Managing a gout flare-up

What is gout?

Gout is a type of inflammatory arthritis that feels like a sudden and often severe joint pain. According to a recent study, roughly 1-2% of the UK population are affected by this condition. [1]

It is triggered by the build-up of uric acid in the body, which causes tiny crystals to form in the joints and surrounding tissues. This causes significant pain and inflammation and is known as a gout flare-up or gout attack. The big toe is the most commonly affected joint, but gout can occur in many different areas of the body. For example, some people may experience:

• Gout in knee
• Gout in ankle
• Gout in fingers
• Gout in hands
• Gout on top of foot
• Gout in elbow
• Gout in finger
• Gout in foot

There are many potential triggers for gout and it seems to be a hereditary condition, with a recent study finding that 20% of individuals with gout have a close relative who has also been diagnosed with this condition. [2] Other risk factors include kidney disease, heart failure, diabetes, hypertension and obesity.

Gout symptoms

The most common symptoms of gout include: 

• Sudden, severe pain in the affected joint(s)
• Inflammation around the affected joint(s)
• Hot, red skin around the affected joint(s)
• Stiffness in/around the joint(s)
• Reduced range of motion in the affected joint(s) and general mobility issues

While each and every person will experience this condition in a slightly different way, the pain is often described as being a very intense, sharp sensation. 

Is there a cure for gout?

Unfortunately, there is no cure for gout, though research is ongoing. There are ways you can manage the symptoms and reduce flare-ups. 

It's important you’re aware of the various treatments you can use to manage your pain and symptoms, from gout NHS medications to home remedies, and which ones you can use together.

What to do when you have a gout flare-up

Most people with gout will experience a few flare-ups a year, which can last a few weeks. If you get a flare-up more than a few times a year or find that you’re getting more flare-ups than you used to, then you should see your GP to discuss using a medicine that will prevent them in the first place. This medicine is called Allopurinol, and should only be started by your GP.

Home remedies

Many individuals find that home remedies can manage their gout symptoms.

For example, applying an ice pack can help ease pain and inflammation. This is because applying something cool to inflamed or hot skin causes the blood vessels to become narrower, which reduces swelling. 

Some people find that following a ‘gout disease diet’ can also be useful. This usually means avoiding foods that are high in purines (a chemical compound that is often considered to be one of the gout disease causes). These foods include;

• Red meat
• Liver
• Shellfish and seafood

In terms of diet, people with gout may also avoid dairy products, and they should lower their alcohol intake. This is because alcohol can increase your body’s production of uric acid.

During a gout flare-up, you should also make sure you’re drinking enough water. This is because staying hydrated can help flush uric acid out of the body, preventing the build-up of crystals and lubricating the joints. [3]

For immediate gout pain relief, you can use over-the-counter painkillers, such as ibuprofen, which is also an anti-inflammatory. Consult a medical professional before taking any medicine, especially if you already take other medicines or have other health conditions.

When to get help for gout

If you are struggling to go about your daily life dealing with persistent pain or are experiencing a flare-up in a way that you are not used to, it's important you speak to your doctor.

In the meantime, we can provide a short course of gout treatment, delivered as quickly as the next day.

Best gout treatments

There are a range of medicines for treating gout in the UK. We offer colchicine and indometacin. Both are prescription-only and cannot be bought over the counter.

Colchicine for gout

Colchicine tablets belong to a group of medicines known as NSAIDs (Nonsteroidal anti-inflammatory drugs). It works to reduce the number of white blood cells that enter the affected joint (i.e., gout in feet), which can reduce swelling and discomfort quite considerably. 

In one study, patients were given either a prescription of colchicine or a placebo tablet. More than half of the colchicine-treated patients reported reduced pain compared to those who took the placebo tablets. 

The study also noted that the best results were when the tablets were taken within 12 hours from the start of the flare-up. [4]

Generally, people tend to notice the benefits of Colchicine within two hours of taking this treatment for gout arthritis. If the pain persists, it can also be used with ibuprofen.

Indometacin for gout

Indometacin is also an NSAID (nonsteroidal anti-inflammatory drug). While it is often prescribed as a medication for gout, it is also used to treat a range of other inflammatory conditions alongside pain and stiffness.

Indometacin therapy for gout works by blocking the body’s production of prostaglandins, hormone-like substances that cause symptoms like pain, tenderness and swelling.

No matter which course of medication you have been prescribed, you should keep a close eye out for any adverse symptoms. If you continue to feel unwell, reach out to your doctor.

Where to buy gout treatments

If you are dealing with mild to moderate levels of pain, you may be able to treat your gout flare-up with over-the-counter medications such as ibuprofen or naproxen.

However, in the majority of cases, you’ll notice the best results when taking Indometacin or Colchicine. This is because they offer more extensive support and often start working within the hour - which can lower the amount of suffering or pain you have to endure during a gout attack or flare-up. [5]

As mentioned, both Indometacin and Colchicine are prescription-only medications. However, this does not mean that you have to wait to see your doctor face-to-face.

Instead, you can start an online consultation with our medical team. There will be a few routine questions about your health, current symptoms, and any other treatment you have tried. One of our doctors will then review your information, approve a prescription for you if appropriate, and our pharmacy will send your order to you.

With our fast delivery, you can have the treatment you need delivered to your door in record time - any orders made before 1 pm are shipped on the same day.

If you’d like to find out more about our services, please do not hesitate to get in touch today. We will happily answer any questions you may have to put your mind at ease. Alternatively, let us know what you need in your online consultation, which typically takes no more than two minutes to complete.

References

1. The painful truth of gout in the UK. The Lancet Rheumatology [Internet]. 2023 Oct [cited 2024 Jul 1];5(10).
2. 1.Xia X, Jin J, Chen Z, Zhou Z, Chen H, Zhang C, et al. Unravelling the genetic causes in large pedigrees with gout by whole?exome sequencing. International Journal of Molecular Medicine.‌
3. Hydration and Gout: Looking at New Modes of Uric Acid Management [Internet]. ACR Meeting Abstracts.
4. Shekelle PG, FitzGerald J, Newberry SJ, Motala A, O’Hanlon CE, Okunogbe A, et al. Management of Gout - Results [Internet]. Agency for Healthcare Research and Quality (US); 2016 [cited 2024 Jul 1].
5. Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894. Gout attacks: Pain relief [Internet]. Institute for Quality and Efficiency in Health Care (IQWiG); 2018.