Gout cold compress or hot compress? What is the best treatment?

Gout is a very common disease in our lives. Generally speaking, after suffering from gout, everyone needs to know more about the treatment methods of gout, massage, cold compress or hot compress for gout?

Cold or hot compress for gout?

Gout is caused by excessive uric acid in the body. Uric acid is deposited in the form of tiny crystals in the joint bursae, tendons, cartilage and other soft tissues around the joints. After being phagocytosed by a large number of white blood cells, they are destroyed, releasing lysozymes that destroy surrounding tissue cells, thereby causing local tissue congestion and edema. Since hot compress increases local blood flow, it will aggravate the congestion and edema of the affected area. Therefore, hot compress during an acute attack of gout not only fails to relieve pain, but sometimes makes the pain worse.

Since hot compress doesn’t work, why not use cold compress instead? In fact, cold compress is equally inappropriate. Although cold compresses can temporarily relieve local pain, low temperature stimulation can cause local blood vessels to constrict and reduce blood flow, which is not conducive to the absorption of gout inflammatory substances. Local low temperature can easily lead to more uric acid deposition under the skin, aggravating local inflammation.

How should gout be treated?

1. General treatment

Eat a low-purine, low-energy diet, maintain a reasonable weight, quit drinking, drink plenty of water, and drink more than 2000ml of water per day. Avoid overeating, excessive drinking, cold and dampness, excessive fatigue and mental stress, wear comfortable shoes, prevent joint injuries, and use drugs that affect uric acid excretion such as certain diuretics and low-dose aspirin with caution. Prevent and treat concomitant diseases such as hypertension, diabetes and coronary heart disease.

2. Acute gouty arthritis

Rest in bed, elevate the affected limb, apply cold compress, and resume activities only after the pain is relieved for 72 hours. Seek treatment as early as possible to prevent prolonged illness. The following drugs should be used early and in sufficient amounts, and dosage should be gradually reduced after effectiveness is achieved. Do not start uric acid-lowering treatment during an acute attack. Those who are already taking uric acid-lowering drugs do not need to stop taking them during an attack, so as to avoid fluctuations in blood uric acid, prolonging the attack time or causing metastatic attacks.

(1) Nonsteroidal anti-inflammatory drugs (NSAIDs) Nonsteroidal anti-inflammatory drugs can effectively relieve acute gout symptoms and are the first-line medication. Common adverse reactions of non-selective non-steroidal anti-inflammatory drugs such as indomethacin are gastrointestinal symptoms. Gastric protectants can be added when necessary. They are contraindicated in patients with active peptic ulcers and should be used with caution in patients with renal insufficiency. Selective cyclooxygenase (COX)-2 inhibitors such as celecoxib have fewer gastrointestinal reactions, but attention should be paid to their adverse reactions to the cardiovascular system.

(2) Colchicine is a traditional medicine for treating acute attacks. Colchicine has many adverse reactions, mainly gastrointestinal reactions, but can also cause bone marrow suppression, liver damage, allergies and neurotoxicity. Adverse reactions are dose-related, and patients with renal insufficiency should use a reduced dose.