Q: I am a 67-year-old male. I have been having attacks of gout in my big toe once every two years since 1988. However, about 2 years ago, I got this terrible pain in my ankle. Presuming it to be gout, I took the gout medicine I have and the pain disappeared. Now about a month ago, I got this excruciating pain in the knee. Uric acid test was taken, and it was found to be over the safe limit. The gout medicine was prescribed again. I have been taking it for over a month now. I can walk now but with a limp. My knee is still very painful, although the pain is not as bad as it was about a month ago. My uric acid level has gone down though. I am normally quite active as I walk, jog a bit and do exercises like push ups, etc. Please advise how to get rid of the pain.

A:It is necessary to realise that treatment of gout is not just a few pills here and there, and it does not have very close correlation with uric acid levels. There are several other things that may bring in an acute gouty attack. The medicines for cutting short or aborting an impending attack are different from long-term drugs that need to be given continuously over years to reduce the chances of future attacks of acute gouty attack. In addition to medicines, important changes should be made in life-style to not only prevent further attacks, but also to prevent a condition called metabolic syndrome, usually seen in those with gout. Because of these reasons, it is absolutely essential that you immediately contact a specialist in joint diseases called a Rheumatologist (a physician who specialises in joint diseases, and not orthopaedic surgeons). They will be able to advise you on the various aspects of this disease.