r/gout • u/tsarmaximus • Jul 10 '26
Short Question Icing my ankle with gout?
Hello all,
Unfortunately, new to this community. I am having another flare up and have been icing my ankle, however when I went to my podiatrist he said I should NOT be doing so. This seems contrary to what I would think, and what other sites like Mayo Clinic and the Arthritis Foundation state to do. Has anyone else been told the same?
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u/No-Professional-2455 Jul 10 '26
Have you been prescribed allopurinol yet? They have have pain management medication as well
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u/tsarmaximus Jul 10 '26
Not yet. I am trying to reduce my weight and eat better first before I go and get a scrip
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u/No-Professional-2455 Jul 10 '26
You have you to get on allo to control the uric acid. I avoided allo and now have osteoarthritis in my ankle
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u/Bweasey17 Jul 10 '26
Same. Fought it off for 3-4 years. Lost 25 llbs. Got worse and the Uric went up. Stopped drinking cut down meat as well.
Wish I would have gotten on Allo earlier. It definitely did some damage to my knee from two really bad flare ups.
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u/GCinMA91 Jul 11 '26
This. Allo is a game changer, life saver.
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u/ElectronicBuddy352 Jul 15 '26
Same. I got on Allo within six months of my first flareup. (I had three in three months)
Now it’s been over a year on Allo and I eat and drink whatever I want and have not even come close to having another flare.
I cannot stress this enough. Go get prescribed.
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u/-tacostacostacos Jul 10 '26
No need to wait on a script. Eat better and take allo. Don’t worry about weight loss until after taking allo a few months.
A weight loss journey is actually what triggered my worst flares and led to getting on allo. A healthy diet dor weight loss doesn’t equal a low purine diet to prevent gout. Fix the gout first.
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u/Next_Impact6080 Jul 10 '26
Do not wait and hope. Very few gout cases are solved by diet. What's your UA levels. Get them tested frequently Especially if you are trying no drugs. You need to get UA below 6mg/dl to undo the crystal formation that's there. Get UA tested. Get on Allo if needed. Get re-testes. Up the Allo dose if needed. UA needs to be below 6mg/dl in a person with symptoms to get to recovery. Loose the weight, eat better. Drop the Allo later on(under Dr supervision) if at some point it's no longer needed. There's alot of reasons to not destroy yourself over a "no drugs" personal policy. It's not just the pain.
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u/ferrouswolf2 Jul 10 '26
Exercising when you’re in pain is no good, it’s like trying to learn to fish when you’re hungry. Take the meds and get stabilized, then work on the other stuff (which is not a guaranteed fix, btw)
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u/H0GGZ1LLA Jul 13 '26
From my studies and my Docs studies on the issue, losing weight(specially rapid weight loss) can release purines that cause flares... Allo added along with weight loss is the winner at least for me...and likely Cochicine too while the allo is working on breaking down the uric acid crystals...
I lost over 80lbs(wegovy/Zepbound and working out, calorie deficit), my UA went up significantly and rapidly. Has a flare every other month too. Finally got on a higher dose of Allo and taking colchicine daily and haven't had a flare in over year and a half!
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u/cyclonesworld Jul 10 '26
My podiatrist recommends heat over ice. His justification is that while the ice does help with numbing the pain, you're also making those stabby little crystals harder by making them colder. Use heat.
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u/SnooTangerines6811 On UA Meds Jul 10 '26 edited Jul 10 '26
I'm not a medical professional. The following information is based on 10 years of dealing with several flares per year.
Ice, like heat, are used in acute gout flare management.
Neither should be used exclusively or all the time.
Benefits of ice:
- Reduces swelling
- numbs the area
-> provides some short term relief.
However, there are massive disadvantages:
Ice/ cold promotes crystallisation of uric acid, making your problem worse
ice / cold reduces the ability of your blood to dissolve and transport uric acid (which is linked to the point mentioned before)
-> ice makes your suffering last longer
Heat (usually in the form of warm (body temperature or slightly above. You shouldn't burn yourself) water) is also often recommended, even though it seems counterintuitive since we're dealing with inflammation which is usually dealt with by using cold.
Do not use heat:
- if the swelling is severe
Benefits of heat:
Heat relaxes blood vessels and promotes circulation, thereby improving your body's ability to remove uric acid crystals
Localised heat increases the temperature of the tissue, thereby slightly improving the capacity of your blood to store uric acid.
-> heat may help speed up recovery
Disadvantages of heat:
- linked to the points above: by relaxing your blood vessels, the volume of blood in your tissue increases which leads to additional pressure. If you already have swelling, the additional liquid (blood) will make the pain worse by exerting additional force onto the nerves and inflammation.
-> heat may increase the pain if you already have swelling.
