Is it possible to quickly relieve gout pain? Gout (other Greek literally – a foot grabber) is a chronic pathology associated with metabolic disorders, in which the uric acid content in all fluids and tissues of the body is increased, as a result of which the acid accumulates in the form of crystals. The disease belongs to the category of metabolic disorders, has a paroxysmal nature. Its increase in blood is called hyperuricemia.
Gout has been known since antiquity and was first described by Hippocrates. Its frequency today is 0.3%, men suffer from it 2-7 times more often. The peak of the disease occurs at the age of 40-50 years. After menopause, women in the absence of estrogen also have gout. The dependence of gout on the nature of food was noted during the war when the incidence of gout was sharply reduced due to the lack of meat.
The clinical manifestations of gout are mainly in 2 types – gouty arthritis and nephrolithiasis with urate in the kidneys. The accumulation of uric acid in the joints is expressed in the appearance of tophus – bumps under the skin that contain uric acid. These gouty nodules disrupt joints.
Etiology of the phenomenon
Excessive urate levels are the main cause of gout. This picture can arise only as a result of 2 reasons:
- the intake of uric acid is so increased that healthy kidneys do not have time to excrete it;
- this is exactly the moment when a person has an addiction to food and does not abstain at the same time.
2 reason – the acid is supplied in moderation, but the kidneys themselves are sick and cannot cope with the task of excretion. Urates choose places where the blood supply is less and are deposited exactly there, because it is easier for crystals to strengthen here: cartilage, joints and tendons. They also like to be deposited in the kidneys, then the patient develops an ICD, but with gout, such patients have few attacks of renal colic. The provoking role is also played by:
- addiction to red meat;
- fatty foods;
- coffee ;
- alcohol ;
- hereditary predisposition;
- liver and kidney pathology;
- little water intake.
It should be noted at once that it is not possible to cure gout completely today, but the disease can be curbed. For a long time, the pathology has no symptoms, then suddenly there is an attack of acute pain in the joint, more often at night. Patients describe these pains as gnawing, eversible. The joint becomes red, swelling appears, and the joint and surrounding tissue begin to burn. General hyperthermia can reach 40ºC. Symptomatology develops within an hour.
Gouty tophus with uric acid crystals’ favorite localization is the big toe, it’s metatarsophalangeal joint, and swelling and redness appear around it. Classic analgesics are ineffective at this time. The pain recedes a little during the day, but in the evening it all begins again. Such an acute period can last up to a week. Then gout subsides and goes into a slumber for up to six months to a year, sometimes up to 3 months, often the lull can be long – 10-20 years.
Silence is not synonymous with recovery. With each attack, the time of remission will shorten. The joint gradually collapse, affecting neighboring joints. Gout nodules that appear over time is an indicator that the body is actively fighting the salt deposits, trying to destroy them with leukocytes, perceives salts as a foreign body. With the arrival of leukocytes to the affected area and expresses itself in inflammation, tissues become swollen. Inflamed tofus burst, and white dust appears – these are nothing but uric acid crystals. One joint is usually affected.
The chronic course is characterized by:
- The appearance of arthritis in the small and medium-sized joints of the extremities, pressing sensations in them;
- tofus in joints, eyelids and ears.
Often, an ugly lump appears on the first toe – a growth, a tumor that interferes with shoes. The area of the diseased joint is purple-cyanotic, swollen, sensitive even to light touch. In the kidneys, urate crystals can damage their tubules. This leads to the appearance of inflammation in them – glomerulonephritis, pyelonephritis, and nephritis. The course of such inflammations is imperceptible, but they can quickly lead to acute renal failure.
Help with an attack
How to relieve pain with gout on the legs ? Even with the implementation of all the recommendations, it is impossible to relieve pain instantly during an attack. But it is possible to alleviate the condition by shortening the time of pain. How long does a gout attack last? It usually lasts from a few hours to a week.
To begin with, the patient is prescribed bed rest and complete rest of the leg. The legs should be raised with a pillow above the level of the head.
What to do with a gout attack? In the case of unbearable pain, the affected joint can be covered with ice for half an hour. At night, a compress with Vishnevsky ointment or Dimexidum is required. Drinking alkaline drinks – oatmeal and other jellies, mineral or plain water with lemon, milk. Other food is excluded for a while. With healthy kidneys, the volume of water consumed is 3 liters.
