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The goals of treatment for gout are fast pain relief and preventing future gout attacks and long-term complications, such as joint destruction and kidney damage.
Specific treatment depends on whether you are having an acute attack or are trying to manage long-term gout and prevent future attacks.
To treat an acute attack
To stop a gout attack, your doctor can give you a shot of corticosteroids or prescribe a large daily dose of one or more medicines. The doses will get smaller as your symptoms go away. Relief from a gout attack often begins within 24 hours if you start treatment right away.
To ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another anti-inflammatory medicine can also help you feel better. But don't take aspirin. It can make gout worse by raising the uric acid level in the blood.
To manage long-term gout
If you've had gout symptoms off and on without treatment for several years, they may become ongoing (chronic). And they may affect more than one joint.
To manage long-term gout and prevent future attacks, your doctor can prescribe a medicine to reduce uric acid buildup in your blood.
If needed, your doctor may prescribe a medicine to treat tophi. These are chalky nodules that form from uric acid crystals. They may first appear as nodules on the hands, elbows, or ears. Drugs called xanthine oxidase inhibitors may shrink the tophi until they disappear. In rare cases, surgery may be done to remove large tophi that are causing deformity.
Long-term medicine treatment depends on how high your uric acid levels are and how likely it is that you will have other gout attacks in the future.
After an acute attack of gout, talk with your doctor about what's causing the high uric acid levels in your blood. A review of your overall health may reveal diseases, medicines, and habits that could be raising your uric acid levels.
If there is swelling that causes pressure in a large joint such as a knee or ankle, your doctor may relieve the pain and pressure by aspiration. A needle is inserted into the joint. Then fluid is drawn out (aspirated) with a syringe connected to the needle.