals may find relief with alternating hot and cold therapy. Always consult your healthcare provider for personalized advice.

2. Medication Management

Proper use of prescribed medications is crucial for managing gout pain and preventing future attacks:

• Take prescribed pain relief medications at the first sign of a flare
• Follow your healthcare provider’s instructions for preventive medications
• Don’t stop taking uric acid-lowering drugs without consulting your doctor, even if symptoms improve
• Keep a record of your medications and any side effects

How can you remember to take gout medications regularly? Setting reminders on your phone, using pill organizers, or incorporating medication into your daily routine (e.g., taking it with breakfast) can help ensure consistent use of prescribed medications.

3. Dietary Modifications

Making smart food choices can significantly impact gout management:

• Limit high-purine foods like red meat, organ meats, and certain seafoods
• Increase intake of low-fat dairy products, which may help lower uric acid levels
• Choose complex carbohydrates over refined sugars
• Stay hydrated by drinking plenty of water
• Limit or avoid alcohol, especially beer and spirits

Are there any foods that can actively help reduce gout pain? While no food can cure gout, some studies suggest that cherries and cherry juice may help reduce gout attacks. However, it’s essential to incorporate these as part of a balanced diet and not as a substitute for prescribed treatments.

4. Weight Management

Maintaining a healthy weight is crucial for gout management:

• Gradually lose weight if overweight or obese
• Focus on balanced, nutrient-rich meals
• Avoid crash diets, which can temporarily increase uric acid levels
• Combine dietary changes with regular physical activity

How does weight loss impact gout symptoms? Losing excess weight can help lower uric acid levels and reduce the frequency and severity of gout attacks. Even modest weight loss can have significant benefits for gout management.

5. Regular Exercise

Physical activity plays a vital role in gout management:

• Engage in low-impact exercises like swimming, cycling, or walking
• Aim for at least 150 minutes of moderate-intensity exercise per week
• Include strength training exercises to maintain muscle mass
• Practice gentle stretching to improve joint flexibility

Can exercise trigger gout attacks? While intense exercise may temporarily increase uric acid levels, regular moderate exercise is generally beneficial for gout management. Start slowly and gradually increase intensity, always listening to your body and consulting your healthcare provider.

6. Stress Management

Stress can exacerbate gout symptoms, making stress management an important aspect of pain control:

• Practice relaxation techniques like deep breathing or meditation
• Engage in activities you enjoy to reduce stress
• Consider joining a support group for individuals with gout
• Get adequate sleep to help manage stress and promote overall health

How does stress impact gout symptoms? Stress can trigger inflammation in the body and may increase the risk of gout attacks. Additionally, stress may lead to behaviors that exacerbate gout, such as poor diet choices or increased alcohol consumption. Implementing stress-reduction techniques can contribute to better overall gout management.

The Importance of Ongoing Care and Monitoring

Managing gout is an ongoing process that requires regular medical care and self-monitoring. Consistent follow-up with healthcare providers helps ensure that treatment plans remain effective and allows for timely adjustments if needed.

Key Aspects of Ongoing Gout Care

• Regular check-ups with your rheumatologist or primary care provider
• Periodic blood tests to monitor uric acid levels
• Tracking of gout attacks, including frequency, duration, and potential triggers
• Open communication with healthcare providers about symptoms and treatment efficacy
• Adjusting treatment plans as needed based on symptoms and test results

How often should you have your uric acid levels checked? The frequency of uric acid testing can vary depending on your individual case and treatment plan. Generally, more frequent testing may be necessary when starting or adjusting medications, while stable patients may require less frequent monitoring. Always follow your healthcare provider’s recommendations for testing and follow-up appointments.

Emerging Treatments and Research in Gout Management

As our understanding of gout continues to evolve, researchers are exploring new treatments and management strategies. Staying informed about these developments can help patients and healthcare providers make informed decisions about gout care.

Promising Areas of Gout Research

• New uric acid-lowering medications with fewer side effects
• Targeted therapies to reduce inflammation during gout attacks
• Genetic studies to identify individuals at higher risk for gout
• Investigations into the gut microbiome’s role in gout development
• Advanced imaging techniques for early gout detection and monitoring

How can patients stay informed about new gout treatments? Regularly discussing the latest developments with your healthcare provider, attending educational seminars, and following reputable arthritis organizations can help you stay up-to-date on emerging gout treatments and research findings.

