How to Get Immediate Gout Pain Relief

Gout is the most common form of inflammatory arthritis--and arguably, the most painful. Gout flare-ups are typically accompanied by severe pain. The affected joint (often the big toe) is also often red, swollen, hot, and excruciatingly tender to touch.
DOCTOR PATIENT WOMAN

If you’re looking to relieve gout pain fast, we have tips—but true relief comes with timely and ongoing treatment. Read on to learn about the cause of gout, treating gout symptoms, and how to reduce flares and other health issues over time through an ongoing treatment plan.

What Causes Gout & Gout Pain?

Woman holding the knee with pain

The root cause of gout is high uric acid levels and the buildup of uric acid crystals around a particular joint or tendon.

While gout most often affects the big toe joint, it can also affect other joints in both upper and lower extremities.

Uric acid crystals are deposited around joints over time when there is too much uric acid in the blood. This accumulation can lead to flares or “attacks.”

Flares are caused by inflammation, which can lead to tremendous pain. Those suffering from a gout flare up are likely to seek ways to relieve gout pain fast.

About Uric Acid

Man scientist in protective gloves holding test tube with reagent

Uric acid occurs naturally in the body when purines (found in foods like red meat, shellfish, etc.) break down in the body. Everyone has uric acid in their system, but too much can lead to developing gout and other health issues.

Prolonged periods of time with excess uric acid in your system (>6.8 mg/dL) is called hyperuricemia.

This can also lead to crystals and tophi (large collection of crystals) forming around other joints, like the big toe, ankle, knees, wrists, elbows, and more.

Once urate crystals build up, the risk for a sudden gout attack increases.

Other Factors for Gout Development

Old man visiting doctor

Elevated uric acid is the root cause of gout. There are several factors that may contribute to increasing uric acid levels or developing gout. Some examples are below.

Genetics

Having a family history of gout is the number one contributing factor to developing gout. While elevated uric acid is the root cause, those who have high uric acid levels do not always have gout.

Food & Beverage Choices

While there is not a core “gout diet,” several foods have been known to trigger gout attacks—especially when uric acid levels are not under control.

Those with gout should limit purine-rich foods—like red meat, shellfish, and organ meats—that can increase uric acid levels, but it is not necessary to totally eliminate these foods. It is also helpful to avoid diets that focus on high-protein intake. Excessive alcohol intake, especially beer, should be avoided.

High fructose corn syrup and processed foods should be eaten in moderation.

Other Risk Factors

There are several other factors that can trigger gout flares. Those who are obese or have a high body mass index (BMI) are more likely to be at risk.

Other health conditions–such as diabetes, kidney stones or kidney health issues, heart attack, and stroke–can also put one at risk for gout attacks.

Treating Gout & Pain

Man taking medicine

Getting a prompt and accurate diagnosis–right from the first flare–is the most important step.

Once gout is identified, it’s important to work with your doctor and create an action plan.

Below are some tips for not only getting immediate gout pain relief but also helping to fight gout for the long haul.

Medications

From pain relief to prevention, there are several types of medications that to treat gout.

Your doctor will identify a proper medication plan. It’s important to take medications as prescribed.

Inflammation & Pain Relief

When having a gout attack, pain relief and reducing inflammation is a top priority.

Your doctor may recommend over-the-counter or prescription medications to relieve pain and inflammation. These should be taken as soon as symptoms appear.

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the standard methods of pain management when it comes to acute gout attacks.

Common over-the-counter options to reduce inflammation and pain include Advil®, Aleve® and Motrin®. Prescription options may include Celebrex®, Indocin® or Naprosyn®. These may be taken at maximum recommended doses until the pain subsides.

Colchicine

Colchicine helps to reduce swelling and inflammation during an acute attack but has a different mechanism of action than NSAIDs.

Colchicine is most effective when taken within the first 12 hours of an acute attack. The sooner it is taken, the sooner you may experience relief.

Your doctor may recommend taking two tablets together at once and as soon as possible after the pain begins. A third tablet is typically taken one hour later, followed by one tablet 2-3 times/day for a week.

Your doctor may prescribe name brands like Colcrys® and Mitigare®

Glucocorticosteroids

Glucocorticoids is another treatment that can help reduce inflammation during a gout attack. Glucocorticoids can be taken orally or may be injected in the affected area.

