What should I do during a gout flare in my knee?

The first 24 hours

• Rest the knee and avoid walking long distances; crutches help if standing is very painful
• Elevate the leg on pillows when sitting or lying
• Use a cold pack wrapped in a cloth for 15 to 20 minutes several times a day; avoid direct ice on the skin
• Drink water regularly and avoid alcohol and sugary drinks
• Start the flare medicine you have been prescribed as soon as symptoms begin, because early treatment usually works better

Medicines doctors commonly use

Most flares are treated with one of three options: an anti-inflammatory tablet, colchicine, or a short course of steroid. The choice depends on your kidneys, stomach, heart, diabetes and other medicines, so it should be agreed with a doctor rather than borrowed from someone else.

When a single large joint like the knee is affected, a steroid injection into the knee can calm the flare quickly, often after fluid has been drawn off to relieve pressure. This is only done once infection has been ruled out.

What not to do

Do not stop a regular uric acid-lowering medicine such as allopurinol during a flare unless your doctor advises it; stopping and restarting can cause further attacks. Do not start one for the first time in the middle of a flare without medical advice either.

Avoid massaging or heating the knee, and do not try to exercise through the pain. Gentle movement of the ankle and hip keeps the leg comfortable while the knee settles.

When to get help in Doha

Go to an emergency department if you have a fever, feel unwell or cannot bear weight, or if the knee has recently been injected or operated on. Book a review if the flare has not improved after a few days of treatment, or if attacks keep returning. At Aman Hospital Dr. Gelber can confirm the diagnosis with a fluid sample, treat the knee and discuss a long-term prevention plan with you and your GP or rheumatologist.