In conclusion, effective gout management requires a multifaceted approach combining medical treatments, lifestyle modifications, and ongoing care. By implementing these strategies and working closely with healthcare providers, individuals with gout can significantly reduce pain, prevent future attacks, and improve their overall quality of life. Remember, each person’s experience with gout is unique, so it’s essential to work with your healthcare team to develop a personalized management plan that addresses your specific needs and circumstances.

Gout | Arthritis | CDC

• What is gout?
• What are the signs and symptoms?
• What causes gout?
• What are the risk factors?
• How is gout diagnosed?
• Who should diagnose and treat gout?
• How is gout treated?
• How can I improve my quality of life?

What is gout?

Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). There are times when symptoms get worse, known as flares, and times when there are no symptoms, known as remission. Repeated bouts of gout can lead to gouty arthritis, a worsening form of arthritis.

There is no cure for gout, but you can effectively treat and manage the condition with medication and self-management strategies.

What are the signs and symptoms of gout?

Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remission—weeks, months, or years—without symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.

Symptoms in the affected joint(s) may include:

• Pain, usually intense
• Swelling
• Redness
• Heat

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What causes gout?

Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat. When there is too much uric acid in the body, uric acid crystals (monosodium urate) can build up in joints, fluids, and tissues within the body. Hyperuricemia does not always cause gout, and hyperuricemia without gout symptoms does not need to be treated.

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What increases your chances for gout?

The following make it more likely that you will develop hyperuricemia, which causes gout:

• Being male
• Being obese
• Having certain health conditions, including:
  • Congestive heart failure
  • Hypertension (high blood pressure)
  • Insulin resistance
  • Metabolic syndrome
  • Diabetes
  • Poor kidney function
• Using certain medications, such as diuretics (water pills).
• Drinking alcohol. The risk of gout is greater as alcohol intake goes up.
• Eating or drinking food and drinks high in fructose (a type of sugar).
• Having a diet high in purines, which the body breaks down into uric acid. Purine-rich foods include red meat, organ meat, and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout, and tuna.

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How is gout diagnosed?

A medical doctor diagnoses gout by assessing your symptoms and the results of your physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint.

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Who should diagnose and treat gout?

The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases. Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a provider near you, visit the database of rheumatologistsexternal icon on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout.

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How is gout treated?

Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to

• Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
• Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food (like red meat or organ meat), may help prevent future attacks. Changing or stopping medications associated with hyperuricemia (like diuretics) may also help.
• Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.

In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.

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How can I manage my gout and improve my quality of life?

Gout affects many aspects of daily living, including work and leisure activities.  Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.

For gout in particular:

• Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines (like a diet rich in red meat, organ meat, and seafood), and limit alcohol intake (particularly beer and hard liquor).

CDC’s Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.

• Learn self-management skills. Join a self-management education class, which helps people with arthritis and other chronic conditions—including gout—understand how arthritis affects their lives and increase their confidence in controlling their symptoms and living well. Learn more about the CDC-recommended self-management education programs.
• Get physically active. Experts recommend that adults engage in 150 minutes per week of at least moderate physical activity. Every minute of activity counts, and any activity is better than none. Moderate, low impact activities recommended include walking, swimming, or biking. Regular physical activity can also reduce the risk of developing other chronic diseases such as heart disease, stroke, and diabetes. Learn more about physical activity for arthritis.
  • Go to effective physical activity programs. For people who worry that physical activity may make arthritis worse or are unsure how to exercise safely, participation in physical activity programs can help reduce pain and disability related to arthritis and improve mood and the ability to move. Classes take place at local Ys, parks, and community centers. These classes can help people with arthritis feel better. Learn more about CDC-recommended physical activity programs.
• Talk to your doctor. You can play an active role in controlling your arthritis by attending regular appointments with your health care provider and following your recommended treatment plan. This is especially important if you also have other chronic conditions, like diabetes or heart disease.
• Lose weight. For people who are overweight or obese, losing weight reduces pressure on joints, particularly weight bearing joints like the hips and knees. Reaching or maintaining a healthy weight can relieve pain, improve function, and slow the progression of arthritis.
• Protect your joints. Joint injuries can cause or worsen arthritis. Choose activities that are easy on the joints like walking, bicycling, and swimming. These low-impact activities have a low risk of injury and do not twist or put too much stress on the joints. Learn more about how to exercise safely with arthritis.

