The Use of Localised Cryotherapy for Gout Pain Control



Gout is a type of arthritis that is an acute inflammatory disease that affects intra and peri-articular tissues (1). It has a high prevalence in the male population, mainly from the age of 40 with a drop-in hormonal rates (2,3).


Conventional remedies have the purpose of lessening pain and inflammation with the use of medications recommended, with non-steroidal anti-inflammatory drugs, colchicine, and prednisone being the drugs of choice in the acute period of the disease. (4) These drugs are efficient; however, they have unpleasant side effects, intestinal and renal, and are dose-dependent (5,6). Furthermore, the occurrence of drug interactions occurs with a certain degree of toxicity, requiring that other methods be used to relieve symptoms. An alternative treatment is Local Cryotherapy due to its capacity for analgesia (7).


Ice has been used over time for the treatment of gout, but more recently Localised Cryotherapy has been used as an adjunct therapy to control pain in patients with gout due to its ability to decrease swelling and reduce pain allowing more range of motion. Although studies are only limited at this current time, their findings have been successful in indicating that patients with gout that have been treated with Localised Cryotherapy, have presented with a significant reduction in pain scores. These studies also found that joint circumference and synovial fluid volume also tended to be more effectively reduced after one week of localised cryotherapy (8).


Conclusion

Although the research is limited, it is evident that Localised Cryotherapy does decrease inflammation and provides an analgesic effect. Due to these effects, the range of motion is increased due to the reduction in inflammation of gout-affected joints, which allows for patients to have better mobility and less pain.


References

(1) Mitroulis I, Kambas K, Ritis K. Neutrophils, IL-1β, and gout: Is there a link? Semin Immunopathol. 2013;35(4): 501-512


(2) Roddy E, Mallen CD, Doherty M. Gout. BMJ. 2013; 347(7927): f5648. 3.



(3) Stamp LK, Jordan S. The challenges of gout management in the elderly. Drugs Aging. 2011;28(8):591-603.


(4) Finch A, Kubler P. The management of gout. Aust Prescr. 2016;39(4):119-141. 11.


(5) Assis L, Milares LP, Almeida T, et al. Aerobic exercise training and low-level laser therapy modulate inflamma-tory response and degenerative process in an experi-mental model of knee osteoarthritis in rats. Osteoarthr Cartil. 2016;24(1):169-177. 12.



(6) Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 Ameri-can college of rheumatology guidelines for management of gout. part 1: systematic nonpharmacologic and phar-macologic therapeutic approaches to hyperuricemia. Arthritis Care Res. 2012;64(10):1431-1446


(7) Tavares, Alana & Ross, Iranilda & Pradal, Lilian & Neves, Morgana & Jamilk, Bárbara & Bertolini, Gladson. (2021). The Use of Cryotherapy in the Gout Pain Control: A Systematic Review. Journal of Musculoskeletal Science and Technology. 5. 1-5.


(8) Schlesinger N, Detry MA, Holland BK, Baker DG, Beutler AM, Rull M, Hoffman BI, Schumacher HR Jr. Local ice therapy during bouts of acute gouty arthritis. J Rheumatol. 2002






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