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Last Updated: Mar 17, 2022
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Gouty Arthritis: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Gout is a kind of arthritis that develops when uric acid crystals build-up in the joints. When the uric acid gets crystallized in the joint, painful arthritic attacks and kidney stones can occur. The uric acid crystals can block the kidney filtering tubules and this can ultimately lead to kidney failure. Medications alone can treat mild cases of gout. However, recurring attacks of gout require long-term treatment or otherwise there can be damage to bone and cartilage and the kidneys can also get affected.

An excess of uric acid in the blood causes gout. Extra uric acid is usually filtered through the kidneys and is excreted. Uric acid crystals form in the joints if the body produces too much uric acid or fails to excrete it. The crystals cause intense inflammation in the joints and this result in pain and swelling. People who drink too much are the most vulnerable. However, a person can be affected by gouty arthritis due to a number of reasons like injury, surgical procedures, hospitalizations, stress, diet rich in meat. Tumors, cancers and psoriasis can also be accompanied by gout. People who themselves or their family members have suffered from obesity, diabetes or high blood pressure are at risk of gouty arthritis.

Gout, in its mild form, and when it is not frequent and complicated, can be treated with a proper diet and making some changes in lifestyle. However, there are 3 types of medications that are used to treat gout. They are medications for lowering uric acid, prophylactic medications which are used together with the uric-acid lowering medications and rescue medications to deal with gout pain.

What is the difference between gout and gouty arthritis?

Gout is a type of arthritis accompanied by inflammation. Its onset is sudden and usually in one joint at a time. Gouty arthritis is a condition caused due to the deposition of needle-like crystals of uric acid in a joint.

Both Gout and Gouty arthritis refers to the same condition and can be used interchangeably for each other.

Summary: Gout is a painful joint condition caused by the accumulation of extra uric acid in joints of the big toe, knee, elbow, etc. It is associated with episodes of pain, accompanied by tenderness and burning sensation at the affected site.

How serious is gout arthritis?

Gout arthritis is a common but complex type of joint inflammation that can equally affect anyone. It has a sudden onset and is accompanied by pain and swelling which may be severe most of the time. Redness and tenderness also occur at the site of inflammation. It may occur in one or more joints at a time, most commonly affecting the big toe.

Sudden onset of gout, known as a gout attack, can cause such intense pain that can wake us in the night. A burning sensation is felt in the big toe, feeling as if it is on fire. The affected site becomes hot, inflamed, and tender.

The associated tenderness is to such an extent that the joint cannot even bear the weight of light objects such as bed sheets over it. The gradual progression of gout may even cause restricted movements.

Summary: Gout arthritis is painful and discomforting, associated with intense pain and inflammation. It is usually related to the episodic pain arising all of a sudden at night. With gradual progression, the condition may lead to restricted movements.

How is the treatment done?

The primary treatment of gout are the uric-acid lowering medications. They help to decrease the total amount of uric acid in the body and also lowers the serum uric-acid levels. The goal of lowering the overall uric acid content is to achieve a serum uric acid level of less than 6mg/dl. Some of the medications used to decrease the level of uric acid are allopurinol, febuxostat, probenecid and pegloticase.

Prophylactic medications are used together with uric-acid lowering medications for about the first 6 months of therapy. This is to prevent the gout flares or to reduce the severity of such flares. Any medication that works to reduce the level of uric acid in the body can also trigger a gout attack and so prophylactic medications are used. Some of the medicines used for this purpose are: aolcrys and any of the non-steroidal anti-inflammatory drugs like indomethacin, diclofenac, ibuprofen and others.

Corticosteroids like prednisone, prednisolone and methylprednisolone are used during acute gout attacks so as to lower the pain and inflammation. These medications can also be injected in an inflamed joint to get relief from the pain and inflammation if the medicines are not working. These medications, however, start working within 24 hours of their consumption.

In some cases surgery may be required to treat the gout if the joint has been significantly harmed due to insufficient treatment in the initial stage.

Is gouty arthritis curable?

Gouty arthritis is an incurable condition but symptoms can be managed or treated with certain medications, lifestyle changes, self-care techniques, etc. Following are the drugs which help to treat symptoms related to gout:

  • Colchicine
  • Corticosteroids

Certain drugs are there which help to decrease the levels of uric acid in the body so as to minimize risks of episodes of pain or gout pain. Those include:

  • Allopurinol
  • Febuxostat
  • Pegloticase
  • Probenecid

Certain lifestyle changes and self-care techniques that help to control symptoms of gout include the following:

  • Intake of adequate water.
  • Doing exercises on a regular basis so as to maintain healthy body weight.
  • Avoiding consumption of foods and beverages such as alcohol, red meat, shellfish, organ meats, high-fructose-rich eatables, animal proteins, etc.
Summary: Gouty arthritis is not curable but the related symptoms can be controlled or managed by the application of medicines, self-care techniques, and lifestyle changes. Drugs like NSAIDs, allopurinol, corticosteroids, etc. are helpful in treating the condition.

Who is eligible for the treatment? (When is the treatment done?)

A person suffering from gout will experience symptoms like sudden onset of joint pain, swelling of the joint, heat in the area that is affected and redness of the joint. More severe the inflammation, more severe is the pain that afflicts a patient. A person will be eligible for treatment if he/she is experiencing some or all of these symptoms and if a doctor has diagnosed him/her to be suffering from such. Doctors diagnose gout by finding out whether the fluid from the inflamed joint has uric-acid crystals or not.

