Struggling With Gout Pain? Dr. Stuart Weisman's Tips

Gout can strike suddenly causing excruciating pain and swelling in joints. It usually strikes a big toe, but can also affect the ankle, knee, foot, elbow or finger. The affected joint becomes so tender that even the slightest touch can be unbearable.

"Fortunately, an attack will clear in time, and there's a lot we can do to prevent further attacks," rheumatologist Stuart Weisman, MD, of Boulder Medical Center told a crowd of more than 120 people during a free health lecture held at the Boulder Jewish Community Center.

Gout Causes and Symptoms
"Gout is a type of arthritis that occurs when you have high levels of uric acid in your blood," explained Dr. Weismain. "Over time, the uric acid forms needle-sharp crystals that collect around your joints and soft tissues. Eventually, these crystals trigger a gout attack." He said symptoms include:

• Sudden excruciating joint pain
• Warm or swollen joints
• Redness of the skin
• Fever

Gout Flare-Ups: How to Get Relief
Gout attacks can be quite severe, so it's good to know how to quell the pain as soon as possible. Dr. Weisman offered a few options:

• Over-the-counter drugs - Take nonsteroidal anti-inflammatory drugs (NSAIDS) early in an attack and at a maximum dose. For example, he said you could take a naproxen dosage of 500MG two times/day.
• Corticosteroids - Your doctor can prescribe a 5-to-14-day course of corticosteroids to reduce the inflammation.
• Colchicine - Best taken at the onset of an attack, prescription colchicine can help decrease the pain and swelling.

"However, all of these options have possible side effects. None should be taken without checking with your doctor first," Dr. Weisman warned.

Managing Gout
If you're prone to gout, the foods you eat — or don't eat — as well as your lifestyle choices can be key in controlling the disease.

Avoid attack-triggering foods
Dr. Weisman said the following foods are high in purines, which can trigger gout attacks:

• Sugary beverages
• Organ meats such as liver or tongue
• Red meat, including beef, lamb and pork
• Seafood
• Beer, wine and liquor

"The worst types of seafood are anchovies, herring, sardines, trout, tuna and shellfish," said Dr. Weisman. "Alcohol also exacerbates gout by increasing uric acid production and decreasing excretion of uric acid. Beer adds purines to your blood."

Incorporate these foods in your diet
Dr. Weisman said the following foods and beverages tend to lower uric acid levels in your blood:

• Low-fat dairy products
• High doses of coffee
• Hydration with water

He added, "One study showed that cherries might reduce the risk of gout attacks. Another suggested that high doses of coffee - 4 cups a day or more - could be helpful."

Lose weight
Losing weight or maintaining an ideal weight is an important part of managing gout. It can help reduce the uric acid in the blood.

Stay clear of medication triggers
Many medications, such as diuretics and niacin, can cause your uric acid levels to rise. Even low-dose aspirin can cause a flare up. If your doctor is planning to start you on a new medicine, be sure to mention you have gout.

Avoiding the Development of Tophi
Dr. Weisman wrapped up his lecture with a warning about how gout can cause destructive joint disease and uric acid tophi if left untreated.

"Tophi are deposits of urate crystals in people who have excess uric acid in their blood for a prolonged period of time. The deposits collect in and around joints, tendons, and soft tissues. Usually, they appear a decade or longer after the initial gout attack," he said. "To prevent this from happening, your doctor might prescribe the long-term use of uric-acid lowering medication."

To make an appointment with Dr. Weisman, call 303-440-3137.

Click here to view PowerPoint slides from Dr. Weisman's lecture on "Advances in Relieving Gout Pain."

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