Heating pad for gout

Gout Home Remedies: Here’s What You Can Do to Relieve Gout Pain Fast

Anyone who’s experienced a gout attack knows it can be excruciating, causing red, hot, painful, and swollen joints. Gout, a form of arthritis, typically affects the joints in the feet, ankles, or knees; around half the time it strikes in the big toe, which can make it impossible to wear shoes. Even the light fabric of a sock can be aggravating.

Because the pain from a gout attack can be so bad, people with the condition will often try anything out there to get relief, which has led to a boom in so-called gout home remedies.

While there are a few legitimate home remedies for gout out there, prescription medications remain the mainstay for treating gout, during an acute attack as well as over the long term to reduce gout attacks in the first place.

This Is Your Body During a Gout Attack

Gout symptoms occur when excess uric acid in your body forms crystals in the joints. The body treats these crystals like a foreign body and attacks them with white blood cells. The white cells, in turn, release inflammatory chemicals called cytokines into the joint fluid. The cytokines bring in more white cells, and on it goes.

“The joint becomes a battlefield,” says Theodore Fields, MD, professor of clinical medicine at Weill Cornell Medical College and a rheumatologist the Hospital for Special Surgery in New York City.

The Best Way to Treat a Gout Attack

Gout attacks can last for up to 10 days or longer and often subside on their own after a week or two, but medications will speed up healing and prevent future flares.

Standard medical treatments for a gout attack include:

  • Anti-inflammatory drugs like naproxen (which can be purchased over the counter or in prescription strength)
  • Colchicine, which reduces uric acid build-up
  • Steroids, such as prednisone

For 98 percent of patients, says Dr. Fields, one of these medications these will knock out an attack.

Home Remedies for Instant Gout Relief

There are a couple of effective home remedies for a gout attack that you can use as an adjunct to medications. These include:

  • Resting the joint
  • Using ice packs to reduce swelling
  • Drinking cherry juice

Cherry juice is high in vitamin C, which makes uric acid come out in the urine, but the effect is mild compared to some of the available medicines for gout attacks. Cherry juice can also increase the risk of kidney stones; they shouldn’t be used in anyone who is predisposed to them.

Dr. Fields cautions against relying solely on home remedies to relieve gout pain fast instead of taking medicine because the longer you wait, the longer it will take for your gout to get better.

“The good thing about treating a sudden gout attack with drugs right away is that you can take the medication for a very short time,” he says. “You should see a 50 percent improvement within 24 hours of treating an attack. If you’re not seeing that kind of improvement, you need to re-think what you’re doing and consult with your doctor about a different approach.”

Home Remedies for Long-Term Gout Relief

The American College of Rheumatology recommends a couple of lifestyle modifications for preventing future attacks of gout:

1) Lose weight if you need to. Being overweight can increase uric acid levels as well as put pressure on the joints.

2) Follow a low-purine diet. Another effective way to reduce uric acid levels is to follow a low-purine diet. Purines are organic compounds that break down into uric acid. Following a low-purine diet means avoiding “the big four” — alcohol, shellfish, red meat, and high fructose corn syrup.

Limiting these foods is also beneficial for heart health — and people with gout are at higher risk for heart disease.

But don’t go overboard with dietary changes to relieve gout pain though, advises Dr. Fields. “You can find lists of thousands of different foods you’re not supposed to have if you have gout. Those recommendations are impossible to follow and can make you crazy.”

How to Handle Your First Gout Attack

After a first attack of gout, it’s OK to try to stave off another one with dietary changes alone. But if you have another attack, it’s important to start taking preventive gout medications on a regular basis. Long-term medications for gout include allopurinol and febuxostat, both of which limit uric acid production.

Some patients, says Dr. Fields, treat each attack as a separate event and don’t talk to their doctors about doing a preventive approach. He uses the analogy of lighting a book of matches. “If you have one match lit, it’s easy to put out, but if you have the whole book lit, it’s a lot harder.”

Take Caution with Supplements for Gout

As for the many supplements and other purported home remedies available for gout, including turmeric and bromelain, there is no significant evidence backing them up as of now, and there’s no adequate evidence showing that supplements have any effect even comparable to that of medicines.

“From my point of view,” says Dr. Fields, “the home remedy concept to gout is often harmful because it keeps patients from taking medications that we know are effective.”

