In my gout pain relief pages, I explain the best approach to gout pain.
The main difficulty with stubborn gout pain is, it rarely responds to a simple treatment. Usually, you need a combination of more than one pain-relieving drug. Often these combinations need to include general painkillers that are not specifically for gout.
Recently, I was asked about combining indomethacin with colchicine for relieving stubborn gout pain.
There are thousands of different combinations that work.
The secret is finding the right combination that suits you.
Colchicine For Stubborn Gout Pain Relief
Gout pain, as I explain in the Uric Acid guidelines, is a result of the immune reaction to invading uric acid crystals. When the immune system becomes overwhelmed, it calls in reinforcements, and this process is at the heart of the agony we experience during an acute gout flare.
Colchicine, sold as Colcrys in America, is very effective when it is taken early enough. That is why doctors advise you to take it at the first sign of a gout flare. The main purpose of colchicine is to prevent, or limit, gout flares when you take uric acid lowering gout medications.
Colchicine works to prevent gout pain, or prevent it getting worse, by slowing your immune system. White blood cells are restricted from growing, and this limits the inflammation that is part of that process.
Unfortunately, it only stops inflammation spreading. It does nothing to help reduce existing inflammation and nothing to help relieve existing pain. In most cases, the inflammation will disperse naturally in a few days, but if the stubborn pain is too much to bear, you can supplement colchicine with other gout pain relievers.
NSAIDs For Stubborn Gout Pain Relief
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are used for many diseases. They are commonly prescribed for gout patients because they are effective at reducing the inflammation that is part of gout pain. There are lots of different NSAIDs, with indomethacin, diclofenac, ibuprofen, and naproxen being particularly popular for gout patients.
Different NSAIDs should not be mixed. That means, for instance, you cannot take diclofenac and indomethacin together. From discussions in the gout forum, I’ve learned that people react differently to specific NSAIDs. Some people prefer naproxen, others prefer ibuprofen, etc. If you don’t get on with a certain NSAID, talk to your doctor, who can suggest alternatives. NSAIDs can be taken alongside colchicine, or with pain-blocking analgesics, or by themselves.
I recommend colchicine with a NSAID. This two-prong attack on gout pain stops inflammation spreading with colchicine, and it reduces inflammation with a NSAID. In most cases, this is enough to get you mobile and live a normal life. For the stubbornest of stubborn gout pain, there is a third line of attack.
General Analgesics For Stubborn Gout Pain Relief
Analgesic simply means pain-killer. There are hundreds of different types in addition to colchicine and NSAIDs. Many of these are available without a prescription, but you must make it clear to your pharmacist that you are already taking gout pain relief. You should describe exactly which medicines, and their dose, and explain how mobility or other functions are still limited by pain and/or swelling. If in doubt, discuss this with your doctor.
Stubborn Gout Pain Relief: Next Steps
You can see that many pain-relieving drugs can work together to eliminate even the most stubborn gout pain. There are hundreds of choices that make thousands of combinations. It is up to you to understand how each treatment works, and you must consult with your doctor to get the best treatment that suits you. You can find out about individual gout medicines by typing the exact name into the search box at the top of each page.
If you are not sure how different gout pain relief treatments work, you can ask in the gout treatment forum. However, you must not ask about specific combinations. Whilst many combinations are safe, some are dangerous, and only your doctor can advise what is right for you, with regard to other medicines, and your medical history.
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Relief From Stubborn Gout Pain Comments
GoutPal visitor responses and associated research include:
Indomethacin and Ibuprofen Together for Gout
I have been told that I have gout in both my feet(insteps mainly). Now this is on going on a daily basis. So I use Ibuprofen 400 mg 3 times daily. Why does the gout not stop for at least a week and seem to be more irritated if I am not using the Brufen?
I have only had this for about 4 months and it does not subside to go off the meds at all right now. I am keeping an eye on my diet. What else do I need to do? You mentioned “combining indomethacin with colchicine for relieving stubborn gout pain”. Will this also work for combining with my ibuprofen?
We exchanged a few emails in response to this. And the summary of my responses was:
- You cannot combine indomethacin and ibuprofen. They are similar drugs called NSAIDs. So you only use one of these. Your doctor or pharmacist can help you decide which one might be best for you. It is vital to get your gout medicine combinations checked by qualified health professionals before you start taking them. That applies to Over The Counter as well as prescribed gout medicine.
- I mentioned that colchicine is mainly for limiting gout flares during uric acid treatment. I must emphasize the importance of this. Also, it applies to all gout pain relief. After your second gout flare, you must start uric acid treatment. But it takes a few months to dissolve old uric acid crystals. So you need your pain relief combination during those months. Again, make sure you discuss this fully with your doctor.
- Those discussions with health professionals are vital to the success of your gout recovery. So ask in the gout forum if you are not sure how to discuss your concerns. Or if you don’t fully understand the advice you get.
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