title: Local ice therapy during bouts of acute gouty arthritis.
abstract: OBJECTIVE
  To evaluate the effect of local application of ice on duration and severity of acute gouty arthritis.
  
  
  METHODS
  Nineteen patients with acute gout were enrolled and randomized into 2 groups. Group A (n = 10) received topical ice therapy, oral prednisone 30 mg PO tapered to 0 over 6 days and colchicine 0.6 mg/day. Group B was the control group (n = 9), given the same regimen but without the ice therapy. The patients were followed for one week.
  
  
  RESULTS
  The mean reduction in pain for those patients treated with ice therapy was 7.75 cm (on 10 cm visual analog scale) with standard deviation +/- 2.58 compared with 4.42 cm (+/- SD 2.96) for the control group. Using a Wilcoxon rank-sum test there was a significant difference (p = 0.021 ) in pain reduction between the ice therapy and control groups. Joint circumference and synovial fluid volume also tended to be more effectively reduced after one week of therapy in the ice group compared with controls, but these did not achieve statistical significance.
  
  
  CONCLUSIONS
  The group treated with ice had a significantly greater reduction in pain compared with the control group. Although the clinical improvement was impressive, due to the small sample size we could not show statistically significant improvement in all the variables that tended to suggest that effect was more than simply analgesic. Cold applications may be a useful adjunct to treatment of acute gouty arthritis.
authors.affiliation: Department of Medicine and New Jersey Medical School-University of Medicine and Dentistry of New Jersey, Newark, USA.
authors.forename: Naomi
authors.initials: N
authors.lastname: Schlesinger
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Detry
authors.forename: Bart K
authors.initials: BK
authors.lastname: Holland
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Baker
authors.forename: Anna M
authors.initials: AM
authors.lastname: Beutler
authors.forename: Marina
authors.initials: M
authors.lastname: Rull
authors.forename: Bruce I
authors.initials: BI
authors.lastname: Hoffman
authors.forename: H Ralph
authors.initials: HR
authors.lastname: Schumacher
mesh_terms: D015210:Arthritis, Gouty / Q000503:physiopathology / Q000628:therapy*; D017679:Cryotherapy; D006801:Humans; D007053:Ice; D007596:Joints / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D013582:Synovial Fluid / Q000166:cytology; D016896:Treatment Outcome
chemical_list: D007053:Ice