How to relieve the acute pain of gout

If you have ever suffered an attack of gout, you will know just how sensitive and painful it can be. Gout is a form of arthritis, which affects the joints and seems to be particularly common in the toes, although it can also strike the hands, wrists, knees, ankles and elbows. It is caused by a build of uric acid in the body, which occurs if the kidneys are not flushing it from the body quickly enough. This results in small crystals forming around the joint, causing inflammation, pain and swelling.

Attacks can be sudden and painful
One of the features of a gout attack is that it can hit you very quickly, without warning and often at night. The painful swelling can be completely debilitating because of the sensitivity of the affected area, which can make it difficult to move around or even to sleep. If left untreated, an attack may last up to a week and the cumulative effect of several attacks can start to cause permanent joint damage. Fortunately, there are effective treatment options and a range of home remedies that may be worth trying.

How to fight off an attack
If you find yourself suddenly stricken by what you think might be gout, the first step is to get a proper diagnosis by your doctor. The cause of the pain may end up not being gout at all, so it is vital to rule out other possible causes (such as joint infection). Once gout is confirmed, you can discuss various treatment options with your doctor before acting on any of them.

Drug treatments include pain relievers and anti-inflammatories and in some cases corticosteroid injections may be effective. You can also aid pain relief simply by keeping the joint raised and as immobile as possible to prevent aggravation of the affected area.

Unlike other muscle or joint conditions, there is some conjecture over whether using hot or cold compresses are effective. Cold may relieve swelling and inflammation, but some suggest that it the crystal formation is promoted if the joint is cold. Heat may also provide some immediate relief but the increase of blood flow may send more white blood cells to the area and lead to more inflammation.

Possibilities beyond drug therapy
The simplest of first steps is to drink plenty of water. This helps to flush out the urate from your body and may also help to prevent the formation of kidney stones, which can sometimes be associated with a gout flare up.

There are a range of possible home remedies and alternative therapies that you may want to try too. While there may not be a lot of hard scientific evidence for the efficacy of these treatments, anecdotal evidence suggests that some people do find relief from them.

Certain foods may assist in naturally lowering lower uric acid levels. Some studies have suggested that coffee may be one substance that achieves this, although no one is quite sure why this is so. Vitamin C may also help to reduce uric acid in your blood.

Some foods with anti-inflammatory properties may also help relieve symptoms. A tablespoon of apple cider vinegar in water three times a day is one such remedy. Cherries are also said to possess compounds which help to treat inflammation. Try about 20 a day and opt for a more tart variety rather than the sweeter ones. Other berries, such as strawberries and blackberries seem to work for some people too, so try including them in your diet as another alternative.

Ginger has long been held as an effective anti-inflammatory agent. Use ginger root in your cooking or make a ginger tea by adding a half teaspoon of grated ginger to boiling water. 

Beyond dietary remedies, acupuncture and relaxation therapy may be useful approaches to managing pain symptoms too.

Prevention is better than cure
There are things you can do to lessen the chances of getting attacks in the first place – always a better idea than acting after the horse has bolted! Firstly, get in the habit of drinking plenty of fluids every day. Water is the safest bet, but if you are taking other drinks try to limit anything with fructose, which may be counterproductive.

Alcohol is also recognised as a gout inducer and beer in particular may be the worst offender due to the yeast content.

Meat, fish and poultry should be kept in moderation and offal such as liver or heart in particular should be avoided because of the high level of purines – substances which have been linked to gout.

Weight control is highly recommended to limit the onset of attacks and losing weight may decrease uric acid, but avoid crash dieting as this may have the opposite effect. Singling out foods to avoid or to increase should not be done to a radical level, however, as it is important to maintain balance in your diet as a priority.

More information
Arthritis Australia has information sheets available on gout, diet and pain management and these can be downloaded from Arthritis Australia.