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Learn more about gout

• National Institute of Arthritis and Musculoskeletal and Skin Diseasesexternal icon [En Español]external icon
• American College of Rheumatologyexternal icon
• National Library of Medicine—MedlinePlus—Acute Goutexternal icon [En Español]external icon
• National Library of Medicine—MedlinePlus—Chronic Goutexternal icon [En Español]external icon

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Learn more about arthritis

• Arthritis Types
• Physical Activity for Arthritis
• Frequently Asked Questions (FAQs)
• Arthritis-Related Statistics

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Gout Treatment | Arthritis Society Canada

Why is treatment for gout so important?

Gout attacks tend to increase in length and frequency without treatment and can even become chronic. The ongoing presence of uric acid crystals in and around the joint can lead to destruction of the joint and the soft tissues around it.

Fortunately, with proper medical attention and treatment, few patients progress to this advanced stage. Most people living with chronic gout can control the condition with medication. Lifestyle changes are an important part of treatment and can help prevent and manage flares. Early identification and treatment can reduce the chance of permanent joint damage and the number and severity of attacks.

How is gout treated?

Treatment for gout consists of three main steps:

Step 1: Treat active gout attack.
Step 2: Lower uric acid levels in the bloodstream (if indicated).
Step 3: Add a prophylactic treatment if a medication is given to lower the uric acid in the bloodstream. 

When having an attack

When having a gout attack, take these steps to bring pain and swelling under control:

• Ice, elevate and rest the joint.

• Take colchicine, anti-inflammatory medication, or prednisone as soon as possible, as advised by your doctor.

• Drink plenty of water and fluids. Remember alcohol, pop, or sugary drinks can trigger gout attacks, so avoid those.

• Keep track of which joints are involved, the intensity and any changes in pain, and the length of the attack.

• Call your doctor to make an appointment to be assessed.

• Avoid stress as much as possible. Added stress can make a gout attack feel more intense. Consider using relaxation techniques such as mindfulness meditation to relax your body’s response to pain.

Heat and cold

Cold

During a gout attack, using cold can help reduce pain. Cold reduces blood flow to the injury, which helps reduce swelling and inflammation. Cold should not be applied for longer than 20 minutes at a time. As a general rule, 20 minutes on, 20 minutes off, works well. Always use a protective barrier, such as a towel, between any cold pack and the skin.

Using a commercial cold pack or a homemade one (from crushed ice, ice cubes or a bag of frozen vegetables) can be helpful.

Cold is ideal for:

Heat

Heat should not be used during a gout attack since applying heat can make symptoms worse. However, between attacks, taking a warm shower and using warm packs (such as hot water bottles or microwavable heating pads) are great ways to help reduce general pain and stiffness.

Heat is ideal for:

• relieving pain and stiffness

• relieving muscle spasms and tightness

• enhancing range of motion

IMPORTANT: Do not use heat on an already inflamed joint, as it can make symptoms worse.

Relaxation techniques and skills

Developing good relaxation skills can help you maintain balance in your life, giving you a greater feeling of control over your gout and a more positive outlook. Relaxing the muscles around a sore joint can help to reduce pain, though it is not always easy to relax when feeling pain. Gout attacks tend to be very painful, but there are techniques you can learn to help you refocus your mind, and help relax your muscles during a painful attack.

Visualization techniques, such as imagining burning sensations being put out by cold water, or concentrating on imagining what your pain might look like can also help to draw focus away from the pain itself, and help you reframe your experiences of pain or discomfort.

Other techniques to consider include mindfulness meditation, deep breathing exercises, listening to a podcast or audio book, narrated relaxation exercises, or soothing music.

A key to developing relaxation skills is to also practice the techniques that feel most comfortable for you even when you are not experiencing pain. This can be especially helpful for forms of meditation and visualization.