Your doctor may prescribe oral name brands like Deltasone® (prednisone), or intramuscular forms such as Kenalog®-40 or Medrol®.

Urate-Lowering Therapies

If you’ve had one gout flare, you’re likely to have another—even if it’s not for months or even years.

While it may seem like you have your gout under control, uric acid buildup can cause future flares, severe damage, and other health issues. Because of this, it’s important to take ongoing steps to reduce uric acid levels.

Most people with gout need to take daily uric acid-lowering medications. Common medications used to lower uric acid include allopurinol and febuxostat.

Allopurinol may be known as Lopruin® or Zyloprim®, while febuxostat may go by Uloric®.

Both allopurinol and febuxostat are oral medications. They are gradually increased over time to lower uric acid levels. It is important to stay on some anti-inflammatory medication for four to five months after starting a uric acid-lowering drug to prevent future attacks and other health issues.

Once you develop gout and begin medications, you will likely be on urate lowering therapies for life.

Seeking Medical Care

Portrait of smiling doctor

If you have gout, it is important to seek professional medical advice and ongoing treatment.

The best advice on gout treatment will come from a gout specialist (typically a rheumatologist) who has access to the latest medically reviewed research on gout treatment.

But, you may see a number of doctors to treat your gout.

Unsure of what questions to ask the doctor? The Gout Education Society has a fact sheet that can help.

Need a doctor? Visit our Gout Specialists Network.

Primary Care Physician

Once you experience your first gout flare-up, your family care or primary care physician (PCP) will likely be your most common source of care.

If you haven’t yet been diagnosed with gout, your PCP will likely take serum urate blood tests to confirm a diagnosis.

Once gout is confirmed, your PCP will recommend gout treatments to lower your uric acid levels. Your doctor can also prescribe or recommend medications to relieve pain caused by flares.

If possible, it’s recommended to make a same-day appointment with your PCP when you notice symptoms of acute gout flare-ups. If this is not possible, you can visit an urgent care clinic.

You should plan to visit your PCP (or whoever is treating your gout) every six months to have your uric acid level checked and ensure they are at 6.0 mg/dL or below.

Rheumatologists

Your PCP may refer you to a rheumatologist to treat your gout. They are equipped to treat rheumatologic diseases, like rheumatoid arthritis and gout—which is the most common form inflammatory arthritis.

When acute gout develops into later stages, such as recurring or chronic/advanced gout, it is even more important to consult with a rheumatologist.

After years of unchecked uric acid levels and repeated attacks, urate crystals can cause severe joint pain and lead to debilitating deformities and other health issues. Rheumatologists will help attack the root cause of these symptoms to prevent gout flare-ups in the future.

Nephrologists

Nephrologists are medical professionals who treat health issues involving the kidneys. Because gout and kidney health are closely linked, those who have gout may see both a rheumatologist or primary care physician alongside a nephrologist.

When kidneys are not functioning properly, excess uric acid production can increase. Those who have gout are more likely to develop kidney disease and kidney stones, and those with renal health issues are more likely to develop gout.

Other Steps for Gout Management

Beyond taking the right medications, there are other steps you can take to reduce gout flares and relieve gout pain.

During a Flare: Rest

Rest the affected joints for at least 24 hours after initial gout attacks to help speed recovery and reduce further damage.

During a Flare: Ice

Icing the inflamed joint is another helpful way to relieve pain. It is important to note that this may not be possible in the early stages of a flare because of tenderness in the joint and should only be done once tolerable.

Ongoing: Eating a Healthy Diet

Healthy diet food

While changing diet alone is not usually enough to manage gout and lower uric acid levels, eating a healthy and balanced diet does play a role in ongoing management and reducing gout attacks.

There is not a “gout diet,” but studies have shown that following the DASH or Mediterranean diet can be helpful. There is little evidence to support the benefits of a low purine diet. Avoid drinking too much alcohol.

Some research supports that vitamins and supplements, especially vitamin C, may be helpful for men with gout. Drinking cherry juice will not hurt—but it is a myth that this can cure gout.

Ongoing: Lifestyle Changes

While taking daily uric acid-lowering medications are key, not making other lifestyle changes can make gout worse. Those with gout may be asked to lose weight or exercise regularly to maintain a healthy body weight. It is also important to stay hydrated and drink plenty of water to maintain good kidney function.

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