The first attack of gout may settle on its own within a week. Patient will remain symptom-free until the next attack.
The aims of gout treatment are to treat acute attacks and lower the uric acid levels in the body to prevent further attacks in the long term.
During a gout attack, you should:
- Rest your joints
- Take medication to reduce inflammation (Please seek doctor’s advice.)
If gout is not controlled, attacks may become more frequent and last longer. Over time, more and more joints may be affected and they may become deformed. This may lead to chronic pain and stiffness, as well as loss of function.
In some patients, uric acid crystals may get deposited underneath the skin and in tissues, and form lumps. These are tophi which may be found around the joints or along the outer edge of the ears. Tophi may be infected or rupture. Uric acids may also form stones in the kidney. This may cause pain and kidney damage.
Medication used for acute gout attacks:
- Non-steroidal anti-inflammatory drugs (NSAIDs) like diclofenac or arcoxia are often prescribed to reduce the pain and swelling.
- Colchicine is also very effective in relieving acute pain from gout.
- Corticosteroids for:
- Patient who are unable to take NSAIDs or colchicine may need a short course of steroids (e.g. Prednisolone)
- Steroids may be injected into the joint to provide relief
In the long term, your doctor will consider giving medication to lower your blood uric acid levels and prevent gout attack. Common drugs used are allopurinol, febuxostat and probenecid. Over time, these medications reduce sizes of tophi and prevent formation of kidney stones. These drugs will need to be taken long term and continued during a gout attack. Stopping them may cause recurrence of gout attacks.
Surgery does not treat gout. However, it may be performed when tophi are infected or joint movements are affected.