Some of my male patients have a form of arthritis called gout. In fact, men seem uniquely predisposed to the condition as 95% of people who get gout are male and only 5% are women, usually in menopausal age groups. When they have a gouty flare, they come in complaining of pain in their big toe with redness and swelling that makes it very uncomfortable to walk or sometimes even stand.
The immediate treatment for a flare up of gout is pain relief. This usually involves using over-the-counter anti-inflammatory analgesics or, if the pain is bad enough, a stronger prescription. I also advise some things they can do for themselves to prevent further flare ups of the condition and this is what I’d like to share with you here. First, let me explain to you what gout is and how it develops.
Gout – What Is That Pain in My Big Toe?
Also referred to as podagra, gout is a form of arthritis that occurs when excess uric acid crystals build up in joints and cause inflammation. It seems the favorite target point is the big toe joint, although acute and chronic gout can also occur in other joints like the knees or ankles.
The cause of gout is not exactly known but it seems to occur more with:
➢ People who drink a lot of alcohol, especially beer
➢ Obesity/lack of exercise
➢ Kidney disease
➢ People who take blood pressure lowering medicines like hydrochlorothiazide or Lasix.
➢ Leukemia, anemia, and other blood disorders
➢ High cholesterol levels
The symptoms of a gout attack can come on suddenly usually at night and may include:
➢ Intense, throbbing pain in the big toe, knee, or ankle joint
➢ The joint itself becomes very red and hot and hurts with the slightest touch
Gout is determined by a series of tests that include:
➢ Withdrawal of synovial fluid from the affected joint. This is the fluid that surrounds the joint and helps it move correctly. If gout is present, a concentration of uric acid crystals will be present.
➢ Blood and urine tests – looking for a higher than normal level of uric acid.
➢ Synovium biopsy – this involves taking a little piece of the tissue surrounding the joint and testing it for the presence of gout.
What Is The Treatment for Gout?
My patients know that I favor more natural, noninvasive treatments for conditions if possible, but when they come in with a gouty flare, usually their pain is such that it requires both a prescription-strength anti-inflammatory and a stronger pain medication like codeine, hydrocodone, or oxycontin.
They generally will need to take the anti-inflammatory for about 4-10 days, but should be able to stop or greatly ease back on the pain medication after about 48 hours. Or, they may be able to switch to an over-the-counter strength pain medicine like ibuprofen.
Sometimes, in bad flares of gout, steroids like cortisone may need to be injected into the joint to help with swelling and inflammation. Some prescription gout medications like allopurinol or Probenecid may have to be given to help rid excess uric acid to assist natural treatments, at least for a while.
What You Can Do To Avoid Future Gouty Flares
If you have had an attack of gout, there are many things you can do to prevent an attack from occurring again. These mainly involve natural, lifestyle/dietary changes and the addition of some specific foods and supplements that can help keep uric acid down. Here’s what I recommend:
Limit or avoid the following: Red meats, organ meats (liver, kidney, sweetbreads), alcohol, foods like sardines, herring, peas and beans, rich gravies, mushrooms, yeast, coffee, carbonated sodas. Low carbohydrate diets and/or fast weight loss can cause a build up of uric acid and/or kidney stones. Decompress from stress with exercise or meditation.
Include the following: Malic acid from tart apples like Granny Smith’s or apple cider vinegar neutralizes uric acid. Take 1 tb of ACV with each meal or eat an apple after each meal. Taking 1,000 mg of Vitamin C every day helps neutralize uric acid and prevents inflammation in joints. Cherry juice is both high in Vitamin C and is anti-inflammatory. Raw vegetable juices, especially beets and cucumbers, neutralize uric acid and fight inflammation. Vitamin D3 1-2,000 mg a day fights inflammation. Magnesium in Epsom salt foot and ankle baths daily, or a few times a week, helps reduce inflammation/stiffness in joints. The supplement Quercetin is a natural anti-inflammatory as is the food and supplement form of celery. As always, drink sufficient amounts of water every day to dilute urine and flush out uric acid.
Getting a painful flare of gout is no picnic and can really put a damper on your activities for several days. However, if you follow my recommendations here on how to avoid creating gout, or a flare of it, you should be able to remain gout-flare free and sleeping and moving easy!
Photo Credit: Eastop