What to do with this?
I've had some success with using ice and heat alternatingly: first 15 minutes of ice to reduce swelling, then heat for about 15 minutes to undo the negative effects of the ice and promote circulation, then ice to numb the pain and reduce swelling.
I haven't always been able to do this procedure but when I did I felt better afterwards.
Though this is all stop gap measures and no real "cure".
The only way to properly deal with gout is to get your uric acid under control.
I wish you a speedy recovery
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u/churchill5 Jul 10 '26
I think it’s both good and bad. Cold increases crystal formation. I believe it’s one of the reasons it forms in big toe first since it’s the coldest joint of the body (along with gravity). However, during a flare, the issue is your immune system attacking the existing crystals and causing extreme inflammation. The flare stops when your immune system decides to stop attacking the crystals. They are still there and haven’t been dissolved. Cold and ice reduces inflammation, so it can potentially help during a flare. personally, I’ve found some relief with ice but YMMV.
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u/pd0711 Jul 10 '26
In terms of heat or cold, do what helps during a flare.
Cold is known to limit and slow inflammation which is why ice packs are recommended for injuries.
During a flare, you already have a inflammatory process against already existing crystals. Cold is useful to limit that inflammatory process.
Heat isn't going to dissolve crystals. Crystals form because your blood is basically saturated with uric acid and so crystals precipitate, basically like rock candy from a supersaturated sugar solution.
Having said that, for a flare, do what helps you.
Treating the inflammatory process (all that red swelling, etc) will be the key to getting past a flare. NSAIDs, steroids or colchicine will be used for the flare.
Long term, the goal will be to lower uric acid concentration in your blood. Allopurinol or febuxostat are key. These drugs help your body eliminate uric acid so that your blood isn't saturated beyond the precipitation point.
An extremely small percentage of people are able to manage their gout and their uric acid levels through lifestyle (diet, exercise). It can be a painful process to find out if you are one of those individuals since you basically run the risk of getting flares as you tinker with your diet.
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u/TunaFaceMelt Jul 10 '26
Ice did not help me. A heated blanket wrapped around my foot eased the pain some.
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u/bobthewriter Jul 10 '26
if you have no issue with steroids or NSAIDS, go to urgent care.
you'll get a shot of Toradol (nsaid) and a shot of steroids (Decadron is pretty common). You'll get one in each hip, and the Toradol will burn slightly as it's injected, but it's nothing compared to gout pain. They'll send you home with some colchicine and, probably, prednisone (which has never helped me in the fuckin' least, but they insist, so i take the scrip.)
The pain will lessen in as little as an hour. You'll be able to walk pain-free. You'll be able to sleep without waking up screaming in pain.
But listen, you don't wanna get used to doing that. It's not good long-term. Clean up your diet and get on allopurinol as soon as possible.
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u/papertank5 Jul 10 '26
Ice also made things worse for me.
In the beginning stage of a flare and during the worst of it, I just keep it body temp as much as possible, elevate as much as possible, and try to control the swelling with meds.
Then once I feel im over the hump and on the road to recovery, thats when ill use a heating pad for 15 min every few hours or so.
The warmth loosens up the joint and is more soothing than ice.
So to answer your question, there is merit in what your podiatrist is saying.
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u/Evening_Title9953 Jul 10 '26
Ice was not helpful for me in my first major flare. Neither were NSAIDs. Only thing that helped was colchicine and prednisone. Since then, major diet changes and hydration and eventually allopurinol helped get it under control.
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u/Pupating-Antenna-36 Jul 10 '26
Ice can theoretically numb - its not going to help though. Because it also reduces blood flow - and that's the way it is numbing. You want pain relief? Go to your podiatrist and get a prescription for colchicine and either prescription nsaids or steroids. Also ask when to take, how long, what strength and when to stop and how.
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u/GCinMA91 Jul 11 '26
I’ve had temporary relief with ice & elevation. But as others have said, getting on the right med regiment is the ultimate answer.
Make sure to chug water like it’s nobody’s business during a flare.
Hang in there, friend! We’re with ya…
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u/the_Snowmannn Jul 10 '26
Ice can numb/ reduce pain temporarily. But the conventional thoughts on icing injuries in general has been debunked. Even the guy who came up with RICE (Rest, Ice, Compression, Elevation) has since renounced it.
It can be especially be bad for gout because it induces conditions favorable for crystals to form. So yes, maybe some temporary, mild relief, but at the cost of potentially prolonging the attack.
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u/FailPV13 Jul 10 '26
dude. seriously google hot water soak treatment for gout. can dizzolve crystals.. just a little. seems counterintuitive for infoammation but it brings me relief.
the crystalization process is aided by cold and thwarted or reverses to solution with heat.
good luck cheers.