Medications to treat an acute gout attack

A number of medications do a good job of preventing pain and swelling in the short-term. Depending on the severity of the gout attack, medications can be given individually, or in combination.

• Non-steroidal anti-Inflammatory drugs (NSAIDs)

  Non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat pain and inflammation. The term “non-steroidal” means that they do not contain steroids. NSAIDs are commonly used drugs, and there are many different types and brands. Many can be obtained without a prescription. These medications control the symptoms of gout, but do not alter the course of the disease. NSAIDs can be taken as needed or taken regularly to control symptoms. While generally well tolerated, NSAIDs may irritate the stomach or cause other side effects. Talk with your doctor to decide if NSAIDs are an appropriate treatment option for you.

• Colchicine

  For those unable to take NSAIDs, colchicine is an option that has been used to treat gout for more than 2,000 years. Originally from a plant extract, colchicine is often used to relieve the pain and swelling of gout attacks. By intervening in this early phase of a gout attack, colchicine can reduce the production of neutrophils that cause pain, inflammation, and swelling. When taken after the first 48 hours of an attack, the neutrophils have often had too much time to enter the affected joint, and colchicine will provide little to no benefit.

  While effective, many people cannot take colchicine due to its side effects; however, you and your doctor can decide if colchicine is right for you.

• Corticosteroids

  For those who cannot take NSAIDs or colchicine, corticosteroids may be a good alternative. These are given either orally or as injections into the affected joints. Injections tend to work quickly – within a few days or even within a few hours for some people. If you would like to explore this option, discuss with your doctor to determine if corticosteroids make sense for your treatment plan.

Lowering uric acid in the bloodstream

After a first gout attack, your doctor will discuss with you whether you may benefit from medications to help lower the level of uric acid in your bloodstream. Your doctor will consider the following indications to help make this decision:

• Two or more gout attacks within the span of 12 months

• A history of kidney stones

• Chronic kidney failure

• Bone erosion on x-ray

• Presence of tophi (uric acid crystals under the skin – pronounced toe-fi)

When working with you to lower your bloodstream uric acid levels, your doctor will want to help you reach the following target uric acid levels in your bloodstream.

• If you have no erosion or tophi present, uric acid levels should be less than 360 µmol/l.

• If there is erosion or tophi present, uric acid levels should be below 300 µmol/l

Medications that reduce uric acid levels

To achieve lower bloodstream levels of uric acid, your doctor may prescribe a medication. Medications that reduce uric acid levels will prevent future gout attacks and keep the condition from becoming chronic.

Taking medications that regulate uric acid levels is often a long-term treatment option since starting and stopping these medications can trigger a gout attack. Your doctor may wait to introduce this type of medication to first determine how frequently you experience gout attacks, and if they can be controlled through other treatment options. If you experience two to three attacks per year, your doctor may wish to explore this medication option with you.

Since starting a medication to lower uric acid levels can also trigger a gout attack, your doctor will likely also prescribe another medication, usually an NSAID or colchicine, to take daily for the first few months to help prevent further gout attacks while your body adjusts to taking a uric acid lowering medication.

Once you start a medication to lower uric acid levels, you may not notice any benefit right away. In some cases it could take years to achieve target uric acid levels, and for the uric acid crystals in joints and soft tissues to disappear.

The following medications are commonly used to help lower uric acid levels in the bloodstream:

• Allopurinol

  Allopurinol is a medication used to lower uric acid levels. It can take several weeks for the effects to become noticeable. It is common for a gout attack to happen in the first few months after starting allopurinol. Continue to keep your doctor informed of any new symptoms you may experience. If you have concerns about any side effects, or still have gout attacks while taking allopurinol, talk with your doctor about your treatment plan.

  Allopurinol may interact with other medications you are already taking. You and our doctor can decide if taking allopurinol is right for you.

• Febuxostat

  Febuxostat works to reduce the level of uric acid in the body, which can help in the management of gout. Although febuxostat is generally well tolerated, it is always best to have a conversation with your doctor to decide if febuxostat is right for you and your treatment plan.

