The gout support forums are often used to discuss the length of time for a gout attack.
Questions vary, but the common theme is stubborn or prolonged gout that lasts much longer than the usual three days to a week.
It goes without saying, that if gout is failing to respond to treatment, then you must see your doctor. It is perfectly possible to have some other health problem, in addition to gout. It is also possible that gout was misdiagnosed. But you may be wondering how prolonged gout attacks occur, or what specific questions to ask your doctor.
The first point to bear in mind is that gout is a progressive disease. If you do not control uric acid levels properly, gout attacks become more frequent and last longer. What appears to be 2 weeks of gout pain might well be 2 or 3 separate flares, so close together, they merge into one.
The biggest factor that affects how long a gout attack can last is your specific gout treatment.
Gout pain is caused when uric acid crystals form, and it can also occur when they dissolve. It is common for the early stages of uric acid lowering treatment to trigger gout flares. The flares from partially dissolved crystals are usually much less severe, and can easily be controlled by adequate pain relief. For this reason, I recommend you ask your doctor to provide colchicine as a preventative for two weeks whenever you start uric acid lowering treatment, or increase your dose.
This effect of allopurinol, febuxostat, and other uric acid lowering treatments is another reason why gout attacks might last longer than normal. If the dose is inadequate, you can end up with uric acid crystals forming, then dissolving. This happens where uric acid fluctuates in the 6 to 7 mg/dL range (0.36-0.42 mmol/L). It is far too common, and you must check your blood test results carefully to ensure that you stay in the safe range of 5mg/dL (0.30mmol/L) or below.
So if you are wondering how long do gout attacks last, the answer depends on the current stage in your treatment plan.
If you are not controlling uric acid, then joint pain will eventually be continuous. At first, this is due to increased frequency of gout attacks. Eventually, it is due to crumbling joints that have been destroyed by uric acid crystals.
For the first few months of uric acid lowering therapy, you may experience flares of a few days. These should be easy to control with adequate, gout strength pain relief.
Gout attacks should never last more than a few days, but if they do, you must seek medical attention to ensure that your uric acid level is in the safe range, and to rule out any co-existing medical problems.
To be sure that your pain relief combination is adequate, please see my Gout Pain Freedom article. If you are experiencing prolonged gout attacks, and need more guidance about what to ask your doctor, please ask in the gout support forum.
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