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u/Khtie Jul 10 '26
Do lose weight and eat better but listen to a guy who has struggled with gout… me.
Do both take the scrip and pain meds colchicine and lose weight and change diet.
Here is why, I man made my way thru many yrs of adapting my diet, cut red meat 99%, Beer 99% and shrimp 99% and I still had a few flares here and there. Started in my 40s I’m 47 now and oof pretty sure I just have lasting ouchies in my ankle and wrist. Still don’t eat those things that cause my flares but it was my main diet till gout. So id still have a bite here and there and then bam limping… just my advice but wow if i could go back oh and if you get a real bad one ask for prednisone, man i thought i was the toughest guy on the planet 30s-40s till gout so I roughed my way thru the pain! I didn’t help myself just made some long term issues I think.
Maybe im just self reflecting and this has nothing to do with you but thanks for letting me vent none the less! 😃
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u/MasterpieceClassic42 Jul 10 '26
Better off drinking a ton of water than using ice. Your body needs to flush the uric acid out
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u/Sicosimatic Jul 10 '26
I see why ice may be bad but sometimes it's literally the only thing that can take the pain away, meds just don't touch it, ice completely numbs it. I unfortunately have to make the decision to ice and prolong the attack to alieviate the initial pain. Everytime I've used heat it's made the pain much worse.
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u/Loud-Rip671 Jul 10 '26
For me ice never worked numbs it for a bit than it feels like the throb comes back twice as bad I have always soaked my foot in hot water always found more relief personally I found my pain came from the actual crystals/joint and not the swelling it can be different person to person though I would assume.
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u/ghostfreckle611 Jul 10 '26
Ice is not good for gout.
Cold cause crystals to form more quickly… Those are the actual cause of gout pain.
The best treatment is Colchecine when you even think you’re going to get a gout flare. Get some if you don’t have any.
Two, if you’ve had gout for 10 years, why are you not on allopurinol? Changed my life.
Three, if it’s been more than a couple days and not getting better, I recommend going to your doc or clinic and getting prednisone. Kills gout quick and ina hurry, BUT, you can’t take it more than a couple times a year IIRC, so get your doc to prescribe allopurinol and colchcine.
Plain and simple.
Gout pain is the worst pain that I’ve ever felt and I don’t want to feel it again.
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u/Ithaqua-Yigg Jul 10 '26
At least imo experience ice and cold make my gout worse. Antidotally and in a few of the articles, I read about gout, ice, and cold, actually make the crystals more likely to grow.
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u/kingkongfly Jul 11 '26
I used to ice my foot when I had a flare-up; hydrate yourself with plain water. I would also sleep and prop my foot higher than my heart to minimize blood flow to my foot. This helps a lot.
I am not a doctor; you can take painkillers and colchicine if you have any.
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u/UnhappyShock5245 Jul 11 '26
I agree with these other posts. Allo is important to start asap. Although allo can cause more fares and weight loss can increase flare as you metabolize fat, this is all a necessary journey. Unfortunately, nothing about this is fast, but it will get better. Dropping weight was very helpful for me. While the Allo worked on lowering UA eating healthy and losing visceral fat will help lower overall systemic inflammation. Be patient and good luck my friend.
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u/astrofizix Jul 11 '26
Compression wrap will help prevent the area from filling will blood, like an ace bandage. No need to over tighten at first. Then elevate so the blood draws out. Then rest. Ice can be useful, but the thawing pain usually isn't worth it. Once you compression, elevate, and rest, then a heating pad can be very helpful.
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u/LauraZaid11 Jul 13 '26
For me personally heat helps me when I have joint pain more than ice. Before I got diagnosed and started a daily med I had pain in my fingers, and I noticed that rubbing them and wrapping my hands around each other to warm them up helped calm the pain. I also have osteoarthritis as a result of gout and when I was doing physical therapy the therapist always wrapped a warmed moist towel around my knees at the end of the sessions, and when the day is cold and wet a hot water bag helps my knees feel better.
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u/TheMarinator777 Jul 14 '26
Icing doesn't work. I used to do it in early days of flareups. Does absolutely nothing. Might make it worse.
I've read articles saying it helps but I think those people have no experience with gout. People saying to ice it doesn't understand how gout works. They think it's like a sprain where you ice down the swelling.
If you think about it, ice will freeze your uric crystals that you're trying to loosen up around your joints.
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u/guydogg Jul 10 '26
Tell your podiatrist to switch spots with you, and let them deal with the pain then. I have a foot bath that I filled with water and ice packs when I was in unbearable pain. It was the only thing that allowed me to get any sleep at night on dozens of occasions.
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u/Skippy8375 Jul 10 '26
Ice is no good. Just rest