Gout is a common condition and a complex form of arthritis that affects over nine million people in the United States. It causes sudden, severe pain, swelling, redness, and tenderness in one or more joints, most commonly in the big toe. Gout attacks can occur suddenly, causing those affected to wake up in the middle of the night in pain.

While gout symptoms may come and go, there are ways to manage it and prevent flare-ups from happening. This article will discuss gout treatment guidelines for Houstonians.

What are gout symptoms?

As mentioned above, gout tends to occur suddenly and usually at night. Standard signs and symptoms of gout include:

• Intense joint pain. Gout generally only affects the big toe but can also occur in other joints in the ankles, knees, elbows, wrists, and fingers. Pain can last as little as an hour or as long as twelve.
• Lingering discomfort. Once the more severe pain subsides, some joint discomfort may last a few days to weeks. The longer you have gout, the longer the attacks are likely to stay.
• Inflammation and redness. Joints affected by gout may become swollen, warm, tender, or red.

Treatment guidelines for gout

According to the American College of Rheumatology (ACR), there are dozens of treatment guidelines recommended to combat gout. The strong recommendations from the college include the following:

• Patients with tophi (nodules formed from a mass of uric acid crystals at joints or in soft tissues), radiographic evidence of damage due to gout, or those with multiple gout flairs should be prescribed orate-lowering medications.
• Allopurinol is the first-line orate-lowering medication that is strongly recommended for patients.
• Allopurinol or febuxostat is recommended over probenecid as a first-line treatment for patients with moderate-to-severe kidney disease.
• Pegloticase should not be used as a first-line treatment for gout.
• Experts recommend starting with a low dose of allopurinol and febuxostat over a higher dose.
• Anti-inflammatory medication, like colchicine, nonsteroidal anti-inflammatory drugs, or prednisone, as a preventative measure against gout, along with orate-lowering medications, is recommended. Experts recommend continuing the anti-inflammatory medications for three to six months with regular monitoring and adjustments if gout flares continue.
• A treat-to-target strategy is strongly recommended by adjusting urate-lowing medications to reach a target uric acid level of fewer than 6 milligrams over using a fixed dose of the medicine and no target.
• Patients who continue to have frequent attacks and fail to reach the target urate level are strongly recommended to switch to pegloticase instead of continuing the current orate-lowering drug. However, switching to pegloticase is strongly advised against for patients who have not reached a target rate level but don’t have frequent flares.
• Colchicine, NSAIDs, or glucocorticoids (corticosteroids) is recommended as a first-line treatment for gout flares over interleukin-1 inhibitors (biologic medications) or hormone treatments (ACTH). Low-dose colchicine is strongly recommended over high doses. For patients who cannot take oral medicines, glucocorticoid shots are strongly recommended by experts.

Contact Phoenix Medical and Wellness Clinic for help with gout.

At Phoenix Medical and Wellness Clinic, we offer treatment for gout and a variety of conditions. We can help you manage your treatment plan, keep track of all the different elements, and ensure you always have the information and services you need at your fingertips. We strive to help our patients achieve complete health and wellness and improve or maintain their quality of life.

If you are in Texas and would like to talk about developing a gout management plan, contact us today to book an appointment.