Acute attacks of gout often face the challenge of red, swollen, hot joints and severe pain that is difficult to relieve. In addition to medications, many people choose to apply hot compresses, medicated oils, and plasters during an attack to promote inflammation absorption and reduce swelling. Others opt for ice packs or physical therapy, acupuncture, etc., in an effort to reduce pain. But very often the result is often counterproductive, the condition is often relief is not obvious or even aggravated. The essence of gout attack is uric acid in the form of tiny crystals deposited in the joint bursa, tendons, cartilage and joints around the joints and other tissues, a large number of white blood cells phagocytosis of uric acid crystals are damaged, the release of internal lysosomal enzymes, damage to the surrounding tissue cells, causing the process of local tissue congestion and edema. Reminder, the inflammation caused by gout is different from general trauma and chronic inflammatory arthritis, and the local treatment of gouty arthritis should not be generalized. 1, the acute period of gout attack prohibit hot compresses It is currently believed that in the acute period of gout attack (especially within 48 hours) prohibit hot compresses. Acute hot compresses will aggravate the lesion congestion, edema, not only can not stop the pain, sometimes will make the pain will be aggravated. In addition, it is also inappropriate to use physical therapy that leads to an increase in skin temperature and local blood circulation, and it is even more inappropriate to apply safflower oil, orthopedic water and other medications, and it is also inappropriate to apply traditional Chinese medicine creams such as wound-dampness pain relieving creams. Acupuncture, massage and other therapies will also make the local acute inflammation aggravation, should not be used. 2, gout acute attack can cold compress? For the acute attack of gout can cold compress, there is still controversy. Some people suggest that according to the conventional treatment of acute joint swelling and pain, local ice packs can be applied during an attack to promote small blood vessel contraction, reduce local congestion and exudation, which can effectively relieve pain, reduce synovial fluid secretion and reduce joint swelling. Although cold compresses can temporarily reduce local pain, but the low temperature can stimulate the local vasoconstriction, blood flow is reduced, and is not conducive to the absorption and dissipation of inflammation. And local low temperature, easy to promote more uric acid deposits in the subcutaneous, making the local inflammation further aggravated. 3, gout acute attack, try magnesium sulfate wet compresses for acute arthritis there is no recommended local treatment? Currently believe that the application of magnesium sulfate wet compresses can achieve very significant results. On the one hand, magnesium sulfate can reduce joint swelling: magnesium sulfate is a calcium antagonist, can inhibit the transmission of nerve mediators and smooth muscle contraction, so that the vascular smooth muscle diastole, promote the flow of interstitial fluid back to the blood vessels, so as to reduce the local joint swelling. On the other hand, magnesium sulfate can effectively reduce pain: magnesium sulfate is a natural N-methyl-D aspartate (NMDA) receptor blocker, which can inhibit the excitation of NMDA in the central nervous system, thus reducing pain. During the remission and recovery periods of gout attacks, physical therapy that promotes increased local blood circulation and elevated skin temperature is recommended. Physical therapy at this time can achieve the effects of promoting the dissipation of inflammation, relieving pain, relieving muscle spasms and stiffness, and accelerating the regeneration and recovery of tissues. Recommended physiotherapy measures include infrared rays, low-energy helium-neon laser irradiation, direct current ion introduction, ultrashort wave, localized wax therapy, mud compresses, warm wraps, water baths, mineral baths, steam baths and so on. The DC ion implantation commonly used in rheumatology and immunology wards has the dual effects of electrical stimulation and drug introduction, which can improve local blood circulation and nutrient metabolism, which is conducive to the dissipation of inflammation and accelerate wound healing. In short, in the acute stage of gout, cold compresses and hot compresses are not desirable, and physical therapy to promote local blood circulation, skin temperature rise is not recommended. The easiest and safest way to deal with acute gout is to rest in bed, minimize moving, elevate the affected limbs, and use magnesium sulfate wet compresses if necessary. It is recommended to use medication as soon as possible. The drugs available are non-steroidal anti-inflammatory drugs, colchicine, glucocorticoids. The choice of drugs depends on the patient’s cardiovascular disease, gastrointestinal tract and renal function status, and it is recommended that they be used under the guidance of a doctor. For patients who have their first attack, it is recommended to complete a comprehensive examination and then be instructed by a doctor as to which medication should be used for the next attack. After the doctor’s guidance on the appropriate medication program, it is recommended to keep the medication as a backup. The earlier the medication is used, the easier it is to control the arthritis.