I don’t know if this will help Ross, but I appreciate everything about your last sentence. Here goes…
Gout pain happens because our immune system goes crazy when it’s overwhelmed with uric acid crystals. It’s nature’s way of telling us that we are in danger. So, I say ‘Thank you, Nature. How do I cope?’
First, colchicine can slow your immune system down. That’s an infection risk, so be careful if you are exposed to any viral or bacterial infections. Assuming you are not infected, colchicine is a friend to gout. But, a stern friend.
Colchicine will not help immediate pain. It does not reduce inflammation. It just slows it from getting worse.
If you are taking it as required, take one colchicine as soon as you notice the slightest twinge of gout. If your twinge does not go in 2 to 4 hours, take a second colchicine. Never more than two per day.
If you are taking colchicine as a preventative, take one at bedtime. Next morning, take a second if you need it, as advised by your doctor. Never more than two per day.
So, if your immune system hasn’t gone crazy, that should be enough. But if the gouty inflammation party is swelling, it needs a party-pooper.
Indomethacin will reduce the inflammation caused by your immune reaction. In doing so, that will reduce most pain. Indomethacin is a great combination with colchicine because it’s fighting inflammation on two fronts.
The recommended dose of indomethacin for gout is 50mg three times a day.
If it’s been a really heavy party, your immune system hangover might linger. If a good nurse wants you quiet in your hospital bed, she will intersperse each indomethacin dose with a compatible pain-blocker.
Ross, if your colchicine-indomethacin combo is not quite letting you dance and sing, I’d recommend talking to your doctor/pharmacist about a compatible pain-blocker. Alternatively, get round to your local hospital, and chat up a nurse 🙂