From the Guidelines
Yes, a gout flare can last up to 2 weeks without treatment. Typically, untreated gout attacks may persist anywhere from 3 days to 2 weeks, with the pain and inflammation gradually subsiding on their own as the body processes and eliminates the uric acid crystals that triggered the attack 1. However, treating a gout flare can significantly reduce this duration and alleviate the intense pain. Common treatments include NSAIDs, colchicine, or corticosteroids, which are effective in reducing pain in patients with acute gout, as shown by high-quality evidence 1.
Treatment Options
- NSAIDs: such as naproxen or indomethacin, can be used to treat acute gout, with a strong recommendation and high-quality evidence supporting their use 1.
- Colchicine: is also an effective treatment for acute gout, and can be used as an alternative to NSAIDs, with a strong recommendation and high-quality evidence supporting its use 1.
- Corticosteroids: such as prednisone, can be used to treat acute gout, with a strong recommendation and high-quality evidence supporting their use 1.
Additional Measures
During a flare, it's also important to:
- Rest the affected joint
- Apply ice to reduce inflammation
- Stay hydrated
- Avoid alcohol and purine-rich foods
While the flare may eventually resolve without intervention, treatment is strongly recommended to minimize suffering and prevent potential joint damage from prolonged inflammation.
From the FDA Drug Label
Treatment of gout flares in patients with mild (Cl cr 50 to 80 mL/min) to moderate (Cl cr 30 to 50 mL/min) renal function impairment, adjustment of the recommended dose is not required, but patients should be monitored closely for adverse effects of colchicine However, in patients with severe impairment, while the dose does not need to be adjusted for the treatment of gout flares, a treatment course should be repeated no more than once every two weeks.
The duration of a gout flare is not explicitly stated in the provided drug label. However, it can be inferred that a gout flare can last long enough to require repeated treatment courses, with a recommended interval of at least two weeks between courses in patients with severe renal impairment 2. No direct information is provided about the maximum duration of a gout flare without treatment.
From the Research
Gout Flare Duration
- A gout flare can last for varying durations, but the provided studies do not directly address the specific duration of up to 2 weeks without treatment 3, 4, 5, 6, 7.
Treatment and Flare Duration
- The treatment of gout flares typically involves the use of NSAIDs, colchicine, and glucocorticoids as first-line agents 3.
- Urate-lowering therapy, such as allopurinol, is also used to manage gout and prevent flares 4, 5, 6, 7.
Flare Frequency and Predictors
- Studies have shown that flares can occur frequently during the first year of treatment, with the highest frequency seen during the initial months 7.
- Baseline crystal depositions, subcutaneous tophi, and prior use of colchicine are predictors of flares, while self-efficacy for pain is a protective predictor 7.