Treatment For Gout In The Knee

'The Knee Is Unique In It's Function And Delicacy'

Treatment for gout in the knee – specifically which exercises help? How far should you elevate it? What supportive equipment is best?

Anything Affecting Your Knee Needs To Be Customised. Treatment For Gout in the knee is no different. Gout is agony. In your knee it will literally stop you in your tracks.

This is part of our series looking at specific treatments for gout in detail. Not just listing ‘exercise’, but which exercises for each part of your body affected by gout? Where so many ‘big’ websites seek to offer generic advice that doesn’t help at all, we seek to get to the heart of the issue.

A photo of an inflamed gouty knee from someone about to go running

A Little Reminder About Gout

Just as a reminder in case you haven’t read our general page on what gout is – gout is created when your body produces more uric acid than it can get rid of. The result is a build-up also known as hyperuricemia.

This build up isn’t always a major problem – some people can still flush it through.

Unfortunately for many people however, this build up ends up forming urate crystals and these crystals travel around your body until they settle on joints, causing very painful inflammation, swelling and long-term joint damage.

This stage is known as ‘gouty arthritis’ – or gout to you and I.

If you want to more about how gout is diagnosed, the triggers behind likely attacks and the dangers of not treating it properly, please see our page ‘Gout Triggers’.

Now Back To Your Gout-Ridden Knee…

We all know gout loves to attack your big toe, but the truth is that many people get it in their knees first or in addition to other areas. Gout is just a lover of your joints and will happily rest on your knees and attack them either instead of, or as well as, lodging on other areas of your body.

However, if you understand how gout operates, what causes it to flourish and how your knees interact with gout, then it is manageable now and avoidable in the future.

Avoiding future attacks…

Treatment for gout in the knee, as with all gout, revolves around two key aims – to control the pain during an attack and to prevent future flare ups.

In the case of gout in the knee, the really specific symptom that we need to pay close attention to is the reduced range of motion. Warmth, swelling and tenderness will affect all joints, but the range of movement is a particular problem for your knees that have to be flexible to carry your body.

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A picture of a knee wrapped in barbed wire

Treatment For Gout In The Knee – The Specifics

I’ll start by trying to shed more light on those treatments that can help in the middle of a gout attack that has affected your knees –

Cold Therapy

Ice or cold therapy is great for relieving the swelling/ pain during an attack. It does so by slowing the blood flow (and therefore pressure) around the chilled joints. If using ice do not apply it direct to your skin.

Because of the unique function and shape of the knee, a piece of tubular bandage may be far more effective.

This can be put in the freezer in a plastic bag for up to 30 minutes to make it really cold (longer if you like, but not long enough to freeze it solid) and then rolled over your knee.

The plastic bag stops the bandage sticking to other items in the freezer or getting infused with pure ice.

‘Never put ice direct on to your skin’

Obviously a lot of people will opt for the standard bag of peas, which still works but only cools the surface of one part of your knee.

Another choice is a flexible knee brace – one that ‘tightens by Velcro above and below the knee’.

This is a more complicated choice. The advantage is that, once chilled, it will hold in place nicely. The problem is the you don’t want to be applying too much pressure to a gout-attacked joint (unless you love pain).

I have seen knee braces sold for gout on the grounds that the ‘pressure reduces the swelling’. In theory that is correct, but I’d hate to the person who tried to put one on tight!

Use common sense… pressure = trauma = worse gout

If you are going to use a knee brace, start with it really cold (for the cold benefits) and tighten as far as comfortable.

Tightening a knee brace to a normal level will cause trauma to your gout attacked knee, and will make it worse.

Tubular bandages as above are far safer and less painful. They shouldn’t be tight either, but you can always ‘fix’ them to your knee with a plaster if you find they roll down.

Drugs

Your standard NSAIDs are effective and topical versions of the same in creams can sometimes deliver quicker relief to your knee, but the difference is not as great as with your feet. The aim when under attack is always to reduce inflammation.

Elevation

This is much easier with knees than with feet – a simple cushion under your knees when reclined in a chair or in bed at night will help.

The important factor is to keep your knees above chest level for as long as you can to help the swelling go down.

Rest

Try to sleep on your back at night if you can – it will stop you twisting painful knees and making them worse.

Some people find it easier when they are suffering gout to sleep in warm clothes with shorts on, lying on top of the duvet. This helps to keep your knee cool and makes it feel more comfortable.

Another option that I’ve heard used is a small bed table slid over your knees when in bed (the type you can buy to eat dinner or work while lying in bed). The duvet then goes over the table, effectively forming a small tent for your knees.

This offers two key benefits – the frame ensures you don’t get painful rubbing on your knees and it helps to keep them cool.

Supportive Equipment

If it just one knee that is affected, then a cane or walking stick can be effective, but better support is always gained from using crutches.

However, of course in practical terms, your knee is not weakened in the same sense that a dislocated or broken knee is, so walking normally (as long as it is not too painful) wont necessarily make it worse.

The key is to avoid steps or anything that might jolt your knee and make the swelling or pain worse.

Keeping Your Knee Cool

Essential to keeping the swelling down, but I have covered how to do this under ‘Cold Therapy’ and ‘Get Rest’ above.

Treatment For Gout In The Knee – Long-Term Prevention…

Exercise

Yes that old ‘easy answer’ for everything – exercise and a healthier lifestyle makes it better.

Of course this is true, but not all exercises. If you suffer with gout, you really want to stay away from competitive games that involve contact.

Football, soccer, hockey (especially ice hockey) have the potential to cause regular trauma to your knees and therefore should be avoided unless you want a regular barrage of gout.

Avoid running as it will most likely cause more trauma

Similarly running should be avoided generally if possible for the impact that is causes.

As should rowing for the ‘jolt’ that your knees can get.

The best exercises for gout in the knee are cycling, swimming, some of the conditioning machines and anything that doesn’t involve sudden impacts or jolts on your knees.

Weight machines that allow you to gradually strengthen your knees are a great idea.

Unfortunately the urate crystals that form to make gout are attracted to bruised/ traumatised joints like a magnet! Many people with gout in the knee decide to jump on a treadmill at the first chance and then wonder why they can never seem to stop their gout from flaring up again and again.

Diet Changes

Please take a look at our page ‘following an anti-inflammatory diet’ or for more specific tips, the various ‘impact’ studies in to cherry juice and other foods that are great for gout.

The key is to use natural anti-inflammatories and, if you are overweight to lose it, with aerobic activity that does not involve impact.

Stretching/ Massage

When it comes to strengthening your knees and preventing future gout attacks, massage can play a key role.

The knee is not a good place to massage (being bone), but a good series of morning stretches can help as can taking up a hobby like yoga.

Yoga is great for improving your mobility and the better mobility you have, the stronger your joints will be against the formation of urate crystals around them.

The Final Word –

Like any part of the body, treatment for gout in the knee requires another slightly different, but also similar approach in some ways.

The key element with managing your knees is to try and keep their mobility by getting control of the swelling.

This in turn will help you get control of the pain. In the long-term, you just need to be mindful that gout is highly attracted to joints that suffer trauma or bruising. The urate crystals cannot get enough of bruised joints.

Indeed, it is not at all unusual for someone to get gout while recovering from surgery, precisely because of the trauma caused by the surgery.

The same is true if you play contact sports or enjoy running (you might not much longer).

If you have any other key tips please leave them below in the comments. Always happy to answer any questions as well.

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