The goals of treatment for
gout are fast pain relief and prevention of future
gout attacks and long-term complications, such as joint destruction and kidney
damage. Treatment includes medicines and steps you can take at home to prevent
Specific treatment depends on whether you are having an acute attack or are trying to manage long-term gout and prevent future attacks.
If your mother or grandmother had a knee or hip replacement, the odds are good she was in her late 60s or 70s when she opted for the surgery, and it was a "last resort" decision -- either get a new knee or start using a cane or a wheelchair.
That's not today's joint replacement surgery. With the baby boom generation hitting their 60s -- the age at which joints start to hurt and ultimately give out -- more and more people are seeking knee and hip replacements to maintain their active lifestyle.
Pegloticase (Krystexxa). This medicine is for gout that has lasted a long time and has not responded to other treatment.
Treat tophi. These are chalky nodules that form from uric acid crystals. Treatment includes:
Drugs called xanthine oxidase inhibitors, which may shrink the
tophi until they disappear.
In rare cases, surgery to remove large
tophi that are causing deformity.
What to think about
If the blood uric acid is
high but a person has never had an attack of gout, treatment is rarely needed.
But people with extremely elevated levels may need regular testing for signs of
kidney damage. And they may need long-term treatment to lower their uric acid
levels. Your blood uric acid level may be watched by your doctor until it is
lowered to normal levels.
Long-term medicine treatment depends on how high your uric acid levels are and how likely it is that you will have other gout attacks in the future.
After an acute attack of gout,
talk with your doctor about the causes of the elevated uric acid levels in your
blood. A review of your overall health may reveal diseases, medicines, and
habits that could be raising your uric acid levels.
Most doctors will wait several days to weeks after a gout attack is over to begin medicine to lower the high uric acid
levels. These medicines can cause uric acid stored elsewhere in the body to begin moving through the bloodstream
and could make symptoms worse if treatment begins during a gout attack.
If there is swelling that causes pressure in a large joint such as a knee
or ankle, your doctor may relieve the pain and pressure by aspiration. A needle is inserted into the joint and fluid is drawn out (aspirated) with a
syringe connected to the needle.