Hi, thank you for your question. Gout is usually treated with non-surgical methods. Doctors rarely do surgery for gout unless patients have tophus and it has to be removed to prevent complications. Tophus is a chalk-like nodule that forms due to gout. Tophus are made up of uric acid crystals and it usually develop in areas like the elbows, hands, knees and feet.

Tophus is removed surgically if there is infection, it affects movement of the joint or for cosmetic reasons. Another type of surgery is joint replacement surgery. It is only done when uric acid crystals cause severe damage to the joints, but this is very rare.

Other than medications, gout can be managed with cold packs to relieve pain, drinking more water and control of diet. Your aunt should limit the intake of food which are high in purines, for example, red meat, seafood and organ meats. Alcoholic beverages and sweetened drinks should also be avoided. This is because all these food can increase the uric acid level in the blood. She should also exercise regularly.

Before that, discuss with her doctor or physiotherapist to work out what types of exercise suits her best. Do low impact exercises and do not overexercise because it can aggreviate the pain. Exercises suitable for people with gout include range of motion exercise, gentle stretching, strengthening exercises like weight training and using a resistance band, aerobic exercise like cycling and yoga, and water exercises, such as water aerobics and swimming.

Your aunt should also maintain a healthy weight. Weight increase can worsen her pain. Aim to maintain your BMI at <25 and waist measurement at <35 inches. This can be achieved by eating a healthy diet and exercising regularly.

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