Is Gout Painless?

Why would I think gout is painless?

Am I mad?

There you are, crying in agony, and I ask stupid questions! But is it really stupid?

Painless Gout

For most gout sufferers, pain relief is our primary goal. The more sensible will seek permanent control of gout through safe uric acid management. That stops pain returning but takes a few months. In the middle of a gout attack, all we want to do is stop the pain.

In fact, I discussed this at length when I wrote about finding freedom from gout pain.^[1] That is a formula for getting rid of gout pain, and I am expanding the principles in my Stop Gout service.^[2] You will be able to generate your own personal gout treatment plan to get rid of gout pain in a way that suits you.

But, getting rid of gout pain does not get rid gout. Treating pain alone, just leaves more uric acid crystals growing all around your body, slowly destroying your joints and damaging your organs. In between attacks, you have painless gout. With practice, you can learn to block gout pain as soon as you feel the first twinge. In fact, some gout patients take preventative pain relief. They experience painless gout, but as well as failing to stop serious damage from uric acid crystals, they risk serious illness from long-term pain relief drugs.

Now that you understand that painless gout is possible, I hope you also understand that it is only desirable as a temporary measure until you control uric acid properly. Now that you understand painless gout, spare a thought for people who are cursed with it.

The Curse Of Painless Gout

Gouty Tophi Can Be Painless Photograph — Does painless gout exist? You still have gout if you block the pain, but true painless gout is worse. See the curse of patients with gouty tophi without pain.

When I was searching for some case reports about gouty tophi, I was struck by the number of times the word painless occurred. Apart from those times when painless means “with very little effort,” it is a word rarely associated with gout, and immediately grabbed my attention.

I will add more summaries of individual cases to my tophi guidelines. For now, I want to explore some extreme effects of painless gout.

Most gout sufferers only ever seek treatment because they cannot bear the pain of gout. Even where regular health checks reveal high uric acid, you will never get treatment for it under normal circumstances. Doctors are loath to treat high uric acid with no gout symptoms.^[3] This fails us on two counts:

Doctors frequently ignore uric acid above safe levels if it is statistically average ^[4]
Lack of immediate painful swollen joints does not mean joints are safe. Modern techniques have revealed that crystals start destroying our joints long before they cause gout flares.^[5]

The gout flare is the end stage of a process that starts with uric acid crystals growing in the body. This leads to an immune response with white blood cells attacking the crystals that MIGHT cause painful inflammation. It relies on sufficient numbers of free uric acid crystals circulating at the same time, and it relies on the immune system of the individual. Some people do not react easily to uric acid crystals, with the damage you see above being apparent before any joint pain is experienced.

Pain Free Gout — When can you see Painless Gout?

Painless Gout: Next Steps

Just because gout stops hurting, uric acid does not stop destroying your body. Always stay safe at 5 mg/dL (0.30 mmol/L) or below. Never rely on anyone to check your results. After every test, insist on knowing your number, and insist on treatment if that number is above safe levels.

Painless Gout Searches

I’ve covered many of the topics here in more depth. The easiest way to find more information is to search for the topics in the search box below (or near the top of every page):

Pain Freedom Or Gout Freedom?
Stop Gout: Personal Treatment Plan
asymptomatic hyperuricemia
Normal Uric Acid? No Thanks!
DECT Uric Acid Bone Erosion

The quickest way is to triple-click the phrase you are interested in, and drag it to the search box. Along with my guidelines, your search results may include relevant discussions. Join those discussions if you have relevant questions, or start a new forum discussion to ask your questions or share your opinions and experiences.

Leave Painless Gout to read more Gout Facts.

Painless Gout Comments

GoutPal visitor responses and associated research include:

Asymptomatic Hyperuricemia

Frank wrote…

I have the Tophi white lumps on some of my fingers which my doctor confirms are the uric acid crystals. However, I have never experienced any typical gout pain. It is as if the uric acid excess is developed these lumps but not penetrated the joints. Is there anything which can remove these lumps? It would appear that even reducing my uric acid levels {last test 520 [520 μmol/L = 8.74 mg/dL]} would not necessarily evidence itself by the lumps disappearing.

Gout pain happens when our brain interprets signals from our immune system as pain. So it’s a complicated series of reactions that does not always happen in every person. Medically, this situation of excess uric acid without a gouty pain reaction is called Asymptomatic Hyperuricemia. If this progresses far enough, then tophi can develop, as in Frank’s case. Removing the lumps is an advanced gout management topic beyond the experience of most family physicians. Because it involves very low uric acid targets or surgery. So discuss that with a rheumatologist with extensive gout experience.

Please remember: to find more related pages that are relevant to you, use the search box near the top of every page.

Common Terms: asymptomatic, gouty tophi definition, Tophi