Gout, also known as gouty arthritis, is an arthritic condition caused by high levels of uric acid in the tissues, joints and blood. People who suffer from it either produce too much of this acid or are unable to excrete it efficiently; when the concentration in the body is too high, it causes pain, redness and swelling. Since painful attacks often occur during the night, it is wise to know how to avoid them and how to relieve the pain once it occurs.
Steps
Part 1 of 5: Treating Acute Pain for Better Sleep
Step 1. Apply ice to the affected area
Generally speaking, the first 36-48 hours of the attack are the most painful, but you can find relief and do everything possible to end the inflammatory phase as soon as possible. To soothe the discomfort, apply ice to the joint; use a cold pack wrapped in a towel and place it on the painful area for 20-30 minutes for every hour you are awake.
Lift the affected area as much as possible while applying the ice pack to prevent blood from pooling
Step 2. Take over-the-counter pain relievers
You can take common pain relievers, such as ibuprofen (Brufen) and naproxen sodium (Momendol). However, do not follow the therapy for too long, because prolonged use of these medicines can increase the chances of heart attack or stroke, as well as increasing the risk of ulcers and bleeding; for your safety, strictly follow the instructions on the leaflet.
- However, avoid aspirin and any topical acetylsalicylic acid products (such as Diprosalic or other similar ointments), as they can increase uric acid deposits in the joints.
- Paracetamol (Tachipirina) is not an anti-inflammatory drug and is not useful for this ailment.
- You can also take colchicine, but a prescription is required in this case.
- If you want to keep gouty attacks under constant control, you should take allopurinol, which reduces the amount of uric acid in the body.
Step 3. Try topical pain relieving creams or gels
Topical pain relievers have been shown to be very effective, especially on joints such as toes, ankles, knees, elbows and hands. For example, Voltaren Emulgel is an over-the-counter topical NSAID that can greatly reduce the pain caused by gout; ask your doctor for more details. Other over-the-counter topical treatments useful for your condition include:
- Capsaicin ointment: This is a substance extracted from cayenne pepper and is capable of blocking the emission of substance P - a pain signal. Make sure you wash your hands well after applying it, otherwise it could cause a strong burning sensation, especially if you rub it near your eyes.
- Homeopathic creams: there are several that contain a mixture of homeopathic remedies for pain;
- Ointments to relieve gout: in herbal medicine you can find several creams based on medicinal herbs that can soothe suffering.
Part 2 of 5: Preparing for Sleep During a Gout Attack
Step 1. Find as comfortable accommodation as possible
Gout rashes often occur during the night, at any time, for example when the blanket puts pressure on the aching toes, causing extreme pain. If you know that this can be a cause of your pain and you are having a gouty attack, avoid such discomfort by raising the room temperature and removing the blanket from the affected area of the body.
- You can feel more comfortable, at least in the first part of the night, by sleeping in an armchair or a reclining chair that allows you to keep the ailing joint raised.
- If the pain is localized in the toes, ankles or knees, it is best not to use a blanket or place it as a "tent" over the affected area if possible.
Step 2. Manage sleep disorders
Gout is also associated with various problems of this nature, such as sleep apnea. If you've woken up in the middle of the night from gout in the past, see your doctor for treatments for sleep disorders.
- Do not take any stimulants, such as caffeine or tobacco products, and also avoid purine-rich foods and drinks. among these, the main ones are: red meat, anchovies, shellfish, fatty fish, asparagus, spinach and most of the dried legumes. If you want to sleep more deeply, avoid such products.
- Drink lots of water. While it doesn't necessarily help get you to sleep, it does help flush out the uric acid that has built up.
Step 3. Take your medications one hour before bed
In this way, the active ingredient has plenty of time to act effectively; for example, if you are taking topical pain relievers, apply them about 20-30 minutes before going to bed.
If you are taking NSAIDs, you should take them with foods, such as yogurt or peanut butter crackers; food lines the stomach walls and reduces the chances of developing gastrointestinal ulcers or bleeding
Step 4. Practice proper sleep hygiene
Avoid loud noises or too bright lights and turn on some soothing music or a "white noise" machine to relax. If you can, take a warm shower or bath before bed, as it can help you calm down even more.
- Practice some deep breathing exercises, turn on some soothing music, or practice meditation to try to relieve tension as much as possible.
- Get up in the morning and go to bed at the same time every day. Don't force yourself to sleep at all costs: if you can't fall asleep, do something until you feel tired; you also resolve conflicts and problems before going to sleep. Don't drink alcohol and don't smoke before bed, try to exercise in the morning and don't work out for the last four hours before bed.
Part 3 of 5: Treating Gout with Drugs
Step 1. Get a diagnosis
If you think you are suffering from gout, it is important to see your doctor, who can help you relieve the symptoms and advise you on the most appropriate treatments. Usually, gout is diagnosed simply by checking for symptoms and taking a medical history.
The doctor may also take a sample of synovial fluid to check the characteristics of the uric acid crystals, order a blood test to measure levels, an x-ray, ultrasound, or computed tomography, although imaging tests are rarely used
Step 2. Take your prescribed medications
To treat gout, you need to take medicines that block the production of uric acid, such as allopurinol (Zyloric) and febuxostat (Adenuric), or that increase its excretion, such as probenecid (Probalan). As you can imagine, these medicines cause significant side effects:
- Allopurinol can cause rashes, anemia, and sometimes increase joint pain. People of Asian and African descent run a high risk of skin rashes by taking this drug.
