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No pain, but still swollen 2 months later?

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I am a 29 year old male, very thin and in relatively good shape. I developed gout in my big toe about 6-8 weeks ago beginning with the terrible pain in the middle of the night for 3-4 days, accompanied with a swollen joint. After the severe pain subsided, the swelling did not. I drank a ton of water every day for about a week, and the swelling never subsided. Still, there was absolutely no pain.

Almost 2 months later and things have not changed. The joint is still relatively swollen and there has seemingly been no pain at all. I like to play a lot of golf and I walk, and I walk with ease without any pain also. To be honest I had kind of forgotten all about the joint even being a little swollen since it doesn’t interrupt my daily routine. However, this morning I noticed a little tenderness for the first time in 2 months, and that reminded me that the swelling of my joint hasn’t really gone down, and pushed me to post about it.

Is a swollen gout joint with no accompanying pain normal for gout sufferers? I don’t know how to make the swelling diminish. Does it mean I’m having a gout attack even without pain, or just that I am not icing it or taking enough ibuprofen? As for me my diet isn’t excellent, but it’s not terrible. I don’t eat out a lot, but when I eat at home there is some red meat (although I have been substituting turkey a lot lately) and it’s nearly impossible for me to give up lite beer. I wouldn’t think I do beer or red meat in excess, though I’m sure even a little probably aids in my gout not going away completely. Thanks for any help.
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replied June 2nd, 2012
Experienced User
Kiteman - As you stated, your severe gout pain developed over night, which I presume was while you were asleep. So instead of focusing on what you eat or drink, focus on what's happening when you sleep.

Gout attacks during sleep are caused by the reduction of oxygen in your body resulting from sleep apnea, which is the frequent stoppage of breathing during sleep for many seconds at a time. Gout is an early warning of sleep apnea, which over the long term can lead to more serious life-threatening conditions such as heart disease, diabetes, kidney disease, high blood pressure, cancer, etc.

Make sure that you don't have sleep apnea. You are fairly young for sleep apnea or gout to develop, so you may have to be very persistent to get your doc to arrange for you to have a sleep test. Overcoming your sleep apnea will probably cure your gout, and will certainly reduce your risk for developing those life-threatening diseases. One thing to keep in mind is that drinking alcohol shortly before going to sleep exacerbates sleep apnea.

Based on my experience, the swelling of a gout attack lasts much longer than the pain. But if you take steps to assure that you don't continue to have gout attacks, the swelling will eventually subside.
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