Keep Reading:

  • WEBINAR: Gout Fact vs. Fiction
  • Most Gout Patients Stop Taking Their Medication, and This Is Why
  • High Uric Acid Levels Linked to Higher Death Risk in Gout, Study Confirms

Summit Medical Group Web Site

What is gout?

Gout is a type of arthritis caused by having too much uric acid in your body. The uric acid may not cause symptoms for years, but after a time too much of it can cause painful joint inflammation (arthritis). Usually gout first affects the joint between the foot and the big toe. Later attacks may affect other joints of the foot and leg. Less often, the arms and hands have gout.

In addition to the arthritis, gout can cause tophi. Tophi are lumps of uric acid crystals just under the skin. Common places to have tophi are the outer edge of the ear, on or near the elbow, the fingers and toes, and around the Achilles tendon near the ankle.

Gout can also cause kidney stones made of uric acid.

Most people who have gout are middle-aged men, but it can occur at any age. It is less common in women.

What is the cause?

Gout usually happens because too much uric acid is in your blood. Uric acid is a chemical your body makes when it breaks down substances called purines. Purines are found in all of your body’s tissues. They are also in many foods. Normally, uric acid dissolves in the blood and passes through the kidneys and out of the body in the urine. If the level of uric acid builds up in the blood, sharp uric acid crystals may form in the joints. The crystals cause pain and swelling.

Most cases of gout happen because your kidneys do not get rid of enough uric acid. The specific problem with the kidneys is usually not found.

Gout may also happen because your body is making too much uric acid. There are different reasons this may happen:

  • You may eat a lot of purine-rich foods, such as seafood and meat, especially game, such as deer (venison), and organ meats, like liver.
  • You may drink a lot of alcohol.
  • You may have inherited a tendency to make too much uric acid.
  • You may have a disease such as cancer or a red blood cell problem.

Some conditions, such as dehydration, can cause high levels of uric acid. Diuretic medicine (also called water pills), which is often used to treat high blood pressure, can increase the level of uric acid. Other medicines can also affect the level of uric acid in the blood.

Uric acid levels in men start to go up after puberty. Women’s uric acid levels usually do not go up until after menopause. For this reason women are protected from gout until several years after menopause. Usually the uric acid levels have to be high for many years before you start having gout.

People who have recently had a serious illness or surgery have an increased chance of having an attack of gout.

Some people have gout even though they have normal uric acid levels.

What are the symptoms?

Many people have high uric acid blood levels for years and never have any symptoms. Only 10 to 20% of people with high levels of uric acid develop symptoms in their joints. Symptoms may include:

  • Sudden, severe pain, especially of just 1 joint at a time
  • Redness of a joint
  • Swelling of a joint

Sudden attacks sometimes happen with illness, injury, or drinking too much alcohol. The symptoms may last for days to weeks. These attacks of pain, redness, and swelling usually happen months or years before you start having tophi or kidney stones.

The tophi do not cause any symptoms unless they open and drain. They are usually not painful. Depending on where they are on the body, they may limit movement of a joint.

The symptoms of uric acid kidney stones are like those of other kidney stones. They can cause severe abdominal pain and sometimes nausea, vomiting, fever, or blood in the urine. The stones may block urine flow, which can damage the kidneys if it is not treated.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and your medical history and examine you. Your provider will ask about the medicines you are taking. You will have blood tests, including for uric acid in your blood. Your provider will suspect that you have gout if you have one or more of the following:

  • Your first toe joint is red, swollen, and very painful.
  • You have a blood test that shows a high level of uric acid in your blood.
  • You have tophi.
  • You start taking the drug colchicine and your arthritis symptoms get better. (Colchicine, an anti-inflammatory drug, is effective only for gouty arthritis.)

To confirm the diagnosis, your provider may take a sample of fluid from an affected joint for lab tests. If there are uric acid crystals in the fluid, you have gout.

How is it treated?

Usually, if you have high uric acid levels but no symptoms, you will not need treatment. In special cases (for example, if you have a family history of gout or kidney stones), you may be treated for gout even though you do not have any symptoms. Discuss this with your healthcare provider.

If you have symptoms of gout, the goals of treatment are:

  • Stop the pain.
  • Try to keep the problem from coming back by controlling uric acid levels.
  • Prevent serious problems such as kidney damage.