• Pegloticase

  If other medications are not effective at lowering uric acid levels, pegloticase may be used as an alternate option. Pegloticase may only be used if no other treatment options have been found effective. Many people experience side effects that make them unable to tolerate this medication. Talk with your doctor to determine if pegloticase is right for you. This medication should not be used in people with a history of kidney stones.

For more information about medications, consult our Medication Reference Guide.

Surgery

Surgery is rarely required for gout. Occasionally, surgery is considered for people who have suffered from gout over a long period of time to remove problematic tophi or to repair badly damaged joints. However, with proper medication and treatment, these situations are generally avoided.

❮ Gout Symptoms and Diagnosis Gout Self-Management ❯

Discover More

Risk Factors and Gout Attacks

Learn about who gets gout and what happens during a gout attack.

Learn about who gets gout and what happens during a gout attack.

Symptoms and Diagnosis

Recognize the signs and symptoms of gout, as well as how gout is diagnosed.

Recognize the signs and symptoms of gout, as well as how gout is diagnosed.

Treatment

Catching an attack early is an important step in managing gout. Treatment options for gout include medication, diet, and pain management.

Catching an attack early is an important step in managing gout. Treatment options for gout include medication, diet, and pain management.

Self-Management

Making dietary changes, staying active, monitoring weight, and avoiding triggers can help in the self-management of gout.

Making dietary changes, staying active, monitoring weight, and avoiding triggers can help in the self-management of gout.

This gout resource was reviewed in October 2022 with expert advice from:

Dr. Jean-Philip Deslauriers

Clinical Professor at the University of Sherbrooke

Rheumatologist

Bathurst, New Brunswick

Gout, gouty arthritis, joint pain, treatment of gout in Kiev

Gout is a metabolic disease in which the level of uric acid in the blood rises, which then precipitates in the joints and tissues, causing an inflammatory reaction.

Normal uric acid levels are up to 6.8 mg/dL.

Causes of gout

• increased consumption of purines (meat products)
• reduced excretion of uric acid from the body
• an increase in the production of urates occurs in diseases accompanied by increased cell decay, enzyme disorders

Gout is also called “royal disease” because in the old days meat products could be consumed mainly by the nobility, so they were more likely to have this disease.

The deposition of crystals of uric acid (sodium monourate) occurs mainly in poorly vascularized areas (tendons, ligaments, walls of synovial bags) or in cold peripheral regions (leg joints, mainly 1st metatarsophalangeal joint, ankle, knee joints) . In a more severe form of gout, uric acid crystals can be deposited in large joints, in the kidneys.

Areas of uric acid crystals can be found under the skin as small hard nodules called tophi.

Exacerbation of gout can be triggered by alcohol intake, dietary disorders (eating meat or acidic foods), trauma, infectious diseases.

Symptoms of gout

Acute gouty arthritis usually begins at night with redness and pain in the area of ​​the affected joint.

Most often, with gout, the first metatarsal-falve joint becomes inflamed, but other joints can also be involved: ankle, knee, wrist, elbow, foot joints.

Pain in the joint quickly increases and becomes unbearable, it is accompanied by hyperemia, swelling, limitation of joint mobility.

In the initial stages of the disease, more often one joint is affected and the attack can last several days. As the disease progresses, the frequency and duration of attacks increases, and more joints are involved.

Tophi are usually found under the skin in the form of white or yellowish nodules. Basically, they appear in the chronic course of gout, a favorite place for their localization are the fingers, feet, the region of the olecranon, and can appear on the auricles. Also, tophi can form in the area of ​​synovial bags of the joints and in the internal organs.

Chronic gout Manifested as chronic gouty arthritis, urolithiasis, nephropathy, cardiovascular disorders.

Chronic arthritis usually affects several joints, which may become inflamed at the same time or alternately.

Gout diagnosis

The following diagnostic criteria apply:
• clinical manifestations of the disease
• blood and urine test for uric acid
• analysis of synovial fluid, if necessary, to differentiate gout from other diseases
• X-ray of the joints helps to identify bone erosions and tophi
• ultrasound of joints and kidneys

Treatment of gout

The following treatments are used :
• diet – foods rich in purines (meat, lard, legumes), as well as foods that can contribute to the development of an attack of gout (alcohol, acidic foods – salads, spinach, pickles) are excluded.
• drug treatment : NSAIDs, colchicine, corticosteroids, drugs that reduce the synthesis of uric acid (allopurinol), increase its excretion by the kidneys – probenecid (not prescribed for urolithiasis, elevated levels of uric acid in the urine).
• physiotherapy treatments aim to reduce inflammation and break down uric acid deposits.

