Mar 20, 2019
Out With Gout: Preventing and Managing Your Pain
Dr Cory Pilling. DPM
Have you ever had a gout attack before?
If you have, you’d remember. Gout attacks often come without warning, even in the middle of the night, and can bring searing pain. Enough pain that you can’t even think about anything else.
Although they can technically strike any joint, the one at the base of the big toe is by far the most common target for gout attacks.
Unfortunately, gout is not “curable,” at least not with current medicine. It’s a lifelong, chronic condition that you have to learn to manage.
However, gout attacks can often be prevented, or at least shortened and minimized, through a variety of strategies and treatment methods that we can help you with.
What Is Gout?
First things first.
Gout is a complicated form of inflammatory arthritis. Unlike osteoarthritis, which is caused by wear and tear, or rheumatoid arthritis, which is a failure of your body’s autoimmune system, gout is related to your blood chemistry. Specifically, when the levels of uric acid in your bloodstream get too high.
This deserves a little more explanation.
Uric acid is one of the byproducts when your body digests purines, a chemical compound found in many foods—but especially organ meats, game meats, and some seafood. (More moderate levels are found in other meat and meat products, and relatively low levels in plant foods.)
Normally, uric acid dissolves in your blood and then your kidneys filter it out of the bloodstream. However, for a variety of reasons you might produce too much uric acid, or your kidneys may not be able to filter it fast enough.
And when uric acid levels reach a certain point, the acid can crystalize. Those crystals (now called monosodium urate) can then accumulate in joints, and trigger painful inflammatory attacks without warning.
Preventing Gout Attacks
Gout, as we said, is not really a “curable” disease. After you’ve had one attack, there’s no way to guarantee you’ll never have another. And some people will struggle again and again.
That said, some people never do have another attack, and others are able to significantly reduce the frequency and intensity of those attacks through prevention strategies such as these:
- Limit your intake of high-purine food and drink. Carefully managing your diet is the most important way to reduce your risk of gout attacks, and you can do it right away. Avoid the highest-purine foods (such as organ meats) and limit your portions of other meats and seafoods. You should also avoid or limit sugary foods and drinks, as well as alcohol.
- Maintain a healthy body weight. If you aren’t currently at a healthy weight, make an effort to get there. If you’re overweight or obese, your body simply produces more uric acid naturally. Weigh less, and your body produces less—which means your kidneys are more able to keep up, and you’re less likely to experience attacks.
- Stay hydrated. Drinking a lot of water will help your keep your body at peak operating efficiency when it comes to dissolving and filtering uric acid. Aim for at least 8 cups per day, but no more than 16. Just remember to avoid or limit sweetened drinks and alcohol, as these can actually increase your risk for gout attacks.
- Manage underlying conditions. Gout is often associated with, and can be magnified by, certain other health conditions. These include diabetes and metabolic syndrome, kidney disease, and high blood pressure. Managing these conditions may correlate with a lower incidence of gout attacks.
- Take your meds. If you struggle with recurring gout attacks, you may benefit from certain prescription medications designed to either decrease uric acid production or increase uric acid excretion. Ask us, or your general practitioner, if you think these may be beneficial for you.
Treating Gout Attacks
Unfortunately, even if you do everything “right,” you may not be able to prevent another attack from occurring. And you may not be able to predict when it will come.
If you do get hit by a gout attack, it’s important to act fast to limit the intensity and duration of the pain. Take an appropriate anti-inflammatory medication as soon as you can—either an over-the-counter painkiller if that’s all you have available, or the medication that was prescribed to you for your gout if you have one.
(An important caveat: do NOT take aspirin, which can make gout worse. Choose ibuprofen or naproxen instead.)
Now, grab an ice pack and call your doctor—either us, or your general practitioner. Depending on your circumstances, we may be able to prescribe you a new medication or get you into the office right away for a steroid injection (to provide quicker pain and inflammation relief) and/or a joint fluid test.
In the meantime, drink lots of fluids. Just as this helps prevent gout attacks, it also can help flush uric acid out of your system faster. And of course, continue to avoid high-purine foods.
Other quick tips that may help:
- Elevate your foot above chest level with pillows to reduce swelling.
- Go sockless if the weight of the fabric is bothering you. (Yes, gout attacks can really make your joint that sensitive.) Alternatively, take a cheap pair of socks and cut out the toe.
- Re-tuck your bedsheets into the sides so that the weight of the sheet isn’t on your toe.
- Try to keep pressure off your toe joint in general. Even walking with a cane for a while can help you get around better with less discomfort.
If gout attacks are getting in the way of enjoying your life, know that help is available. Our team will do everything we can to reduce the frequency and discomfort of your gout attacks—if not stop them completely.
To schedule an appointment, please call Canyon Foot & Ankle in Twin Falls or Burley today.
- Twin Falls: (208) 733-0436
- Burley: (208) 678-2727