Anti-inflammatory medicines are used to treat the arthritis, such as:

  • Ibuprofen or naproxen
  • Steroid drugs, such as prednisone
  • Colchicine

Anti-inflammatory medicines are sometimes taken daily to prevent recurrent attacks of gouty arthritis.

  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and naproxen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
  • Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider’s approval. You may have to lower your dosage slowly before stopping it.

Aspirin is not usually recommended because it may keep the kidneys from getting rid of the uric acid.

Your healthcare provider may prescribe narcotic medicine, such as hydrocodone, to help relieve the pain during attacks.

If the gouty arthritis becomes a frequent problem, other medicines may also be prescribed to lower the amount of uric acid in your body. Examples of these medicines are allopurinol, febuxostat, and probenecid. The medicines can help keep uric acid crystals from forming in the joints. This can help prevent painful attacks of gouty arthritis and damage to the joints.

How long will the effects last?

The sooner treatment is started, the sooner the symptoms stop. You may start feeling better 1 to 2 days after you start treatment. If gout is not treated, it could last a few days to several weeks.

You could have another attack of gout, but usually not for at least 6 months to 2 years. It could be years before you have gout again, or you may never have another attack.

How can I take care of myself?

To treat symptoms of gout:

  • Make the changes in your diet, the fluids you drink, and alcohol use as recommended by your healthcare provider.
  • Take medicine as prescribed by your provider.
  • A warm washcloth or heating pad set on the lowest setting may help lessen pain. You can put heat on the painful joint for 15 to 30 minutes 3 to 4 times a day. Be careful not to fall asleep with a heating pad on. It could cause a burn.
  • Acetaminophen or nonprescription anti-inflammatory medicine such as ibuprofen or naproxen may help lessen your pain. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.

People with gout have a higher risk of blood pressure, heart disease, and kidney disease. If you have gout make sure that you are checked for these problems.

Follow your healthcare provider’s instructions. Ask your provider:

  • How and when you will hear your test results
  • How long it will take to recover
    • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent gout?

There is no sure way to prevent gout. However, you can take these steps to lessen the chance that you will have high uric acid levels:

  • Eat a diet low in purines. Don’t eat a lot of beef, chicken, and pork and avoid the following foods:
    • Organ meats, such as sweetbreads, liver, and kidney
    • Anchovies
    • Sardines
    • Mussels
    • Dried legumes (beans)
  • Don’t drink a lot of alcohol. It’s best not to drink any alcohol.
  • Unless your healthcare provider has restricted how much fluid you can have, drink lots of nonalcoholic fluids. Ask your provider how much you can drink.

Get rub-on relief for arthritis joint pain

Availability and cost may limit the use of topical NSAIDs for some people. In the United States, the only prescription topical NSAID widely available in pharmacies is diclofenac gel. Other types, such as ibuprofen, ketoprofen (Orudis), indomethacin (Indocin), and piroxicam (Feldene) may require a special order from a compounding pharmacy. This could raise the
price, and insurance reimbursement varies according to the type of topical formulation prescribed.

Most benefit if:

  • your stomach is sensitive to NSAIDs

  • the source of pain is near the surface

  • the pain comes from a focused area, such as a single joint.

Less benefit if:

  • you have active ulcers

  • you have a history of gastrointestinal bleeding

  • you have severe pain.

Possible side effects

Adverse side effects from topical medications are mild and uncommon. They usually include redness, itching, and other skin irritation. Dr. Borg-Stein says that when her patients experience skin irritation, the cause is often the material used to make the cream or gel. In these cases, a pharmacist can create a topical preparation with ingredients that are less irritating to your skin.

A key safety tip for all topical drugs is to wash your hands thoroughly after use so that you don’t smear the drug into your eyes, nose, mouth, or other mucous membranes.

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

6 Ways to Deal with Painful Gout Attacks

It’s 3 a.m. and suddenly you’re awake, with sharp stabbing pain coming from your toe. It hurts so much that just having the sheet over your foot is painful.

This is the harsh reality of what happens during an attack of gout .

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Icing a joint affected by gout can help relieve pain, so it pays to keep ice packs ready. Video: How to Make 5 Quick and Easy Ice Packs

Gout is a condition that has plagued people for centuries and currently affects millions of Americans, mostly men. It’s caused by the build-up of uric acid in the body, which crystalizes in joints and can cause episodes of inflammation and mild to intense pain.

