Gout is a condition in which uric acid crystals become deposited in one or more joints, particularly the joint of the big toe. An increase in uric acid levels or a decrease in blood volume can cause uric acid concentrations in the blood to rise, leading to gout. Acute gout attacks cause intense pain and inflammation and often require treatment.
Supportive Care
The simplest way to treat a gout attack doesn't even require a physician's care. The most important thing is to get all pressure off the joint. If the gout's in the big toe, the person should get off his feet. Because even mild pressure can cause intense pain, he should also keep sheets and clothing off the affected joint. Ice packs should also be applied to the swollen area if they can be tolerated, as this will partially numb the joint and reduce swelling.
Medications
A variety of medications can be taken to relieve the symptoms of an acute gout attack. Nonsteroidal anti-inflammatory drugs, also known as NSAIDs, are often used to treat acute gout pain. These drugs, which include naproxen, ibuprofen and indomethacin, reduce the inflammation and pain associated with gout. Corticosteroids, such as prednisone, can also be used for the management of gout inflammation and pain, according to the University of Maryland Medical Center. A third option is colchicine, which can quickly reduce gout pain if it is taken shortly after the onset of an attack.
Side Effects
Each of the three types of pharmacological treatments has distinct side effects that can make it unsuitable for some patients. NSAIDs can cause gastrointestinal bleeding and kidney damage even if they are taken at recommended doses. Corticosteroids can cause thinning of the skin, a weakened immune system and osteoporosis. Colchicine can cause severe abdominal pain, nausea, vomiting and diarrhea.
Considerations
In general, NSAIDs are the treatment of choice, especially for those who are young and healthy. Colchicine, despite its unpleasant side effects, is often used as the second-line treatment for those who cannot tolerate NSAIDs. Finally, corticosteroids may be used for those who cannot tolerate NSAIDs or colchicine. It may be especially beneficial for those who are elderly, the University of Maryland Medical Center reports.
Joint Aspiration
Joint aspiration can be used both as a diagnostic and therapeutic measure, notes the American College of Rheumatology. In joint aspiration a needle is inserted into the affected joint and is used to drain the fluid. The procedure also removes the uric acid crystals from the joint.
