Without warning and, for some reason, in the middle of the night, gout strikes -- an intense pain in a joint, most often the big toe, but sometimes other joints, including knees, ankles, elbows, thumbs, or fingers.
Attacks of gout can be unexpected and excruciatingly painful. With prompt treatment, the pain and inflammation usually disappear after a few days, but they may recur at any time.
More than 2 million Americans suffer from gout. Gout occurs more often in men than in women. Men usually...
But despite the pain and inconvenience, she takes no medication to relieve
Her doctor tried her on some prescription anti-inflammatory drugs, "But
I was always wary of using medicines," she says. "And when the news
came out showing the risk of heart attacks and strokes, I decided to stay away
from drugs altogether."
Dawson is in a common bind, one shared by many Americans. She suffers from
severe chronic pain but fears the side effects of common painkillers called
non-steroidal anti-inflammatory drugs (NSAIDs.)
Two anti-inflammatory drugs - Bextra and Vioxx - have been taken off the
market because of heart risks and other side effects. A similar but slightly
different drug, Celebrex, is available by prescription, with warnings about
But even long-term use of over-the-counter anti-inflammatory medicines like
ibuprofen and naproxen (Advil, Aleve, and Motrin) may carry some of the same
What should you do if you, like April Dawson, suffer significant pain from
arthritis? First, it's important to understand the tradeoffs you make with all
medicine. Medications can cause side effects; they also can relieve suffering.
It's important to talk with your doctor about the potential benefits versus
risk in your particular case. Second, it's critical to be monitored by your
doctor if you are taking any medicine regularly for longer than a couple of
weeks. Careful monitoring can catch side effects early.
"There's no simple answer," says cardiologist Nieca Goldberg, MD, a
spokesperson for the American Heart Association and Chief of Women's Cardiac
Care at Lennox Hill Hospital, New York City. The degree of risk from NSAIDs
varies greatly from person to person, she says, and depends on things like your
medical condition and the medicines you take.
"Pain is a serious problem and it needs to be treated," says
Goldberg. "But you have to do it in the safest way possible."
There is no question that the risks of NSAIDs can be serious, even
According to the American Gastroenterological Association (AGA), each year
the side effects of NSAIDs hospitalize over 100,000 people and kill 16,500 in
the U.S., mostly due to bleeding stomach ulcers.
But it's important to put those numbers in context. The AGA also says that
every day, more than 30 million Americans use NSAIDs for pain from headaches,
arthritis, and other conditions. And while some experts emphasize the dangers,
others stress that living with chronic pain is terrible in itself.