If evening gout flares are keeping you up, know you’re not alone.
How to Stop Gout Pain at Night
Dr. Brittany Panico, gout specialist and Chief of Rheumatology at Summit Rheumatology works with patients who suffer from chronic gout, including gout pain at night.
“Gout is not your fault and flares are not your fault. We are here to help you take control of your gout and understand if seeing a rheumatologist is the next best step in your care. We are ultimately here for you, and will work alongside you to decrease the burden and pain that having gout attacks causes.”
Thankfully, there are steps you can take to prevent or relieve gout pain at night. Many of these remedies are only temporary, and will not cure gout or completely resolve your gout symptoms and pain. Relying only on at-home gout remedies or over-the-counter medications for gout is often not enough to properly manage the underlying cause of gout, or even manage pain.
“If you are someone who suffers from more than 2 gout attacks in 6-12 months, it is time to start treating your gout,” says Dr. Panico. “You will likely find that the flares start happening closer together and take more time to resolve. So treating flares is about treating the pain you are having in the moment, and also treating the underlying high uric acid levels that will lead to the next flare. “
Preventing Gout Pain at Night
Prevention is the most important step you can take to avoid gout pain at night. Gout attacks typically strike when there is a buildup of uric acid in the blood. Your kidneys can only filter a certain amount of uric acid. When the levels in the body are too high, the excess crystallizes and settles around the joints. These uric acid crystals are the cause of inflammation and joint pain in individuals with chronic gout.
“Gout is a systemic, or whole-body condition that causes severe joint pain and swelling, potentially damage to the joints, and can be linked to increased risk of heart disease, type 2 diabetes, and kidney disease,” says Dr. Panico. “When we think about preventing gout, it is also about preventing the long-term complications that this disease can cause. “
There are a few preventative habits you can start practicing today that may help prevent uric acid levels from elevating.
Stay Hydrated During the Day
One of the simplest ways you can help prevent gout pain at night is to make sure you drink plenty of water throughout the day. Water helps your kidneys to work properly and can help them to better filter out excess uric acid.
Plus, drinking enough during the day can help prevent nighttime dehydration, which may increase gout pain at night. If you are concerned about drinking too much water right before bed, try increasing your water intake throughout the day. Carry a reusable water bottle and make sure to take frequent sips.
Cut the Sugar
Sugar and gout aren’t a great combo. There is strong evidence to suggest that sugars and dietary fructose are a contributing factor to gout. This includes sugary drinks and food items with corn syrup and high fructose corn syrup.
When it comes to sources of natural sugar, like fruit, you can still enjoy these in moderation.
Dr. Panico recommends cherries to curb your sweet tooth.
“Tart cherries are an excellent way to combine something sweet with a natural way to lower inflammation caused by gout. You can enjoy dehydrated tart cherries or tart cherry juice without added sugar.”
Avoid Alcoholic Beverages
Alcohol, especially beer, contains high levels of purines which ultimately convert into uric acid in the body. Frequent consumption of alcoholic beverages can cause a buildup of uric acid in the body and cause gout pain at night.
Remember, the kidneys also filter out alcohol, and consumption can decrease kidney function when it comes to eliminating uric acid.
Managing Gout Pain at Night
If diet and lifestyle changes aren’t preventing nighttime gout attacks, it’s time for a visit with your provider or rheumatologist. They can help manage gout pain and lower uric acid levels with medications that aren’t available over the counter.
“There are several excellent medications that help get to the root of why gout happens in the first place, and this all starts with lowering the uric acid levels in the blood,” says Dr. Panico. “When considering the right medication to treat your gout, there are factors that we can discuss during an office visit to decide on the best treatment plan for each individual.”
In the meantime, there are a few tips you can try to alleviate gout pain at night.
NSAIDs for Gout
Anti-inflammatory medications like ibuprofen can offer short-term relief. But caution is advised, as extended use of these medications can increase the risk of gastrointestinal bleeding and stroke.
Colchicine is also a potent anti-inflammatory and is available as a prescription. This medication is excellent at decreasing flares associated with gout and can be taken at the onset of a flare to reduce pain.
Elevate Joints to Reduce Gout Pain
Raising the affected joints can help reduce gout pain at night because it can reduce blood flow and minimize swelling in the area. For gout in the big toe or foot, you may use a pillow to elevate the joints. Ideally, you should elevate the area so it is above the heart when lying down.
Ice for Gout Pain at Night
Ice helps minimize inflammation and swelling. If you have an ice pack, you can apply it to the affected area and leave it on the joints for around 15 to 20 minutes. If you plan to reapply, it’s recommended to wait 30 minutes.
You may also make your own icepack by putting ice cubes in a zip lock bag or using a frozen bag from your fridge. Do not apply ice directly to your skin. Homemade ice packs should be wrapped in a paper towel or a dish towel before applying to the joints.
If you are experiencing more than 2 gout attacks in 6 months, ongoing joint pain or swelling, or have developed bumps (tophi) around your joints, it’s time to visit your provider or rheumatologist. A gout specialist can prescribe the appropriate medications to take control of chronic gout and lower uric acid levels.
Our team of rheumatologists at Summit Rheumatology is currently accepting new gout patients in Gilbert, Surprise, Casa Grande, or via telehealth. Give us a call at (480) 494-2770 or send us a message to schedule your gout appointment.