See Gout Causes and Risk Factors

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Fortunately, there are several measures that can help ease your pain and get you through a gout attack:

1. Take pain medications.

Over-the-counter pain medications can help you through an attack, particularly anti-inflammatory options like ibuprofen or naproxen (Aleve). Ask your physician which option and dosage is best for you.

See Pain Medications for Arthritis Pain Relief

2. Take your prescription drugs.

If you’ve had a gout attack before, your physician may have prescribed drugs to treat future attacks, such as:

  • A strong painkiller such as such as codeine, hydrocodone, and oxycodone
  • A corticosteroid, either taken orally or given as an injection into the affected joint
  • An oral medication called colchicine, which is specifically for gout and has been shown effective in reducing pain and inflammation if given in the first 24 hours of an attack

3. Apply ice to the affected joint.

If you can tolerate the pressure of an ice pack, cold therapy can offer pain relief by decreasing inflammation and dulling pain signals.

See When and Why to Apply Cold to an Arthritic Joint

4. Elevate the joint.

If your foot is affected, prop it up on a pillow or footstool. In fact, the RICE (rest, ice, compression, elevation) protocol—except for compression, which is too painful—can help ease a gout attack.

5. Take it easy.

Rest the affected joint and keep pressure off it until pain eases. Have roomy slippers on hand, so you can keep your feet warm and comfortable until the attack passes.

See 5 Unusual Gout Symptoms

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6. Stay hydrated.

Drinking water throughout the day will aid in flushing the uric acid from your system. Aim for 8 glasses a day.

See Hyperuricemia – High Uric Acid Levels and Gout

For severe cases of gout, your physician may recommend corticosteroid injections into the affected joint, which can be useful for those with sensitivities to other medication options.

See Cortisone Injections (Steroid Injections)

While this is rarely needed, surgery may be recommended to remove tophi, which are small white growths that occur under the skin where uric acid has crystalized.

See Gout Treatment

There are also important measures you can take to prevent a future gout flare-up, including avoiding food and the drinks high in purines.

See Gout Prevention Diet

Learn more:

Gout Symptoms

Gout Prevention

Gout

What is gout?

Gout is a condition caused by having too much uric acid in your body. Uric acid is a waste product your body makes when it breaks down certain chemicals called purines. Purines are in many foods, but are especially high in organ meats, dried beans and peas and anchovies. Normally, uric acid dissolves in the blood and passes through your kidneys and out of the body in your urine. If the level of uric acid builds up in the blood, sharp uric acid crystals may form in your joints or under your skin. The crystals cause pain and swelling. If not treated, the uric acid crystals can cause kidney stones and kidney damage.

Usually the uric acid levels have to be high for many years before you start having gout. Uric acid levels in men start to go up after puberty. Women’s uric acid levels usually do not go up until after menopause. Gout can start at any age, but is most common in middle-aged men.

What is the cause?

Gout usually happens because too much uric acid is in your blood. This may be because:

  • Your kidneys do not get rid of enough uric acid. The reason this happens is not always known. You may be at higher risk for gout if you have a disease such as high blood pressure, diabetes, kidney disease, or a problem with your red blood cells.
  • Your body makes too much uric acid. This is more likely if:
    • You eat a lot of seafood and meat, especially game such as deer (venison), and organ meats, like liver.
    • You drink a lot of alcohol, particularly beer, which increases your uric acid levels.
    • You have a family history of too much uric acid in the blood.
    • You take medicines that raise the level of uric acid in the blood.

Gout is similar to a condition called pseudogout. Pseudogout also causes joint pain and swelling, but is caused by a buildup of calcium crystals instead of uric acid. The treatment of pseudogout is different from gout.

What are the symptoms?

Many people have high uric acid blood levels for years and never have any symptoms. Sudden attacks sometimes happen with illness, injury, or drinking too much alcohol. The symptoms may last for days to weeks. Gout symptoms may include:

  • Sudden, severe pain, often in just 1 joint at a time
  • Redness and swelling of a joint

Usually gout first affects your big toe. Later attacks may affect other joints.

If uric acid crystals cause kidney stones, symptoms may include:

  • Severe, crampy pain in your back, side, or belly
  • Nausea and vomiting
  • Fever
  • Blood in the urine

How is it diagnosed?

Your healthcare provider will ask about your symptoms and your medical history and examine you.

Tests may include:

  • Blood tests
  • Joint aspiration, which uses a needle to take fluid from a joint to check for infection or other problems that might cause arthritis. Removing fluid can also help relieve some of the pain and swelling of gout.
  • X-rays

How is it treated?

