Gout is a painful disorder that is the result of the concentration of urate crystals in joints, body fluids and the kidneys. Gout affects men and women equally and typically occurs during middle age. Your first attack of gout will frequently affect only one joint, often the big toe. Prompt treatment can reduce the inflammation and swelling of gout.
Background
The urate crystals that cause gout are the result of overproduction or underexcretion of uric acid, a waste product. Acute attacks of gout can occur when uric acid levels rise or they can occur without provocation. During an acute gout attack of the big toe, you may experience symptoms of swelling, warmth and tenderness at the joint. You may also experience a low grade fever. Symptoms typically peak within one to two days of symptom onset and last seven to 10 days without treatment. With treatment, however, pain relief can occur much more quickly.
Types of Pain Relief
Nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen and naproxen, can control the inflammation and pain of an acute gout attack. These medications can be purchased over the counter in various brand names. Colchicine is another option that reduces inflammation by blocking the release of some of the byproducts of uric acid, but it is most effective taken soon after an attack begins. Corticosteroids are potent anti-inflammatory agents that can be taken orally or injected directly into the affected joint. Both colchicine and corticosteroids must be prescribed by your physician.
Risks
NSAIDs are often the first treatment used for pain relief of gout in the big toe, but they cannot be used if you have a history of peptic ulcer disease, congestive heart failure or kidney problems. Colchicine is used in these situations, but its use has a number of possible gastrointestinal side effects, including nausea, vomiting and diarrhea. If you are taking colchicine and experience these side effects, you may tolerate a lower dosage and should discuss this with your physician. In the short term, corticosteroids are tolerated well but may cause bone thinning and immune system suppression if used for a longer duration.
Alternative Therapies
According to MayoClinic.com, medications are the most effective way to treat gout symptoms, but modifying your diet may prove beneficial. During an attack of gout, drink eight to 16 cups of fluid a day, with at least half of this amount being water. Avoid alcohol, limit your daily intake of meat, fish and poultry to 4 to 6 ounces, and eat a moderate amount of protein from sources such as low-fat dairy, eggs and nut butters. Additionally, techniques such as meditation and deep-breathing exercises may help you cope with the pain.
Considerations
Once you have achieved pain relief from your acute attack of gout, visit your physician to discuss treatments for preventing attacks. A number of medications can be used to lower the level of uric acid in your body. According to the American College of Rheumatology, limiting alcohol consumption and limiting foods such as red meat can help to control gout. With careful monitoring, you may never have to experience pain in your big toe again.
