How to Treat Gout

Medically reviewed by Siddharth Tambar, MD

Last Updated: October 9, 2021 References Approved

Experts agree that gout attacks may come on suddenly and typically cause pain, swelling, tenderness, and redness in your joints. Often, the first joint affected is your big toe.^{[1]
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Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source} Gout is a common form of inflammatory arthritis that's caused by excess uric acid in your joint tissues. Research suggests that you might be able to control gout flare-ups with medication and lifestyle changes, but it's not curable.^{[2]
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Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} If you recognize symptoms of gout, try not to worry because you may find relief with treatment options.

Part 1

Part 1 of 4:

Diagnosing Gout and Understanding Aggravating Factors

1
Understand the symptoms of gout. Caused by an excess buildup of uric acid, gout's symptoms may vary significantly from patient to patient, including development of chronic gout instead of isolated episodes. By and large, however, gout's symptoms include:^{[3]
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Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
- Warmth, pain, redness, and swelling in a joint of a limb, usually a big toe in the foot, although it often develops in the ankle or knee.^{[4]
  X
  Expert Source
  
  Siddharth Tambar, MD
  Board Certified Rheumatologist
  Expert Interview. 25 August 2020.}
- Pain that starts during the night and maintains an almost unbearable intensity.
- Peeling or itchiness in the skin around the affected joint(s).
2
Know the goals of treating gout. Gout comes with several different side-effects and symptoms. Treating gout often involves understanding how to treat the different possible aspects of the condition:^{[5]
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Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
- End the pain of acute flares.
- Prevent future attacks.
- Halt the formation of tophi (masses of urate crystals deposited in soft tissue).
- Intercept the growth of kidney stones.
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3
Know what causes and aggravates gout. An ounce of prevention is worth a pound of cure. Gout can be triggered and/or aggravated by a number of different factors:^{[6]
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Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
- Gout can be triggered by:
  - Dehydration
  - Heavy eating
  - Heavy alcohol consumption
  - Injury or recent trauma
- Gout can be aggravated by:
  - Obesity and weight gain
  - Alcohol consumption
  - High blood pressure (hypertension)
  - High-fructose corn syrup
  - Certain medications

Part 2

Part 2 of 4:

Treating Gout Attacks

1
Ice the area for 15 minutes at a time.^{[7]
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Expert Source

Siddharth Tambar, MD
Board Certified Rheumatologist
Expert Interview. 25 August 2020.} You can reapply the ice pack several times a day, as long as you rest your skin between applications. Wrap your ice in a towel or put a layer of fabric in between your skin and the ice. The ice can help relieve pain and swelling.^{[8]
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Trustworthy Source
Arthritis Foundation
Main organization devoted to arthritis support and education
Go to source}
- Don't put ice directly against your skin, as it can cause damage.
2
Immobilize the joints of the limbs where the gout is bothering you. Elevate the joint, if you can. This should reduce the pain and inflammation of the joints.^{[9]
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Trustworthy Source
Arthritis Foundation
Main organization devoted to arthritis support and education
Go to source}
- Give yourself time to rest and recover.
- Avoid putting weight on the joint.
3
Take NSAIDs after talking to your doctor. NSAIDs stands for non-steroidal anti-inflammatory drugs, and they refer to common household and prescription items such as ibuprofen, naproxen, or indomethacin. NSAIDs decrease pain and reduce inflammation.^{[10]
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Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
- Don't take any medications without first talking to your doctor.
- Follow all instructions on the label.
4
Ask your doctor if colchicine is right for you. Colchicine is a medicine in tablet form that blocks inflammation caused by uric acid crystals.^{[11]
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Research source} Colchicine may also be beneficial in reducing the pain associated with gout for those patients who cannot take NSAIDs, although it can be taken in combination with NSAIDs. There is some evidence to suggest that taking colchicine may reduce the chances of future gout attacks.^{[12]
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Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
- Colchicine is best for attacks with an onset shorter than 36 hours.
- You should not take colchicine if you've already taken it in the last 14 days for another acute attack.
5
Take corticosteroids for gout. Corticosteroids for gout reduce many of the symptoms associated with gout, including pain, redness, and swelling.^{[13]
X
Research source} Corticosteroids should be used when:
- You're dealing with gout in a single joint
- You're dealing with a gout attack that does not respond to NSAIDs
- Your medical history precludes you from taking colchicine or NSAIDS such as naxopren
6
Ask your doctor for a treatment regimen for your gout attacks. If you suspect that you're dealing with the redness, swelling, and pain of a gout attack, talk with your doctor about following a regimen when an attack of gout disables you. Your doctor will have a list of activities that you can follow and medications that you can take.^{[14]
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Expert Source

Siddharth Tambar, MD
Board Certified Rheumatologist
Expert Interview. 25 August 2020.}

Part 3

Part 3 of 4:

Managing Long-Term Complications

1
Begin taking a medicine that reduces levels of uric acid in your blood.^{[15]
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Expert Source