Usually, if you have high uric acid levels but no symptoms, you will not need treatment. If you have a family history of gout or kidney stones, you may be treated for gout even though you do not have any symptoms. Discuss this with your healthcare provider.

If you have symptoms of gout, you may be prescribed medicine to:

  • Stop pain and inflammation
  • Lower uric acid levels

Aspirin is not usually recommended because it may keep your kidneys from getting rid of the uric acid.

Your provider will recommend that you avoid drinking alcohol and eating certain foods to prevent problems.

You may start feeling better 1 to 2 days after you start treatment. If gout is not treated, it could last a few days to several weeks. Gout can also come back after months or years.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Make the changes in your diet, the liquids you drink, and alcohol use as recommended by your healthcare provider. Take all medicines as directed. Ask your provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

A healthy lifestyle may also help:

  • If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
  • If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.
  • Stay fit with the right kind of exercise for you. Talk with your healthcare provider before you start an exercise program.
  • Try to get at least 7 to 9 hours of sleep each night.
  • Try to keep a healthy weight. If you are overweight, lose weight. Losing some weight can reduce the stress on your joints.
  • Use a warm washcloth or heating pad set on the lowest setting to help lessen pain. You can put heat on the painful joint for 15 to 30 minutes 3 to 4 times a day. Be careful not to fall asleep with a heating pad on. It could cause a burn.
  • Contact your healthcare provider if you have new or worsening symptoms.

How can I help prevent gout?

There is no sure way to prevent gout. However, you can take these steps to lessen the chance that you will have high uric acid levels:

  • Avoid foods such as:
    • Organ meats, such as liver and kidney
    • Large amounts of beef, chicken, or pork
    • Anchovies, sardines, and mussels
    • Beans
  • Don’t drink large amounts of alcohol, especially beer. Alcohol increases uric acid in your body, and can make gout medicine less effective.

How does ice help after an injury and how might heat hurt?
As stated above, icing the injured tissues helps by limiting the leakage of blood and serum from the capillaries into the adjacent tissues. Ice also prevents swelling. In contrast, heating tissues causes the capillaries to widen. This widening can cause an increase in the leakage of blood from the capillaries and add to the swelling and pain. It is important to note that the blood that leaks into the tissues will later lead to inflammation, which slows the healing process.

What about recovery after the injury?
The days after an injury, when the tissues are healing, require a different approach from the immediate treatment. Now, the blood leakage from the injured capillaries has generally stopped because the capillaries have been naturally plugged by microscopic blood clots in the repair process. The blood that remains in the tissues needs to be reabsorbed by the body. At this time, heat applications can help, especially prior to recovery exercise workouts. The heat provides an additional benefit by relaxing the muscles of the injured area so that the workouts can occur as safely as possible. Frequently, immediately after a recovery workout, ice is applied so that leakage of serum and/or blood from any capillaries that are disrupted during the workout is minimized.

ARTHRITIS
What is best with the inflammation of arthritis?
I often recommend that my patients use ice packs on the affected joint in order to minimize inflammation and reduce pain, especially with a newly inflamed joint. This can be helpful for many forms of arthritis, including rheumatoid arthritis, gout, osteoarthritis, pseudogout, ankylosing spondylitis, and many others. It should be remembered, however, that icing usually causes stiffness to the local tissues. Accordingly, heat applications can sometimes work best early in the day by relaxing the muscles around the joints, while ice applications at the end of the day can minimize the inflammation resulting from the daily activities.

BEFORE AND AFTER PHYSICAL ACTIVITY
What about prior to exercise activity?
Again, before an exercise activity, heat applications can help nagging, recurrently injured areas by relaxing the muscles so that the workouts can occur as safely as possible. Muscles that are too tight are prone to injury. This is also why stretching before exercise is optimal in order to prevent injury. Immediately after a workout, however, ice should be applied to areas that have been bothered by activity in the past.

AFTER PROCEDURES
“My doctor told me to put ice on my elbow after a cortisone injection.”
An application of ice can also minimize the inflammation that can occur after an injection procedure. This inflammation can be caused by the leakage of blood by injury to the tiny capillaries from the needle and by the cortisone medication itself. It can, therefore, be very helpful to apply a cold pack to the area for 20 minutes after a cortisone injection.

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