A recent comment from a reader about stubborn gout pain has set me thinking. I started writing a short comment reply, but as I thought about the problem, I realized that this subject deserves it’s own article.
Tom wrote about his stubborn gout pain:
I have used prescription NSAIDS (Ibuprofen,Indicin, etc.) to sucessfully treat a gout attack that affected my toes, ankles and knees.
Second and subsequent gout attacks did not respond to NSAIDS and I tried fresh cherries, dried cherries and cherry juice concentrate. The Cherries worked at first and then failed to give relief.
Next, I tried Colchicine and that worked - with gastric upset side-effects.
I’ve also noticed a difference in pain treatment response to different attacks. The pain is caused by a complicated immune response that scientists are only just beginning to understand.
Gout flares last for a varying number of days. Sometimes one or two days, other times one or two weeks.
A common problem is that once uric acid crystals form, all other things being equal, uric acid in the blood will fall. If this goes far enough, crystals will dissolve again, causing more pain, and so the cycle goes on - often with different joints suffering.
Long term, you must manage uric acid and keep levels down. This is vital to avoid joint damage and tophi, but may well increase pain initially. You have to go through this to avoid more serious damage, so you will need pain relief at the same time.
Whether you take pain relief every day as a precaution (prophylactic) or just as you need it, is something you must discuss with your doctor. Many doctors prescribe a short course of pain relief to accompany long term uric acid lowering medication like allopurinol.
My personal choice for pain relief is to take it as I need it, but everybody has different views, and an informed chat with your doctor is the best way to work out what is right for you.
Whatever you do, you need a range of different pain relief treatments. If one doesn’t work, then try another. Doctors commonly prescribe a combination therapy with different medications being taken either together or alternately.
Don’t forget the non-medical options either. Ice treatment, or ice/heat therapy can help stubborn gout pain, as can keeping the joint wrapped. You can learn more about these on my gout pain relief page, where you can also vote for the ones that help you most.
What do you use to help stubborn gout pain? Feel free to start a gout forum discussion about your pain relief choices.
Tags: stubborn gout pain, _acute gout management, _anti inflammatories, _colchicine, _pain relief
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I am ready to cut my leg off at this point. I use to get 1 or 2 flare ups a year in my ankle. Around September of this year, (2008), I was dignosed with gout in my knee. They drained it, gave me prednisone initially since my usual indomethacin didn’t seem to work. Subsided for about a week and here it is the beginning of December and my knee is still swollen and I am in pain about every other day. That is why I am ready to have my leg cut off. I am only 38 years old and have no history of gout in my family. I have had an MRI, I have been poked and drained, and given more blood this year than my entire life yet I am still in sever pain at least 3 or 4 days a week. It is affecting my sleeping, my mood is cranky for lack of sleep, and I am, (or was), an active person. Someone please point me in the right direction, I am miserable with this gout.
You will never get rid of gout pain unless you get rid of the excess uric acid that is causing it.
Either you’ve not been told this before, or you have been told it and chose to ignore the advice.
If you have not been advised to lower uric acid, change doctor. Today. Find a rheumatologist who has experience with gout patients and focus on lowering your blood uric acid below 6mg per dL. This will take a few months during which time the gout flares will continue, but will get easier and less frequent. Your rheumatologist will advise you on different pain relief choices to help you through these brief pain periods.
If you have ignored advice to lower uric acid then wake up to the dangers of gout. Then follow the advice above.