What to do during a gout attack

When gout pain hits, the first step is to reduce inflammation and pain as quickly as possible. Start by resting the affected joint—stop walking on it if it's your foot or ankle, and avoid using your hand or arm if that's where the pain is. Elevation helps: prop the joint up on pillows to reduce swelling.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or indomethacin work best if you take them early in the attack. Follow the dosage on the package. If NSAIDs upset your stomach or you cannot take them, colchicine (a prescription medication) reduces inflammation when taken within the first 24 hours of symptoms. Acetaminophen does not reduce inflammation and will not help as much.

Ice packs wrapped in cloth can numb the area for 15 to 20 minutes at a time. Some people find heat more soothing—try both and use whichever feels better. Drink plenty of water to help your kidneys flush out uric acid. Avoid alcohol completely during an attack, as it slows uric acid removal and makes pain worse.

Key Takeaways

  • NSAIDs like ibuprofen work best when taken early in a gout attack, ideally within the first few hours of pain.
  • Rest, elevation, and ice or heat can reduce pain while medication takes effect.
  • Prescription medications like allopurinol or febuxostat lower uric acid levels over time and prevent future attacks.
  • Avoiding trigger foods—red meat, organ meats, certain seafood, and alcohol—reduces how often attacks happen.
  • A doctor can prescribe preventive medication and help you understand what triggered your attack.

When to see a doctor about gout

If this is your first gout attack, see a doctor to confirm the diagnosis. Gout pain can feel similar to other joint problems, and a doctor can test the fluid in your joint to be certain. They can also rule out infection, which requires different treatment.

See a doctor if attacks happen more than once a year, if the pain is severe enough to interfere with daily life, or if you have kidney disease or heart disease. These conditions change how gout is treated. If you are already taking a uric acid-lowering medication and still have attacks, your dose may need adjustment.

Go to an urgent care or emergency room if the joint is hot, red, and swollen along with fever, or if you cannot move the joint at all. These signs can indicate infection rather than gout.

Medications that prevent future attacks

Once you have had one gout attack, your doctor may prescribe a medication to lower uric acid in your blood so attacks do not happen again. The two most common are allopurinol and febuxostat. Both work by blocking the enzyme that produces uric acid. You take them daily, and they work over weeks to months—they do not stop a current attack.

If you have frequent attacks, your doctor might also prescribe colchicine or an NSAID to take daily as prevention, separate from the uric acid-lowering drug. This reduces inflammation while your uric acid level drops.

Starting a uric acid-lowering medication can actually trigger an attack in the first few weeks because uric acid crystals in your joints start to break down. Your doctor may prescribe colchicine or an NSAID to take alongside it for the first few months to prevent this.

Foods and drinks that trigger gout

Gout is partly about what you eat because certain foods raise uric acid. Red meat, organ meats (liver, kidney), and shellfish like shrimp and mussels are the biggest culprits. Beer and spirits raise uric acid more than wine does. High-fructose corn syrup and regular soda also increase uric acid, even in people without gout.

You do not have to cut these foods out completely, but eating them less often or in smaller portions reduces attack frequency. If you notice an attack always follows a particular food, that is your signal to avoid it or eat it rarely. Staying hydrated and maintaining a healthy weight also help, because dehydration and obesity both raise uric acid levels.

Purine-rich foods (which break down into uric acid) include beef, pork, anchovies, sardines, and organ meats. Moderate amounts of chicken and fish are usually fine. Vegetables high in purines, like spinach and mushrooms, do not raise uric acid the way meat does, so you do not need to avoid them.

How to know if medication is working

If you are taking a uric acid-lowering medication, your doctor will order blood tests to measure your uric acid level. The goal is usually to get it below 6 mg/dL, though your doctor may set a different target depending on your situation. Tests happen a few weeks after you start the medication, then periodically to make sure the dose is right.

The real sign that medication is working is that attacks stop happening or happen much less often. If you are still having attacks after three to six months on medication, tell your doctor—your dose may be too low, or you may need a different medication. Some people need higher doses than others to reach the target uric acid level.

What happens if you ignore gout

If gout attacks keep happening without treatment, uric acid crystals can build up in your joints and surrounding tissue, causing permanent damage. This is called tophaceous gout, and it can make joints stiff and painful even between attacks. Kidney stones are also more common in people with untreated gout because uric acid crystals form in the kidneys.

Repeated attacks also increase your risk of heart disease and stroke, especially if you have high blood pressure or diabetes. Starting preventive medication early stops this progression. Even if you have had gout for years, starting treatment now prevents further damage.

Frequently Asked Questions

Can I stop taking gout medication once attacks go away?

No. Uric acid-lowering medications like allopurinol work only while you take them. If you stop, uric acid levels rise again and attacks return. Most people with gout take these medications long-term, similar to how someone with high blood pressure takes blood pressure medication indefinitely.

Is gout caused by eating too much meat?

Diet contributes to gout, but genetics matter more. Some people can eat red meat regularly and never get gout; others get attacks even when eating well. If you have gout, reducing meat intake helps, but medication is usually necessary to prevent attacks completely.

Can I treat gout at home without seeing a doctor?

You can manage pain at home during an attack with rest, ice, and over-the-counter NSAIDs. But you should see a doctor to confirm it is gout and to discuss preventive medication if attacks are frequent. Without treatment, gout causes permanent joint damage over time.

Does losing weight help with gout?

Yes. Obesity raises uric acid levels, so losing weight reduces attack frequency. Aim for gradual weight loss—rapid dieting can actually trigger attacks because it raises uric acid temporarily. Talk to your doctor about a safe weight loss plan if you have gout.

What should I do if NSAIDs do not work for my gout pain?

Tell your doctor. Colchicine or a corticosteroid injection into the joint can reduce pain and inflammation if NSAIDs do not help or if you cannot take them. Your doctor can also check whether something other than gout is causing the pain.