Quick questions about recovery options

[gout1]

I’ve recently had a flare up and was told I had gout in my right ankle. It was over a month ago, the initial severe pain went away after four days or so but I’m still having a lot of difficulty walking and putting weight on my right foot and I keep getting repeat mini flare ups where the swelling goes up again and it’s quite painful. I did have three days last week where I got around 60-70percent mobility back in my ankle and was able to walk around like normal without any pain but the pain soon returned.

My question is, while all this is still going on should I still be keeping weight off of it or is it fine to walk around? I’ve gone out a few times walking (actually more like limping) 1-3km each time when the pain is bearable, for exercise and thinking that it helps to strengthen and recover the affected area better but I don’t know if this is actually good or bad for it.

Secondly, what are your thoughts on using wraps and braces? I have an elastic brace I use to restrict the movement which helps with my ankle, I also use a sleeve for when it’s not as swollen but I’ve noticed with both that after more than 30 minutes or so of use the pain actually gets worse. I’ve also tried wrapping an elastic sports wrap around it and after some time removing it resulted in a much more swollen ankle before applying the wrap.

I’ve recently been told I have gout, I don’t have another follow up for another month so any input or advice on the recovery aspect of it would help. Thanks.

[Keith Taylor (GoutPal Admin)]

In my opinion, gentle exercise such as walking or swimming is good. Gout weakens joints, so it is important to avoid any exercise that could induce stress to any joint. Though you are currently experiencing a gout flare in one ankle, you can be certain that other joints are also being attacked by gout – joint weakness starts before an acute gout attack.

When not exercising, it helps to keep the affected joint area raised and rested.

I believe wraps and braces are far superior to ice for non-medicine gout pain relief. However, they will only provide slight relief. My personal preference is to rely on drugs to ease gout pain, hence my Acute Gout Attack Treatment Plan. Some people find relief in herbal anti-inflammatory preparations or diets, but I have found nothing strong enough to match the pain of acute gout attacks. I have had some success with TENS machine to relieve gout pain, but I never persevered with it beyond borrowing a machine for a short time. In my case, the cost of a TENS machine compared to medical pain relief made me choose drugs. You could also check other forms of non-medicine gout pain relief.

[gout1]

Thanks for your input Keith. I’ve been taking low doses of ibuprofen almost daily for a month or so now, I take Indomethacin only when the pain is extremely severe or if I need a bit of buffering from the pain to be able to use the foot when I need. I try not to rely too much on these pills; I can take the pain from gout quite well as long as I’m well situated and able to elevate my foot and ice it when I need. I envision several more years of having to deal with this issue so for now I will keep the drugs to a minimum while I’m able to deal with it well.

I’ve only just started to learn of the extent of the damage this causes. A month ago when I thought it was only Peroneal Tendonitis I looked up a few ankle strengthening exercises and stretches but now I’m not sure if I should treat it as such and go about recovery in the same manner. Should I make efforts to strenghten and stretch it while recovering from a flare up like an injury or is it best to wait until it’s totally gone before I move it around?

[Keith Taylor (GoutPal Admin)]

Ibuprofen and indomethacin are both NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). As such, they are interchangeable according to personal preference, but should not be taken together, unless advised by a qualified medical practitioner (which I am not).

Uric acid crystals start to weaken all aspects of joints long before you get your first gout attack. This has been proved by recent DECT images of gout, though has not become widely acknowledged in frontline medical practice. Bones, tendons, cartilages, and ligaments are all at risk. I get the impression from what I’ve read that tendons are first to suffer noticeable damage. The mechanics involve young specialist cells that are destined to repair joint tissues as they grow and wear out. These young cells get caught up in the battle between the immune system and uric acid crystals. Prior to a full blown gout attack, such battles often go unnoticed, but joints become weaker.

As I often repeat, I have no medical training, but common sense tells me that in these circumstances, attempts to strengthen and stretch tendons and ligaments carries a very high risk.

I’m as bad as the next man for delaying the treatment to lower uric acid that gives a chance of joint recovery. It took a broken knee that I dismissed as a gout flare before I came to my senses – relatively of course 🙂

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