Gout Pal Interactive

In my recent article on better gouty arthritis treatment I focus on the new rheumatologists guidelines for acute gout management.

The first guideline states:

Affected joints should be rested (C) and analgesic, anti-inflammatory drug therapy commenced immediately, and continued for 1?2 weeks (A)

Which I have paraphrased for gout patients as:

Rest the affected joints (C) and take analgesic, and/or anti-inflammatory drugs for 1?2 weeks (A).

So this important first guideline is really a two-parter – rest and remedy.

I’ll start with gout pain remedy. The pain relief recommendation is based on A-class evidence, and may seem obvious to most gout sufferers, but it is important enough to be worth stating strongly. Pain relief is vital to gout sufferers, not only through your first acute gout attack, but also during subsequent attacks. I think the guideline should have been stronger, and included specific advice about choosing suitable pain relief. Specifically it should address the gout patients knowledge and attitude about pain relief.

I can see why the guidelines differentiate the initial acute gout attack from subsequent recurrent attacks. These might never happen, particularly where the gout diagnosis shocks the patient into improving their lifestyle. But for many, subsequent attacks will recur, but might be avoided if uric acid monitoring procedures were implemented earlier.

I certainly think it is vital that the points I raise in Allopurinol Gout Treatment should be explained to the gout patient at the earliest opportunity.

As for resting, I note that only C grade evidence is available to support this. Although, in my experience, resting the affected joint, particularly when raising it above heart level, can ease the pain, I’ve found that gentle exercise causes the joint to heal quicker. Often, I need to take ibuprofen to be able to tolerate the pain of exercising a swollen joint, but I try to keep this to a minimum.

What was your first advice for coping with a painful gouty joint? Did you understand it? Did you follow it? Please share your experience here, or ask a question if you don’t understand what I’ve said.