In our center of vertebrology shock wave therapy is used for this purpose. It helps to destroy urate deposits in the tissues, in the area of ​​​​the joints, relieves inflammation, helps restore joint function.

• kinesitherapy – a method of restoring the function and performance of the joints with the help of special exercises. Treatment is carried out under the supervision of a rehabilitation physician on special simulators that unload the joint and at the same time strengthen and restore its mobility.

With timely detection and treatment of gout, good and lasting results can be achieved.

In our center you can consult with a qualified specialist, get the necessary diagnosis and treatment of gout and gouty arthritis.

Gout – symptoms and treatment

Gout is a disease associated with a violation of metabolic processes in the human body and the deposition of uric acid in the tissues.

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The body contains uric acid. If the amount of acid in the blood serum increases several times, then they speak of hyperuricemia.

Uric acid ceases to be excreted in the urine, begins to precipitate in the form of urate crystals and enters tissues where there is no blood supply – ligaments, tendons or peripheral joints. Uric acid causes inflammation in the joint. If gout is advanced, crystals form in large joints and parenchymal organs such as the kidneys, which can lead to damage.

Types of gout

• Primary – more common in men (malfunctions of enzymes that are involved in the metabolism of purines)
• Secondary – occurs under the influence of other diseases: hemolytic anemia, leukemia, congenital heart disease, kidney damage.

Symptoms of gout

The initial period of gout is often asymptomatic. Hyperuricemia occurs, maintaining a high concentration of uric acid in the blood. Timely treatment can stop the development of gout.

In the second period, specific signs appear. Gout is diagnosed when inflammation occurs in a joint. Over time, gouty nodes “tophi” are formed – deposits of large conglomerates of salts on the joints and acute inflammation occurs. When the growths burst, white crystals of uric acid are visible.

Pain can be triggered by various factors: trauma, alcohol, excessive exercise, drugs. The inflammatory process develops quite quickly. The affected area becomes swollen and red, and the skin of the joint becomes shiny and tight. The pain is most intense at night.

In addition, you may experience: fever, malaise, weakness.

A complication of gout can be a violation of the mobility and functionality of the joints, the formation of kidney stones, kidney failure.

Gout diagnostics

Which doctor treats gout? If you have characteristic symptoms of gout in the legs, you should consult a rheumatologist.

An examination by a doctor is important to determine the disease. Also held:

• laboratory tests (blood, urine)
• x-ray (detection of joint deformity)
• Ultrasound of the kidneys (detection of stones)

Gout Therapy

The treatment of gout is reduced to proper nutrition and taking drugs that reduce the synthesis of uric acid or increase the excretion of uric acid. Treatment should be carried out under the supervision of a physician.

In case of exacerbation of symptoms of gout, bed rest, heavy drinking, cold compresses at the site of inflammation are recommended.

Diet for gout

It is necessary to give up foods rich in purines: liver, brains, kidneys, lamb, caviar, nuts. Nutrition for gout should be rich in vegetables, fruits, butter, milk, low-fat cheese and potatoes. In addition, it is necessary to drink at least 2-3 liters of fluid per day, which will reduce the level of uric acid in the blood. The patient should avoid alcohol.

In our clinic, you can make an appointment with a rheumatologist and other specialists who will prescribe you an examination and select the right treatment.

Reception by doctors:

Choose a branchClinic “Dynasty” in St. Petersburg, Krasnogvardeisky districtClinic “Dynasty” in St. Petersburg, Petrogradsky districtClinic “Dynasty” in St. Petersburg, Primorsky districtClinic “Dynasty” in VsevolozhskVisiting service

Pediatric specialists

Consults online

Klyaus Natalia Andreevna

Rheumatologist, applicant for the degree of Candidate of Medical Sciences

Santimov Andrey Vyacheslavovich

Rheumatologist, pediatric rheumatologist, candidate of medical sciences

Gout treatment cost:

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