Who is not eligible for the treatment?

A person, not experiencing the symptoms associated with gout and who has not been diagnosed by doctors to be suffering from this condition, is not eligible for the treatment. A person suffering from pseudo-gout, which has symptoms similar to that of gout, is not suitable for undergoing treatment using these medications.

Are there any side effects?

The medicines that a person needs to consume to treat gout has a number of side-effects. Allopurinol, the medication used to lower uric acid levels can cause very severe allergic rashes. Intake of colcrys can have a number of side-effects like nausea and diarrhea and they also rarely cause muscle weakness and abnormal blood counts. NSAIDs can cause ulcers and irritation of the stomach while febuxostat can also cause abnormalities of the liver, rashes and nausea.

What are the post-treatment guidelines?

There are certain post-treatment guidelines that a person needs to follow to prevent another gout attack even after he/she has been treated for this condition. A person should exercise and also eat a balanced diet so as to keep the weight in check. Another important guideline is to keep drinking a lot of water so that the body remains hydrated. A person should avoid sugary drinks and alcohol in excess quantities. It would be beneficial for a person to skip meat and seafood and rather meet the protein requirements with the help of low-fat dairy like yoghurt, cheese and milk.

How long does it take to recover?

It takes 12 to 24 hours for an acute gout attack to reach its peak. This condition normally subsides even without treatment. However, a person will require 7-14 days to recover fully from an acute gout attack. A gout attack lasts for 3-10 days with or without medication. So the recovery time will depend on how long the attack actually lasts.

What is the price of the treatment in India?

10 ml of ibuprofen may cost anything in between Rs 10 and Rs 112.50 in India. The cost of medicines to reduce uric acid in the body varies between Rs 900 and Rs 4000. Colcryx, which is a prophylactic medicine, will cost around Rs 14,000 in our country. The cost common version of prednisone, which is used to reduce pain and inflammation, can cost something around Rs 300.

Are the results of the treatment permanent?

Gouty arthritis occurs due to the accumulation of uric acid in the bloodstream. This condition can occur after a surgery, trauma or dehydration. If some people are on diuretics, their risks of developing gout are substantial. Certain other medications can also cause uric acid to get concentrated in the blood. Cancer treatment also causes uric acid to get deposited in excess. In addition to these, genetics and obesity can also play a crucial factor in increasing uric acid count. Therefore, it is to be understood that there is no permanent cure for gouty arthritis as the condition may again flare up when the uric acid level increases in our blood.

What are the alternatives to the treatment?

Due to their anti-oxidant properties, cherries and ginger roots can fight inflammation and bring relief from gout pain. Drinking lots of water helps to flush out a lot of uric acid from the body. The acidity of the apple cedar vinegar is a simple home remedy that helps to treat pain and swelling. Babana is another important home remedy for gout as it is high in potassium which converts the uric acid crystals in the body to liquid. The Vitamin c in banana also helps to reduce pain and inflammation.

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Popular Questions & Answers

I am 21 years old, i'm having a back pain and low hip pain from 2 years and also recently 4 months it's very tough. For that i'm taking daily pain killers like aceclofenac and diclofenac tablets from 1 year. What to do please give me suggestions and now i'm worried about my kidneys because I am taking daily painkillers .please provide useful thing and also tell me tips not to get kidney issues and this pain. Thank you.

Fellowship in Joint Replacement, DNB (Orthopedics), MBBS
Orthopedic Doctor, Thanjavur
I believe that you may have a severe slipped disc, or more likely some form of rheumatoid arthritis or ankylosing spondylitis. Pain killers mask the pain, they do not cure you. You need thorough investigations to find the cause of pain. Treatment ...

From last 2 weeks. I am facing server pain in my ankles.(with swelling) elbows and wrists and few fingers. It gets worse if pressed or moved. I have to take 1 pain killer (fenac plus) twice a day (1/2 each) to survive a day. I am not sure who is the specialist for it and I really don't have money to visit a Dr. to hear who can actually help. Please help with possible root cause and right type of specialist to go to get this cured please help as this is getting worse everyday.

DNB (Orthopedics), MNAMS (Orthopedic Surgery), MBBS
Orthopedic Doctor, Mumbai
Hi, based on your information, it appears you are having inflammatory polyarthritis, most probably rheumatoid arthritis. A consultation with a rheumatologist would be quite helpful to you at this stage of symptoms. Hope this is helpful to you. Wis...
1 person found this helpful

Dear doctor, I have been consulting you often. Of late my urine output seems to be declining. You had prescribed renosave forte when my creatinine had gone up to 1.4 and feburic 40 when my uric acid had gone beyond 7. When my uric acid levels had come down and creatine was 1.2 you had advised me to stop both feburic 40 and renosave but uric acid levels again touched 7.1 after a few months and you asked me to take feburic 40 again. I want an online consultation.

MBBS, CCEBDM, Diploma in Diabetology, Diploma in Clinical Nutrition & Dietetics, Cetificate Course In Thyroid Disorders Management (CCMTD)
Endocrinologist, Dharwad
Hello, thanks for the query. I have seen the details mentioned. However, I do not recall the earlier consultations done. I am Dr. p l jathar, please check whether you have consulted me only. In any case, uric acid level remaining at 7 mg/100 ml is...

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