- The medicine is used to treat chronic gout only and is not suitable for acute cases. If you are suffering from the latter form of gout, you need to take colchicine to relieve symptoms, as allopurinol is not very effective.
- Febuxostat can greatly alter liver enzymes; also this drug is used only for cases of chronic gout.
- Probenecid can cause migraines, joint pain, and rapid breathing.
- Other drugs indicated for this pathology include prescription NSAIDs, such as indomethacin (Indoxen) or celecoxib (Celebrex); alternatively, anti-inflammatory steroids and colchicine (Colchicine Lirca) are also sometimes prescribed, although the latter is of the older generation and is used less frequently due to severe side effects.
Step 3. Follow your doctor's recommendations for lifestyle changes
In addition to taking medications, dietary and lifestyle changes need to be made to treat gout and relieve the pain associated with it. Your doctor can give you several tips on how to do this in order to relieve the discomfort and sleep better.
Part 4 of 5: Making Changes in Nutrition
Step 1. Avoid foods that can increase the chances of acute episodes
If you're experiencing your first attack or haven't made any dietary changes yet, it's time to cut down on your consumption of purine-rich foods. These organic substances break down in the body producing uric acid; you must avoid them completely when you have an acute episode of gout and at least for the following month. Once cured, however, you should not exceed 2-4 servings per week of any of these foods, namely:
- Alcoholic beverages;
- Sugary drinks;
- Fatty foods, such as fried foods, butter, margarine, and high-fat dairy products
- Offal (liver, kidney, brain), which represent the foods with the highest level of purines;
- Beef, chicken, pork, bacon, veal, venison;
- Anchovies, sardines, herring, mussels, cod, scallops, trout, haddock, crabs, oysters, lobsters, shrimps.
Step 2. Increase your consumption of foods that help get rid of the disorder
In addition to avoiding certain foods, you should also increase your intake of those products that protect you from excessive levels of uric acid; among these consider:
- Foods rich in phytates: it seems that these salts of phytic acid are able to prevent the formation of different types of kidney stones, including those of uric acid; among these foods there are beans, legumes in general and whole grains. You should incorporate 2-3 servings of these products into your daily diet;
- Green tea: reduces the risk of developing kidney stones containing uric acid; drink about 2-3 cups every day;
- Foods rich in calcium, including low-fat dairy products
- Black cherry juice: Traditionally used in naturopathic medicine to treat gout and kidney stones. If you are suffering from a seizure, you can drink 3-4 8-ounce glasses of organic black cherry juice every day; you should get relief within 12-24 hours.
Step 3. Take the supplements that are recommended to you
They do not provide immediate relief from being able to sleep, but they reduce the frequency and duration of acute episodes in the long run. If you are already taking prescription drugs to treat gout, consult your doctor before considering such products; also, be sure to carefully follow the directions on the package regarding dosage. Among the most useful for your situation are:
- Omega-3 fatty acids, especially EPA;
- Bromelain: an enzyme extracted from pineapple that is often used to treat digestive disorders, but for gout it acts as an anti-inflammatory;
- Folic acid: a B vitamin that acts on the same enzyme (xanthine oxidase) that is inhibited by the drug allopurinol, thereby reducing uric acid levels;
- Quercetin: a bioflavonoid that works by inhibiting xanthine oxidase;
- Devil's claw (Harpagophytum procumbens): it is traditionally used to treat gout because it is able to reduce uric acid levels;
- If you suffer from gout, you should avoid vitamin C or niacin supplements, as both increase the levels of the "offending" acid.
Part 5 of 5: Recognizing Gout
Step 1. Look for symptoms
Usually, they appear suddenly and often during the night; the main ones are:
- Intense pain in the joints, usually feet, ankles, knees and wrists, although the most affected is usually the base of the big toe;
- Gout usually affects only one joint at a time, but in some cases several are involved, especially if there is an underlying cause that is not being managed;
- Joint discomfort after the initial attack
- Redness and other signs of inflammation, for example warmth, swelling and tenderness to the touch
- Reduced range of motion of the affected joint.
Step 2. Evaluate whether eating can promote the disorder
A diet based primarily on purine-rich, high-fructose foods and drinks (such as sodas and soft drinks) may increase the risk of gout; foods that can potentially trigger an attack are:
- Beer and spirits;
- Sugary drinks;
- Fatty foods (fried, butter, margarine, high-fat dairy products);
- Offal (liver, kidney, brain);
- Beef, chicken, pork, bacon, veal, venison;
- Anchovies, sardines, herring, mussels, cod, scallops, trout, haddock, crab, oysters, lobsters, shrimps.
Step 3. Examine the risk factors
Gout can develop at any age, but is more common in adult men and postmenopausal women. However, there are several elements, besides nutrition, which can greatly affect the pathology; among these consider:
- Obesity or overweight;
- Untreated hypertension, diabetes, metabolic syndrome, heart and kidney disease;
- Drugs, including thiazide diuretics, low dose aspirin, immunosuppressants;
- Family history of gout
- Recent surgery or trauma: If you monitor the amount of purines in your diet, but drop a heavy object on your big toe, you could trigger an acute attack of gout.
Warnings
- If your symptoms don't improve within 2-3 days, see your doctor.
- If you are taking any medications, be sure to tell your doctor if you decide to take any supplements or herbal products.
