Stubborn Gout: 2012 Update

This discussion on How Long Does a Gout Attack Last? is now closed.

Please see the new discussion about stubborn, or prolonged gout, by following the link at the end of that article.

A recent comment from a reader about stubborn gout pain has set me thinking. I started writing a short comment reply, but as I thought about the problem, I realized that this subject deserves it’s own article.

Tom wrote about his stubborn gout pain:

I have used prescription NSAIDS (Ibuprofen,Indicin, etc.) to successfully treat a gout attack that affected my toes, ankles and knees.

Second and subsequent gout attacks did not respond to NSAIDS and I tried fresh cherries, dried cherries and cherry juice concentrate. The Cherries worked at first and then failed to give relief.

Next, I tried Colchicine and that worked – with gastric upset side-effects.

I’ve also noticed a difference in pain treatment response to different attacks. The pain is caused by a complicated immune response that scientists are only just beginning to understand.

Gout flares last for a varying number of days. Sometimes one or two days, other times one or two weeks.

A common problem is that once uric acid crystals form, all other things being equal, uric acid in the blood will fall. If this goes far enough, crystals will dissolve again, causing more pain, and so the cycle goes on – often with different joints suffering.

Long term, you must manage uric acid and keep levels down. This is vital to avoid joint damage and tophi, but may well increase pain initially. You have to go through this to avoid more serious damage, so you will need pain relief at the same time.

Whether you take pain relief every day as a precaution (prophylactic) or just as you need it, is something you must discuss with your doctor. Many doctors prescribe a short course of pain relief to accompany long term uric acid lowering medication like allopurinol.

My personal choice for pain relief is to take it as I need it, but everybody has different views, and an informed chat with your doctor is the best way to work out what is right for you.

Whatever you do, you need a range of different pain relief treatments. If one doesn’t work, then try another. Doctors commonly prescribe a combination therapy with different medications being taken either together or alternately.

Don’t forget the non-medical options either. Ice treatment, or massage is not good for gout, but heat therapy can help stubborn gout pain. Many gout sufferers get help from TENS or Infra-red machines, or simply from keeping the joint wrapped and warm. You can learn more about these on my gout pain relief page.

Stubborn Gout: 2012 Update

This discussion on How Long Does a Gout Attack Last? is now closed.

Please see the new discussion about stubborn, or prolonged gout, by following the link at the end of that article.


  • Ken

    I am ready to cut my leg off at this point. I use to get 1 or 2 flare ups a year in my ankle. Around September of this year, (2008), I was dignosed with gout in my knee. They drained it, gave me prednisone initially since my usual indomethacin didn’t seem to work. Subsided for about a week and here it is the beginning of December and my knee is still swollen and I am in pain about every other day. That is why I am ready to have my leg cut off. I am only 38 years old and have no history of gout in my family. I have had an MRI, I have been poked and drained, and given more blood this year than my entire life yet I am still in sever pain at least 3 or 4 days a week. It is affecting my sleeping, my mood is cranky for lack of sleep, and I am, (or was), an active person. Someone please point me in the right direction, I am miserable with this gout.

  • You will never get rid of gout pain unless you get rid of the excess uric acid that is causing it.

    Either you’ve not been told this before, or you have been told it and chose to ignore the advice.

    If you have not been advised to lower uric acid, change doctor. Today. Find a rheumatologist who has experience with gout patients and focus on lowering your blood uric acid below 6mg per dL. This will take a few months during which time the gout flares will continue, but will get easier and less frequent. Your rheumatologist will advise you on different pain relief choices to help you through these brief pain periods.

    If you have ignored advice to lower uric acid then wake up to the dangers of gout. Then follow the advice above.

  • Sid Barua


    I am 32, suffering from gout for the last 13 yrs. It runs in my family, although my dad’s gout is controlled. I get an attack usually once a month and usually control it with Nasid and colchicine( it usually affects my toe or ankle or the knee) However for the last ten days I am under a severe attack on my kee…colchicine or voveran is not providing any relief. Please help!!

