If you have gout, you know the unfortunate signs of a gout flare-up. There's nothing you can do to stop a gout attack once it's started, but there are things you can do to care for a gout flare at home.
A gout attack happens when someone who already has higher than normal levels of uric acid in the body has a build-up of uric acid around a joint. Uric crystals form, causing a painful gout flare. Many things, including alcohol, some foods, stress, and some medications, can cause your uric acid level to rise, leaving you open to a gout attack.
Warning Signs of a Gout Flare-Up
Some people with gout, also known as gouty arthritis, say a gout attack begins with a burning, itching, or tingling feeling in a joint maybe an hour or two before their gout flare-up starts. The joint may feel a little stiff or a little bit sore. Not long after these warning signals, the telltale signs of gout begin. If you get repeated gout attacks, you'll learn your body's signals that a gout flare-up is about to begin.
Sometimes, people with gout have no early signs that a gout flare is about to start. They may wake up in the middle of the night with a very painful joint.
When the gout flare starts, most people have redness, swelling, and severe pain, usually in one joint. The most common place for gout is the base of the big toe, but it can occur in other joints such as the elbow, knee, wrist, ankle, and instep.
The pain is often so strong that it hurts to have anything touch the joint at all. Many people with gout say that just the feel of the bed sheet touching the inflamed joint is very painful.
Home Care for a Gout Flare-Up
If your gout has been diagnosed and your doctor has given you medicine for a gout flare-up, take the medicine as directed when you know you are having a flare-up. In most cases, that will probably be as soon as the first signs of gout begin.
Your health care provider may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Aleve), ibuprofen (Motrin, Advil), indomethacin (Indocin), sulindac (Clinoril), celecoxib (Celebrex), or meloxicam (Mobic), or suggest you take over-the-counter NSAIDs in prescription doses. This usually will be effective.
In some cases, you already may be taking medicine to help avoid gout flare-ups. Your doctor may have suggested:
- allopurinol (Aloprim, Lopurin, Zyloprim)
- colchicine (Colcrys)
- febuxostat (Uloric)
- lesinurad (Zurampic)
- probenecid (Probalan)
Just because you have a flare doesn't mean these medicines aren't working. In the first few months that you take this type of gout medication, you actually may have a gout flare-up as your body adjusts to the medicine. Your doctor will likely have given you medicine to take if this happens, so take that medicine when you have a flare. Continue to take the preventive medicine, too.
If you have been taking preventive gout medicine for a long time and have started to have flares for the first time in a while, call your doctor. He/she may talk to you about changing your dosage or your medicine.
Non-medication Pain Relief
In addition to medication, these self-care tips may help your gout flare-up pain:
- Use cold. If the pain isn't too bad, try cold packs or cold compresses on the joint to lessen the inflammation and help the pain. Ice the joint for 20 to 30 minutes several times a day.
- Rest the joint. It's a good idea to rest until the pain lessens. Most people having an acute attack of gouty arthritis probably won't want to move the joint much anyway. Raise the joint if you can on a pillow or other soft object.
- Drink water. A lack of water in your body can make your uric acid levels rise even higher than they already are. Drinking water will help your body stabilize uric acid to a normal level.
- Watch what you eat and drink. Foods that are high in purines (some seafood, organ meats like liver, and fatty foods) can increase the uric acid in your blood even more. So can fructose-sweetened drinks and alcohol -- especially beer.
When to Get Help for a Gout Flare
It's always a good idea to let your doctor know that you are having a flare. Sometimes, you may need to follow up to make sure your gout treatment plan is working or if your symptoms don't improve. Call your health care provider, if:
- This is your first gout flare-up -- There are several other conditions, such as a joint infection, that have some of the same symptoms as gout flares.
- You have a high fever and chills-- Gout attack symptoms may include a low-grade fever, but a higher fever may be a symptom of an infection.
- Your symptoms don't improve somewhat after 48 hours or don't end after about a week -- If you don't start to feel somewhat better after a few days, call your health care provider. In addition, he/she may suggest a different treatment. Most gout attacks will resolve by themselves in 7 to 10 days even without gout treatment.