All gout sufferers, and their carers, try to reduce uric acid. Allopurinol medication is a common and effective example. It is a crucial part of the fight against gout, but why do less than 1 in 5 gout patients complete their treatment successfully? Perhaps they fail to understand uric acid, the crippling danger it presents, why they must reduce it, and why reducing uric acid can temporarily cause more pain. As a gout patient, you must understand why you need to endure the pain of allopurinol medication to get rid of gout.

Uric acid is vital to humans, but, like many a good thing, too much of it is bad. Too much causes uric acid crystals to form in and around your joints, and under your skin. Many people imagine these urate crystals to be painful, often describing them as sharp and needle-like. They are actually so small, that they do not cause physical pain directly, but your immune system sees them as virus-like invaders, and attacks them causing inflammation and acute pain. It is not enough simply to get rid of this pain.

Of course, most people need some form of medication to tolerate gout pain. This is usually colchicine or other anti-inflammatory drugs, but pain relief will do nothing to get rid of urate crystals. The inflammation and pain will gradually disperse as your immune system stops fighting the urate crystals. But, unlike a virus, your immune system cannot kill urate crystals. Instead, it hides them in a protein coating, and they will build up to cause crippling joint damage unless you do something to get rid of them. I have seen a 70 year old man in tears with this pain, and I do not want it to happen to you.

The urate crystals build up gradually, often over several years, and they do not always cause the traditionally painful, swollen acute gout flare. Often numbness or tingling are the only signs, yet under your skin the urate deposits increase until they burst through as tophi, or damage your joints, or both. The only way to get rid of them, and avoid the critically painful tophaceous gout stage, is to lower uric acid below 6mg/dL. Though there are several uric acid lowering drugs, and new ones being developed, allopurinol medication is most widely prescribed and currently the most effective, as long as the correct dose is taken every day.

At the correct dose, all uric acid lowering treatments will cause urate crystals to dissolve. Remember, this is what we need to avoid skin-bursting tophi and crippling joint deposits. Unfortunately, as they are dissolving, the urate crystals shed the protein coating, and the immune system starts to attack again, which may result in a painful gout flare. You must be prepared for this, and discuss with your doctor whether you take anti-inflammatory pain relief with the allopurinol medication, or take pain relief when a gout flare occurs.

All too often gout sufferers concentrate on finding pain relief and forget about the dangers of a long-term buildup of urate crystals. You must understand the dangers of uric acid, how crystals can cause serious damage, often without pain, and how lowering uric acid might temporarily increase pain. Distinguishing between pain relief and urate control is one of the key aspects of managing gout. Understand it, and you are less likely to be amongst the 90% of gout patients who fail to endure the pain of allopurinol medication to get rid of gout.

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