Remove the acute gout attack momentarily impossible, but to reduce the inflammation and swelling can be NSAIDs course 2 weeks – Phenylbutazone, indomethacin, ibuprofen, diclofenac. Indomethacin, naproxen, etc. An important role played by drinking alkaline water with exacerbations: it normalizes metabolism and good displays with urine purine. Purines are just those substances that come with food or are formed in the body, they are the precursors of uric acid. The waters must be alkaline and with organic substances.
Treatment of an acute attack of gout should pursue 2 goals: to stop the attack of pain and to prevent exacerbations. To do this, it is necessary to reduce the level of uric acid in the blood and relieve inflammation. For this purpose, the complex of treatment includes diet, drugs, physiotherapy, exercise therapy , massage, folk remedies.
A decrease in uric acid is achieved with the prescription of drugs such as:
- Orotic acid ;
- Febuxostat ;
They serve to prevent attacks and acid dissolution, to reduce its synthesis. The course of taking them is long, the choice of the drug is determined by the doctor.
Rapid relief of pain in gout is carried out by taking Colchicine, GCS – Hydrocortisone, Metipred, Prednisolone (can be injected into the joint). They can quickly remove leg edema, they quickly remove leg pain, swelling, and swelling with redness. The effect is noticeable already on the first day of use. Therefore, their total course does not exceed 2 weeks.
Local treatment is also mandatory – compresses with ointment, you can make applications. Chondroprotectors are prescribed to improve the general condition of the joints, for a period of at least 3 months or more. Vitamins and calcium preparations – Calcemin, Calcium-compliant, etc.
Treatment without drugs is impossible, they are an obligatory component.
Physiotherapy can be treated with chronicity of the process only during the period of remission. They normalize inflammation, blood circulation and biochemical processes at the site of injury. More often than others are appointed:
- electrophoresis with novocaine and bischofite;
- wave treatment;
- laser and balneotherapy.
To improve the condition of the cartilage tissue, restore its motor function, exercise therapy and massage are used. Moderate physical activity improves joint mobility and prevents leg pain, small joints of the limb are developed, which are affected most rapidly. Physical activity is not indicated only in an acute attack.
Removal of excess and normalization of uric acid levels – stops attacks by 90%. From medicines used:
- Allopurinol – inhibits the synthesis of uric acid. By doing this, it reduces its concentration in the body. In addition, it gradually dissolves excess uric acid in the kidneys and joints. It is still the # 1 drug in the treatment of gout.
- Febuxostat (Uloric, Adenuric) – selectively inhibits xanthine oxidase, interfering with the synthesis of uric acid. The results of its use are such that after 3 months of the course, it completely dissolves urate crystals in the joints and prevents them from accumulating again. His big plus is that kidney pathologies are not a hindrance for him.
- Pegloticase (Pegloticase, Krystexxa) is an infusion medication that contains enzymes to dissolve urine salts. It is used in a severe form of the process to stabilize it.
- Probenecid (Santuril, Benemid) – its peculiarity is not that it reduces the synthesis of uric acid, but that it does not allow it to be reabsorbed in the renal tubules. So she comes out with urine. Applicable only in remission.
- Colchicine – relieves pain very well, and the relief of a gout attack is carried out with it. Reduces urate, preventing it from falling into crystals. Contains autumn crocus. It prevents leukocytes from moving to the site of inflammation. Used as an emergency aid. In the first 12 hours of an attack, 2 tablets are drunk at once, with an interval of 1 more hour, in the future – according to the doctor’s scheme.
What can you do at home?
How to relieve gout pain? If the patient has an attack at home, you need to ensure the rest of the diseased leg:
- Create an elevation for her from the pillow.
- Apply ice to the inflamed area: several times a day for up to half an hour, until the pain passes.
- Give more to drink – up to 1.5 liters of alkaline mineral water or simple salted water per day. It is good to use herbal teas.
Recent studies of Americans have shown that fat men who love sausages and sausages are predisposed to gout. A direct link between gout and calcium and vitamin C deficiency has been revealed: after 40 years they are always in short supply.
Prevention requirements are quite simple: proper diet and moderate physical activity. Physical education should be given at least 30 minutes a day, it can be any active movement from dancing to swimming.
The rate of water drunk per day is not less than 2 liters. Monitor the level of uric acid in the body: not higher than 60 mg / l. It is necessary to exclude offal and fatty sausages, meat, smoked meats, legumes, sorrel, xanthines – coffee, tea, chocolate. But you can eat low-fat milk, eggs, cereals, cheese, fruits and vegetables: they do not contain purines.