Gout

Gout is a form of arthritis. It usually occurs after years of buildup of uric acid crystals in the joints and surrounding tissues. Gout usually happens in one joint, often the big toe.

When you have gout, you may eventually have a gout attack. These attacks usually start at night, with sudden burning pain, stiffness, and swelling in a joint.

Symptoms of gout include:

• Warmth, pain, swelling, and extreme tenderness in a joint, usually a big toe joint. The pain often starts during the night. It may get worse quickly, last for hours, and be so intense that even light pressure from a bedsheet is intolerable.
• Very red or purplish skin around the affected joint. The joint may look infected.
• Limited movement in the affected joint.
• Peeling and itching of the skin around the affected joint as the gout gets better.

Gout can also affect the joints of the feet, ankles, knees, wrists, fingers, and elbows.

Gout attacks can last a few days or many weeks before the pain goes away.

To diagnose gout, your doctor may do:

• A joint fluid analysis to look for uric acid crystals. This is the only certain way to diagnose gout.
• A medical history and physical exam.
• A test to measure levels of uric acid in blood.
• A test to measure levels of uric acid in urine.
• Imaging tests, like ultrasound and computed tomography.

While X-rays of feet and hands are sometimes useful in the late stages of gout, X-rays aren't usually helpful in the early diagnosis. Pain often causes people to seek medical care before any long-term changes can be seen on an X-ray. But X-rays may help to rule out other causes of arthritis.

Medicines can help treat gout. To stop a gout attack, your doctor will prescribe pills such as colchicine or NSAIDs (such as naproxen). Sometimes it's treated with a steroid shot. The sooner you get started on medicines, the sooner your symptoms will start to get better.

Resting the joint that hurts can also help you feel better. Taking ibuprofen or another anti-inflammatory medicine can help too. Using ice on the sore joint may also help.

To manage long-term gout and prevent future attacks, your doctor can prescribe a medicine to reduce uric acid buildup in your blood. For the first few months you will probably take another medicine with it to prevent attacks until the long-term medicine has time to work.

There are things you can try at home to manage gout symptoms.

If your joint is swollen, try using ice or a cold pack on the area for 10 to 20 minutes at a time to help reduce swelling. Place a thin cloth between the ice and your skin. You can also try to prop up the sore limb on a pillow while you are applying ice or when you sit or lie down.

It may help to rest your sore joint for a few days. Avoid activities that put weight or strain on the joint.

Avoiding certain foods and drinks may also help you avoid gout attacks. Try to eat less seafood and red meat. Avoid food or drinks that are made with high-fructose corn syrup. And check with your doctor before drinking alcohol.

If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.