Gout Treatment Overview
First steps to consider
- See a healthcare provider if you have never been treated for gout or are having a bad flare-up.
- Prescription medications are usually needed.
- Left untreated, gout can lead to serious complications like joint damage.
Call 911 or go to the ER if you have any of the following symptoms:
- A joint is hot and inflamed and you have a fever
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When to see a healthcare provider
If you have gout symptoms like sudden pain, redness, swelling, and stiffness in a joint (especially the big toe), you should call a healthcare provider. Without proper treatment, gout can cause erosion and destruction of the affected joint, cause tophi (small stones) to form, and increase your risk of kidney stones and heart disease.
Call your doctor at the first signs of a gout flare. It’s best to start treatment as soon as possible, ideally within a few hours of your symptoms starting. This way, you’ll get quicker relief from your symptoms.
Your doctor can diagnose gout based on your symptoms and the appearance of the affected joint. There are also several tests that help diagnose gout, including:
- Blood test to measure levels of uric acid.
- X-rays to rule out other possible causes of joint inflammation.
What to expect from your visit
When you are treated for gout by a doctor, they will ask questions about your symptoms, how often your gout flares occur, what medications you’re taking, and other medical conditions you may have. Your answers help determine the best type of treatment for you.
- You might be prescribed oral glucocorticoids (steroids) or stronger anti-inflammatory drugs (NSAIDs), such as naproxen or indomethacin.
- Another option is colchicine.
- These drugs all reduce inflammation but may take several days to get rid of the pain completely.
- If you have frequent flare-ups or have extremely painful and disabling flares or have tophi, your doctor may prescribe urate-lowering medications. These prevent future flares and may reduce or eliminate tophi.
Prescription gout medications
- Oral, intravenous, or injectable corticosteroids
- Urate lowering medications such as allopurinol and febuxostat (Uloric), probenecid (Probalan), or pegloticase (Krystexxa)
Types of providers
- Your primary care provider can usually help monitor gout and control it once a rheumatologist has diagnosed and effectively treated it.
- A rheumatologist specializes in diagnosing and treating people with gout and other forms of arthritis.
How to manage gout symptoms at home
You may need prescription medication to treat your gout and prevent it from getting worse. But you can help with the pain and inflammation with a few at-home treatments.
Treating gout as soon as possible is important to reduce your discomfort and prevent any long-term joint issues.
- Apply ice to the affected joint.
- Taking OTC anti-inflammatory pain relievers (NSAIDs), like ibuprofen (Advil, Motrin) and naproxen (Aleve) can relieve symptoms.
- Follow healthy eating habits to help prevent and lessen the intensity of gout flares.
- People with gout should limit alcohol and avoid foods high in purines, which are converted into uric acid and may be deposited as crystals in your joints.
- Foods high in purines include bacon, turkey, veal, and certain types of seafood (cod, haddock, trout, scallops, etc.).
- Eating a plant-based diet may help people with gout because fruit and vegetables contain antioxidants that can reduce inflammation.
- Choose minimally processed foods, which may reduce uric acid levels and your risk of gout flares.
OTC medications for gout
- Ibuprofen (Advil, Motrin IB)
- Naproxen (Aleve)
How to help gout with home treatment
- Apply an ice pack to the affected joint as soon as you feel pain. Do this for up to 20 minutes several times a day.
- Take NSAIDs as soon as you feel pain.
- Keep the joint elevated when possible to help reduce swelling.
- Drink plenty of water to reduce swelling and inflammation.
- Rest the joint. Don’t exercise, lift heavy weights, or use your joints excessively while it is inflamed since this can increase pain and will lengthen the time it takes for the flare-up to go away.
- To help prevent flares, avoid foods that contain purines. These are found in some seafood, meat, and fatty foods.
- Limit your alcohol (particularly beer) and sugary drinks.
- Choose low-fat or non-fat dairy products over full-fat dairy foods.
- Keep a healthy weight. Exercising and reducing your calorie intake can help stop or lower the number of flares you get.
- Avoid taking certain medications known to increase uric acid levels, such as diuretics (“water pills”).