Does Heat Help Gout Pain?

'A Quick Readers Question From A Gout Sufferer'

Heat has often been used to treat the pain of many different forms of arthritis. Gout or ‘gouty Arthritis’ as it is often known is different.

The case for heat helping gout is almost non-existent, but we were asked by a reader to answer the question ‘does heat help gout pain’ and so we will…

Image of a hot water bottle under the slogan 'does heat help gout pain?'

Understanding Types Of Arthritis

Gout or gouty arthritis forms in a very different way to any other form of arthritis.

Perhaps the most significant difference is that it is the only arthritis that is principally driven internally by what you’ve eaten. Rather than being an auto-immune disease or based around the concept of wear and tear, Gout is created principally by your internal balance of uric acid.

Uric acid is produced by your body in response to various factors, but principally a result of various foods/ drinks that you consume.

The vital role of your kidneys…

It is then excreted through your kidneys to ensure it all always remains at a safe balance within your body.

However, eat too many uric acid stimulating substances or affect your kidneys such that they slow down with getting rid of excess acid and you have a problem.

Uric acid will start to build up in what is known as hyperuricemia. On it’s own, there is no guarantee that this uric acid build up will in fact lead to gout, as some individuals can cope with much higher levels, without any symptoms.

However, in many people the excess uric acid will start converting into urate crystals.

Creating ‘gouty arthritis’…

These urate crystals will travel around the body until they attach themselves to one of your joints.

As the crystals build up, so they start causing the painful inflammation, swelling and redness we know as gout or ‘gouty arthritis’

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Does Heat Help Gout Pain?

So how does this relate to heat therapy and does heat help gout pain at all?

Well, you will see from a previous article (‘does ice help gout’) that putting ice on your gout affected joint is a very effective method of pain relief during an attack.

Furthermore, for most forms of arthritis we heavily recommend hot/cold therapy.

However, as recognised by Schlesinger, writing in the Journal Of Clinical Rheumatology in the case of gouty arthritis only cold therapy may be of use.

The reason for this stems back to why both are effective in the first place – cold therapy was always great for reducing inflammation by slowing blood flow to the treated area and providing a slight numbing effect.

The role of heat therapy alone…

Heat therapy however, was about providing relaxation to tense muscles and getting them to relax.

Given that gout pain is all about inflammation and swelling, then it would be easy (and not inaccurate) to summize that heat does not help gout pain at all.
And from a clinical stand point, I would confirm – does heat help gout pain – No.

There is no scientific basis for heat to help gout at all.

Does Heat Help Gout Pain – The Positives…

The only theoretical basis on which it might help would be in preventing future attacks. Gout is known to favour cooler areas (hence it’s frequent attachment to your toes/ fingers, because they are cooler being further from the heart).

Following this through, if you were able to keep your body warmer, then the urate crystals are marginally less likely to attach to your joints.

Being realistic…

However, we are talking very marginally and you’d have to be keeping your entire body much warmer all the time, which is rather impractical.

In reality, the only benefit of heat for gout pain is that it can make you feel better.

However, the ‘placebo effect’ as it’s known can be a very powerful healer.

The placebo effect basically describes the fact that your mind is a very powerful object.

If it thinks it will get better, very often it does anyway.

We see this in many clinical trials, where one population will be given a new drug and the other will be given a sugar pill that looks the same, but with nothing in.

The idea is that both groups think they are taking the new drug, but only one group actually is. Theoretically, the group with the empty sugar pill should see no improvement.

The brain is the most powerful healer…

However, what actually happens is 30% of the sugar pill users will report significant improvements and maybe 35% with the actual drug.

In other words, 30% of people who thought they were taking a drug that would make them better, actually got better, partly because their brain’s thought they would.

The actual effect of the drug is only the extra 5%

So how does this relate to answering does heat help gout pain? Well, what I’m really proposing is that while there is no clinical value whatsoever in applying heat to gout affected joints, if you find the warmth comforting and your brain thinks it might work, then heat might well reduce the pain.

It wont do this for sound clinical reasons – other than the fact that you think it might work and sometimes therefore it will.

The Final Word –

Gout is affected by cold therapy but not hot therapy. At least according to the science.

Cold compresses can reduce swelling and numb pain, but the heat should have no effect on your gout.

However, the placebo effect, should rule that in some cases, if you think something will work, it still will – even if there is no reason for it to do so.

Does heat help gout pain? Heat helps many forms of arthritis and gout is also a form of arthritis. However, gout’s unique causes mean that heat therapy is ineffective, with the exception of a mental standpoint that should not really be considered.

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Further Gout-Related Reports...

References –

1. Schlesinger N (Dec 2006). Response To Application Of Ice May Help Differentiate Between Gouty Arthritis And Other Inflammatory Arthritides. . The Journal Of Clinical Rheumatology.

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