If you have gout and suffer with gout attacks, when is the right time to seek medical attention for a gout flare? You may have learned (through trial and error, perhaps) what to do to get through the initial pain of a gout attack. Many people who have the condition follow one or more of these steps to get relief from gout flares1:
- Take an over the counter NSAID (not aspirin, though, as aspirin can make a gout flare worse)
- Apply ice or a cold pack
- Drink lots of water
- Rest and/or elevate the joint in a comfortable position
- Try to relax
- Avoid the foods and drinks that can trigger a flare or make it worse (eg, red meat, shellfish, alcoholic beverages)
But what if you’re having unusual symptoms, like fever or back pain? When should you seek medical attention for gout flares that are becoming more frequent and/or severe?
Seek medical attention for a gout flare if you are running a fever
What’s worse than a gout flare? Having a gout flare and a fever. If you run a fever during a gout attack, call your doctor right away.2 Although fever does occasionally accompany gout flares (especially in older patients2), it can be a sign of septic arthritis, which is a serious infection in a joint3. This kind of infection can start when germs travel through the bloodstream from another part of the body to the affected area.3 Septic arthritis is most common in the knee but can affect other parts of the body as well, including the hips, shoulders and other joints.3 These infections are especially dangerous because they can quickly and severely damage cartilage and bone.3 Be sure to contact your doctor and seek treatment right away if you are having gout flare symptoms and running a fever at the same time.3
Seek medical attention for a gout flare if you have lower back pain
In most people with gout, flares tend to occur in the big toe or other extremities first.4 However, gout does not affect everyone in exactly the same way.4 If you have consistently high uric acid levels and you’ve recently had unexplained back or neck pain, numbness or tingling sensations down your arm or leg, there is a small chance it could be gout.4 Though gout in the spine is very unusual, Theodore Fields, MD, a rheumatologist in The Hospital for Special Surgery in New York City, says it is more common than many people might think.4 According to Dr. Fields, “Gout can travel to almost any joint over time.”4 So if you have back pain and a history of gout, talk with your doctor.4
Seek medical for a gout flare if your gout flares are becoming more frequent and/or severe
In the early stages of gout, the sudden and intense pain and inflammation that accompanies gout attacks typically lasts only a day or two.5 During the periods between gout flares, the joints feel fairly normal and function as they are supposed to.5 If your gout goes untreated over a period of several years, however, you may begin to experience flares more frequently.5 Even more concerning, your gout flares may become increasingly severe, longer-lasting and involve multiple joints.5 All of these symptoms are your body’s way of telling you that your gout is becoming more serious.5
Medication may help prevent gout attacks6
If you are experiencing several gout flares each year or if your gout attacks are increasingly painful, make an appointment to see your doctor.6,7 Your doctor can help you manage the condition and maintain your health. If you are not yet taking a urate-lowering treatment (ULT), your doctor may have you start one.6,7 And whether you’re new to ULT or have been taking it for years, be sure to ask your doctor about adding a colchicine therapy.8,9 Adding colchicine (eg, Mitigare® (Colchicine) 0.6mg Capsules or ) to your regimen may help reduce the frequency and severity of your gout attacks.8-10 to your regimen may help reduce the frequency and severity of your gout attacks.8-10 For more information about colchicine and how it can prevent gout attacks, click here.10
Mitigare® is a registered trademark of Hikma Pharmaceuticals USA Inc.
Colchicine 0.6mg capsules are contraindicated in patients with renal or hepatic impairment who are currently prescribed drugs that inhibit both P-gp and CYP3A4. Combining these dual inhibitors with colchicine in patients with renal or hepatic impairment has resulted in life-threatening or fatal colchicine toxicity. Patients with both renal and hepatic impairment should not be given Mitigare®.
Fatal overdoses have been reported with colchicine in adults and children. Keep Mitigare® out of the reach of children.
Blood dyscrasias such as myelosuppression, leukopenia, granulocytopenia, thrombocytopenia and aplastic anemia have been reported with colchicine used in therapeutic doses.
Monitor for toxicity and, if present, consider temporary interruption or discontinuation of colchicine.
Drug interaction with dual P-gp and CYP3A4 inhibitors: Co-administration of colchicine with dual P-gp and CYP3A4 inhibitors has resulted in life-threatening interactions and death.
Neuromuscular toxicity and rhabdomyolysis may occur with chronic treatment with colchicine in therapeutic doses, especially in combination with other drugs known to cause this effect. Patients with impaired renal function and elderly patients (including those with normal renal and hepatic function) are at increased risk. Consider temporary interruption or discontinuation of Mitigare®.
The most commonly reported adverse reactions with colchicine are gastrointestinal symptoms, including diarrhea, nausea, vomiting and abdominal pain.
NOTE: This article was not written by a medical professional and is not intended to substitute for the guidance of a physician. These are not Hikma’s recommendations for gout flare prevention, but rather facts and data collected from various reliable medical sources. For a full list of resources and their attributing links, see below.