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Know Your Pain: Gout Pain – Symptoms, Causes and Treatments
By Alpro Pharmacy
August 29, 2022
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Gout Pain
Gout is a form of joint inflammation that occurs in people with high levels of uric acid in the blood. The body produces uric acid when it breaks down purines, which are naturally found in the body and certain foods. Normally, uric acid is removed through the kidneys into urine. When too much uric acid is produced in or too little is removed from the body, it may deposit in and around the joints as crystals. This results in gout pain and inflammation. Men are more likely to develop gout, especially between the ages of 30 and 60.
Quick fact: Gout is rare in women before menopause. This is because the female hormone, oestrogen, acts as a natural gout protector by increasing uric acid excretion through urine.
Photo adopted from: https://manadr.com/article/gout-everything-you-need-to-know
Symptoms
Photo adopted from: https://blog.teleme.co/2020/03/20/gout/
A gout attack usually occurs suddenly, often at night. It commonly begins in one joint, most often the big toe joint, but it may spread to more joints such as foot, knee, ankle, hand, wrist or elbow. If left untreated, symptoms may linger on for days to weeks. Subsequent attacks may recur at intervals of weeks, months or years. These are likely to last longer and affect more joints. Repeated gout attacks can permanently damage joints and also lead to kidney problems. Common signs and symptoms in the affected joint(s) may include:
- Intense pain, often to the point that even the weight of a bedsheet becomes unbearable
- Redness
- Swelling
- Warmth and tenderness
- Limited range of joint movement
Who Is At Risk?
You are more likely to develop gout if you have high levels of uric acid in your body. Factors that contribute to high uric acid level include:
- Purine-rich food intake: red meat, internal organ and seafood, such as anchovies, sardines, tuna, shellfish
- Excessive intake of alcoholic and sugary beverages
- Dehydration
- Being overweight
- Medical conditions: diabetes, high blood pressure, high cholesterol, kidney disease
- Certain medications: diuretics (water pills), beta-blockers
- Family history of gout
- Recent surgery or trauma
Photo adopted from: https://manadr.com/article/gout-everything-you-need-to-know
How Is Gout Diagnosed?
Diagnosis is done based on symptoms, physical examination, medical history, lifestyle and laboratory tests which include:
- Blood test
- Joint fluid test
- Scans eg. X-rays, ultrasound, CT scan
Finger prick uric acid test is also available from pharmacies and results can be obtained in a few seconds.
Photo adopted from: Alpro Pharmacy Test Reference Table Sticker
Management
Gout can be effectively managed with medical treatment and self-management strategies to manage the pain and inflammation as well as prevent further gout attacks.
- Medicines to relieve acute gout or prevent gout recurrence: During a gout attack, medicines such as non-steroidal anti-inflammatory drugs (NSAIDs), colchicine or steroid will be prescribed to achieve pain relief and reduce swelling. If you have frequent gout flares, you may need to take uric acid-lowering medicine (such as allopurinol and febuxostat) regularly to prevent recurrent attacks and complications. Always talk to your doctor or pharmacist before you start taking any medicines.
- Ice pack during gout attack: Apply an ice pack to the affected joint for 10 to 20 minutes several times a day to relieve the pain and swelling. Ice pack has to be wrapped in cloth to prevent ice burn.
- Rest and elevate the affected limb while having pain.
- Stay hydrated. Drink at least 2 litres of water daily, unless you have fluid restriction due to other health conditions.
- Supplements. Taking tart cherries, 500mg of Vitamin C or wheatgrass daily have been shown to reduce uric acid levels, which in turn lower the risk of gout attacks. Besides, celery seed extract may be useful in relieving acute gout pain and preventing gout recurrence.
- Maintain healthy weight by engaging in regular physical activity for at least 30 minutes per day and 5 days per week.
- Dietary modification is crucial in gout management and prevention. Let the food be the medicine! Limit intake of fructose-sweetened beverages and alcohol (i.e. ≤2 standard drinks/day in males and ≤1 standard drink/day in females). High purine food should be avoided, moderate purine foods should be limited and low purine foods can be eaten. You may always look for a nutritionist or dietitian to find out more on dietary modification.
Dealing with Gout Pain?
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We have PainWISE Accreditated Pharmacists who can help you to understand your pain, empower YOU in managing pain and achieve a Pain-FREE life!
Managing pain well involves multidisciplinary care, it is not only about medication.
References
1) Rigby, D. (2020). Gout management: treat to target. Australian Pharmacist. https://www.psa.org.au/
2) Centers for Disease Control and Prevention. (2020). Gout. https://www.cdc.gov/arthritis/basics/gout.html
3) UK Gout Society. All about gout and diet. http://www.ukgoutsociety.org/PDFs/goutsociety-allaboutgoutanddiet-0917.pdf
4) Versus Arthritis. What is gout? https://www.versusarthritis.org/about-arthritis/conditions/gout/
5) Choi, H. K., Gao, X., & Curhan, G. (2009). Vitamin C Intake and the Risk of Gout in Men. Archives of Internal Medicine, 169(5), 502. https://doi.org/10.1001/archinternmed.2008.606
6) Zhang, Y., Neogi, T., Chen, C., Chaisson, C., Hunter, D. J., & Choi, H. K. (2012). Cherry consumption and decreased risk of recurrent gout attacks. Arthritis & Rheumatism, 64(12), 4004–4011. https://doi.org/10.1002/art.34677
7) Hussein, H. (2012, May 1). Gout. PORTAL MyHEALTH. http://www.myhealth.gov.my/en/gout-2/
8) Villines, Z. (2019, October 17). What are the benefits of wheatgrass? Medical News Today. https://www.medicalnewstoday.com/articles/320210#_noHeaderPrefixedContent
9) MaNaDr. (2022). Gout: Everything You Need to Know. [Photograph]. https://manadr.com/article/gout-everything-you-need-to-know
10) Healthtips. (2022). Gout. [Photograph]. https://blog.teleme.co/2020/03/20/gout/
11) CreakyJoints. (2019). High-Purine Foods: 4 Foods to Avoid Eating with Gout. [Photograph]. https://creakyjoints.org/about-arthritis/gout/gout-diet/high-purine-foods-avoid-with-gout/