  • zip2play

    I have just gone through a bout of right knee pain that lasted over a month. I don’t know if it IS or it ISN’T my gout acting up.
    If it IS gout, then it is a lot more resistant to treatment than my smaller joints. It is also harder to “see” knee swelling than swelling of a small joint like the big toe or a finger.

    Are you taking enough colchicine? One or two won’t stop a full blown attack. I need 8 or 10 or more once the attack is in full bloom.

    Which NSAID are you taking…I find naproxyn (Aleve) to work best at 800 mg./day (two 12 hour doses.)

    But again, it’s hard to diagnose knee pain becasue they are so prone to injury and once injured take so very long to heal.

  • Sid Barua

    Yeah, thanks a lot. I am right now on indomethacin, its helping me. The pain has reduced although the knee is very stiff…I m finding it difficult to walk. My doc has also not ruled out that it could be an accumulation of sinovial fluid in the knee coupled with gout. If it does not settle down within a week, he might give me a shot of steroid. Anyway thanks for answering my call…really appreciate it.

  • zip2play

    I’m toying with asking for a steroid shot in might right knee also. It’s either that or a month off from the gym to keep from reinjuring it. I find a heating pad helps a lot.

    Sid, with attacks as frequent as once a month you REALLY should be on daily allpurinol. It can make these attacks a thing of the past…at least the FOOT attacks

  • Sid Barua

    Yeah, I m planning to get a shot of steroid. I m also suffering from bad cluster headaches, which are incidentally also a level 9 pain. I m trying to get over my clusters. I m based in India, which does not have many rheumatologist specializing in gout. Once I get over this attack I m surely going to get on a long term allpurinol regime.

  • jane clark

    my husband has had a bad attack for about two months. how long can an attack last? both feet are very swollen and he can hardly walk at all.

  • sidbarua

    Hi Jane

    I am very sorry to hear about your husband. I have been a veteran gout sufferer for last 12 years. My last attack in the knee lasted for almost two months. However have found an almost miracle cure….it is an antacid tablet called Alka Seltzer Gold. The basic composition is citric acid(which makes the uric acid more solvent), potassium bi-carbonate and sodium bi-carbonate (which essentially have alkalizing properties). The trick is to break one tablet into two halves and dissolve each half into a glass of water. One can have upto eight tablets within 24 hrs. But be sure to follow it up by having lots of water. My last attacks disappeared within couple of hours of following this regime. And of course your husband has to be on allpurinol regime. However just to caution you do not get the ordinary Alka Seltzer as it contains aspirin which may aggravate the gout. Be sure to get Alka Seltzer Gold. Hope this helps. Let us know how it goes.

  • Dave Bucks

    I have been suffering now for 9 weeks, every day limping about, not able to work, or play with the kids. I read as much as possible about gout, during my broken sleep due to the pain I read about diets medication, prevention etc. I have drastically changed my diet, but the gout fluctuates between 5-10 on the pain barrier, changing daily. The gout is in my ankle, resting the foot helps a little as does a hot bath, would a foot massage help or hinder, I have swelling that’s gone from my ankle bone to the top of my foot, fortunately I have a wonderful loving wife, that supports me every day. The big question is, is 9 weeks normal or am I missing something else, as 2 weeks appears to be the norm…
    Many thanks in advance

    • ttripletmomme

      My husband gets an attack once every couple of months, and each time he gets it so does his dad and a couple of their friends. He gets it more offen than what they do but he takes proben/colchercine, he tried the allipurinol but it had an adverse effect on his body, it made is blood critically thin. The longest attack that he has had so far lasted five weeks, the norm is usually a couple of weeks on crutches and a course of steriods. My husband started having gout when he was around 27 years old, hes 42 now and it only gets worse with each episode. Now he also has a hole in his esophagus, and has to take another medicication for that. He usually gets gout in his ankles, knees, and feet, but more recently he has gotten it in his toes too. We have read where people have reported getting it in their ears, that would be even more horific. Even when he isnt experiencing gout, he is in pain from all of the damage that it has already left behind. We have a teenage son and eight year old triplet boys, that he can no longer play with like he wants to due to the long term effects that gout has left behind. I really sympathize with anyone who has to go through this, and I hope that you have an understanding spouse to help you through it.

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