Managing a Gout Flare

Few things in life are more painful than a gout flare, so if you’re awakened in the wee hours by a joint that is tender, swollen, red and radiating heat, you’ll want to act fast. Here’s what you can do when a gout flare starts to ease the pain and reduce the risk of others.

Take Medicine You Have on Hand. Start treatment immediately with over-the-counter ibuprofen (Motrin, Advil) or naproxen (Aleve), but never take aspirin, which can worsen a flare. If you have had a flare before and your doctor has prescribed an anti-inflammatory medication like colchicine to take in the event of another, take your prescribed medication as your doctor directed. If you are already taking a uric acid-lowering drug like allopurinol or febuxostat (Uloric) to reduce the risk of flares, continue to take that drug.

Ice Down. Applying an ice pack to the painful joint may help ease pain and inflammation. Wrap a pack (a bag of crushed ice or frozen peas will also do) in a dish cloth and apply to the area for 20- to 30-minutes at a stretch several times a day.

Call Your Doctor. Let your doctor know what is going on right away. She may prescribe a new medication, or have you come to the office for a joint fluid test (to confirm the gout diagnosis) or an injection of a corticosteroid to start relieving inflammation quickly. Getting treatment within the first 24 hours of the start of a flare can lessen its length and severity.

Drink Lots of Nonalcoholic Fluids. Staying hydrated helps flush out uric acid (the cause of your joint pain) and prevent kidney stones, another possible problem associated with high uric acid levels. Aim for eight to 16 cups of fluids a day, at least half of them water.

Avoid Alcohol. Although it may be tempting to have a drink to relax when you’re in pain, it’s important to avoid alcohol, especially beer, which contains high levels of purines. The body creates uric acid when it metabolizes purines. Furthermore, alcohol inhibits the excretion of uric acid from your body.

Get a Cane. Walking with a cane during an acute gou flare can help keep pressure off your painful joint.

Elevate Your Foot. If your toe or foot is swollen and painful, raising it with pillows so it’s higher than your chest may help reduce swelling.

Cut Your Sock. Cut the big toe out of cheap socks or cut the toe section off completely if your toes are affected so you can keep your feet warm feet without pressure on your painful toe.

Chill Out. Try to relax if you can; stress can aggravate gout. Watch a movie, talk to a friend, read a book or listen to music to distract yourself.

Revamp Your Menu. Avoid eating troublesome high-purine foods, such as shellfish, red meat, sweetbreads and gravies.