That means learning about gout treatment options. Of course, your personal doctor is the best source of information in this regard, but for the best results, you will want to take an active role in developing your treatment plan. Here, we’ll go over the basics of this disease and how it can be treated, information you’ll need to make solid, informed decisions about your care.
Gout is a form of inflammatory arthritis. It is characterized by the development of uric acid crystals in the synovial fluid of joints, which cause sudden and severe joint pain, tenderness and swelling, most often striking first in the large joint of one big toe. From there, it can move on to affect other joints – usually just one joint at a time. Joints that are commonly affected include the feet, ankles, knees, hands, wrists and elbows. Gout attacks typically come and go in the early phases of the disease and can last anywhere from a few days to two weeks, and joint pain and inflammation may then become chronic as the disease progresses.
Gout Treatment: The Basic Goals
The first goal of treatment is to relieve the pain and inflammation of an acute attack. Once that is accomplished, the goals become to help prevent further attacks and to reduce the risk of gout-related complications. These can include joint destruction, the formation of tophi, which are lumps under the skin, in the joints and bone caused by deposits of uric acid crystals, as well as kidney stones and/or impaired kidney function.
Treating Acute Attacks
Treatment of acute gout attacks generally consists of taking measures to control pain and suppress inflammation. Typically this includes the use of one or more of the following medications:
- Nonsteroidal anti-inflammatory drugs (NSAIDS) – These drugs can help reduce the inflammation caused by this type of arthritis and can relieve pain. NSAIDS most commonly used in the treatment of acute attacks include ibuprofen and indomethacin.
- Colchicine – Taken orally, this drug can reduce gout-related inflammation, especially when given during the first 12 hours of the onset of an acute attack. Typically, it is used in combination with NSAIDS, which help in controlling pain.
- Corticosteroids – These medications can be taken orally or via injection to quickly suppress inflammation.
Self-care measures that may be recommended to aid in reducing symptoms include:
- Resting the affected joint for 24 hours
- Elevating affected joints
- Applying cold packs to painful joints
- Avoiding aspirin use, which can increase symptoms
- Following a healthy gout diet
Long-Term Gout Treatment
Long-term treatment is about preventing flare-ups and reducing risk of complications. The components of treatment may include regular testing to monitor levels of uric acid in the body, medications to reduce those levels, and lifestyle changes to aid in better uric acid control.
Medications commonly used to control uric acid levels include:
- Drugs that block production of uric acid – These drugs, including allopurinol and febuxostat, limit the amount of uric acid produced by the body, lowering overall levels and risk of a gout attack.
- Drugs that enhance uric acid removal – These medications, which include probenecid and sulfinpyrazone, improve the ability of the kidneys to remove uric acid from the body.
Lifestyle changes recommended for long-term control of symptoms may include:
- Weight control – Maintaining a healthy body weight can reduce risk of flares and complications.
- Dietary changes – Certain foods and beverages can increase uric acid levels, increasing risk of symptoms and complications. Your doctor will likely recommend a diet that limits foods that are high in purines, including red meat, organ meats and seafood. You’ll likely be advised to avoid alcohol and foods and drinks that contain fructose, especially high fructose corn syrup as well.
Gout is often a chronic, life-long condition. However, by working with your doctor to formulate an effective gout treatment plan—including medications and lifestyle changes— and sticking to that plan faithfully, the disease can often be controlled, minimizing its impact on your everyday life, as well as its potential long-term complications.