An attack of acute gout can cause intense pain which is similar to a feeling as if the affected joint is on fire. Always bear in mind that gout is described as a complex form of arthritis that causes warm, reddened and inflamed joints. The condition typically affects the big toe and quite common among men than women. Gout develops once there is build-up of uric acid crystals inside the joint tissues. Always bear in mind that an acute gout attack is very painful during the initial 12-24 hours.
Non-steroidal anti-inflammatory drugs (NSAIDs)
The main objective of treatment is to eliminate the swelling and pain in the affected joint. These medications are used as the initial line of treatment for an acute gout attack. NSAIDs work by preventing two enzymes – COX-1 and COX-2 from working and this minimizes the inflammation. Primarily, the potent NSAIDs are utilized to quickly reduce the pain and inflammation but can be changed to the milder varieties such as naproxen or ibuprofen to reduce the risk for potential side effects. The side effects of NSAIDs include stomach upset and diminished blood clotting.
Corticosteroids such as prednisone can be utilized to manage an acute gout attack once NSAIDs and colchicine could not be used. These medications are potent hormones utilized to minimize the pain and inflammation. Corticosteroids can be given by mouth or via injection directly into the affected joint. When taken orally, corticosteroids must be properly regulated over a period of 7-10 days under the supervision of a doctor. The potential side effects include insomnia, weakness and mood changes.
Colchicine can be given for those who cannot use NSAIDs. This is not a pain medication but categorized as an anti-gout medication. This is commonly used in smaller dosages to manage chronic cases of gout but can be utilized in higher doses for an acute gout attack. It is highly effective once it is started within the initial 12 hours after the symptoms manifest. The potential side effects include stomach cramps, extreme nausea and diarrhea.
Medications to lower the urate levels in the body such as probenecid and allopurinol must not be started during an acute gout attack. The abrupt changes in the levels of uric acid can cause more crystals to precipitate into the joint tissues, thus resulting to a longer and severe attack. Nevertheless, if the individual is already using anti-gout medication at the time of the attack, a doctor should be consulted and continue using it.
Fluids and adequate rest
An attack of acute gout occurs once there is accumulation of excess uric acid in the blood and not eliminated by the kidneys. The uric acid is produced due to the breakdown of purines which are present in the body naturally and in some foods including organ meats, anchovies and asparagus.
It is important to drink plenty of water during a gout attack to flush out the kidneys. Alcohol should be avoided during an attack since it heightens the production of uric acid. The affected area, usually the foot must be raised while the movement is limited until the symptoms of the attack start to subside.