Siddharth Tambar, MD
Board Certified Rheumatologist
Expert Interview. 25 August 2020.} See your doctor about reducing your uric acid by taking certain medicines. These medicines may include:
- Urate lowering agents. Urate lowering agents can include febuxostat, allopurinol, or probenecid. These medications are commonly prescribed to help manage gout.
- Uricosuric agents. Uricosuric agents basically supercharge the kidneys, which in turn help remove excess uric acid. Uricosuric agents have adequate results for about 75% of patients.^{[16]
  X
  Research source} Uricosuric agents have adequate results for about 75% of patients.
- Xanthine oxidase inhibitors. These types of medicines basically keep a chemical called xanthine oxidase from forming.^{[17]
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  Research source} Xanthine oxidase is instrumental in helping uric acid buildup.
2
Watch your weight and get more exercise. Exercise will help you to lose weight as well as help you deal with the pain that comes with arthritis. 30 minutes a day is all it takes to see improvement. Light walking, aerobic exercise, or strength training can help you deal with long-term care of gout.
3
Watch what you drink. Alcohol, but especially beer, blocks the release of uric acid into your urine, causing it to get bottlenecked in your body.^{[18]
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Expert Source

Siddharth Tambar, MD
Board Certified Rheumatologist
Expert Interview. 25 August 2020.} Beer, especially, contains a lot of purines, which are broken down into uric acid eventually.
4
Drink at least 3 litres (0.79 US gal) of fluids each day. It's best to stick to water. Add slices of oranges, lemons, or cucumbers to your water for a little flavoring. You can also drink tea or coffee. Alternatively, eat watery foods, such as soups, fruits, and vegetables.
- Coffee actually helps lower your uric acid levels, so it can be a great option for managing your gout.^{[19]
  X
  Trustworthy Source
  Mayo Clinic
  Educational website from one of the world's leading hospitals
  Go to source}
5
Talk to your doctor about the medications you're currently taking. Some medication that you are currently taking may interfere with the medications you're using to treat gout, in addition to affecting the amount of uric acid your body produces. Talk to your doctor about any adverse pharmacological interactions you might be experiencing.
6
Protect your joints. Avoid joint injuries and repetitive movements that can aggravate afflicted joints. Walk or run on softer surfaces (artificial track or sand, for example) instead of concrete.

Part 4

Part 4 of 4:

Using Diet to Treat Gout

1
Stay away from high-risk problem-foods associated with gout. Foods that are at high-risk to worsening your gout contain purines. Purines raise uric acid levels in your body, causing the painful joint inflammation. Foods that are especially high in purines include:^{[20]
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Research source}
- Animal organs such as liver, kidney, sweetbreads, and brains
- Meats, especially red meats, such as bacon, beef, lamb, and other gamey meats
- Anchovies, sardines, scallops, mackerel and herring
- Gravy
- Beer
2
Limit your intake of food with a moderate amount of purines. Foods that should be consumed with caution and moderation include:^{[21]
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Research source}
- Seafood and fish (other than high-purine seafood)
- Oatmeal
3
Enjoy the foods that are especially low in purines. The following foods can be eaten without worrying about their effect on your uric acid buildup:^{[22]
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Research source}
- Green, leafy vegetables
- Fruits and fruit juices
- Processed (non-whole grain) breads and cereals
- Chocolate and cocoa
- Butter, buttermilk, eggs, and cheese
- Beverages like coffee, tea, and carbonated sodas
- Nuts and assorted nut butters
4
Consider eating foods that reportedly help your gout. Foods that are low in purines don't necessarily help your gout. (Neither do they hurt.) The following foods may actually help you on your quest to stay symptom-free:^{[23]
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Research source}
- Nonfat or low-fat milk
- Low-fat yogurt

Expert Q&A
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Question

What remedies can I take to help with gout?

Siddharth Tambar, MD
Board Certified Rheumatologist
Dr. Siddharth Tambar, MD is a board certified rheumatologist at Chicago Arthritis and Regenerative Medicine in Chicago, Illinois. With over 19 years of experience, Dr. Tambar specializes in Regenerative Medicine and Rheumatology, with a focus on platelet rich plasma and bone marrow derived stem cell treatments for arthritis, tendinitis, injuries, and back pain. Dr. Tambar holds a BA in Economics from State University of New York at Buffalo. He earned his MD from State University of New York at Syracuse. He completed his Internship, Residency in Internal Medicine, and his Rheumatology Fellowship at Northwestern Memorial Hospital. Dr Tambar is board certified in both rheumatology and internal medicine. He also holds Musculoskeletal Ultrasound Diagnostic and Interventional certifications from the American College of Rheumatology and the American Institute of Ultrasound in Medicine.

Siddharth Tambar, MD

Board Certified Rheumatologist

Expert Answer

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Drinking cherry juice may help reduce your symptoms. Omega-3 and curcumin supplements are also known to have anti-inflammatory properties.
Question

What is the main cause of gout?

Siddharth Tambar, MD
Board Certified Rheumatologist
Dr. Siddharth Tambar, MD is a board certified rheumatologist at Chicago Arthritis and Regenerative Medicine in Chicago, Illinois. With over 19 years of experience, Dr. Tambar specializes in Regenerative Medicine and Rheumatology, with a focus on platelet rich plasma and bone marrow derived stem cell treatments for arthritis, tendinitis, injuries, and back pain. Dr. Tambar holds a BA in Economics from State University of New York at Buffalo. He earned his MD from State University of New York at Syracuse. He completed his Internship, Residency in Internal Medicine, and his Rheumatology Fellowship at Northwestern Memorial Hospital. Dr Tambar is board certified in both rheumatology and internal medicine. He also holds Musculoskeletal Ultrasound Diagnostic and Interventional certifications from the American College of Rheumatology and the American Institute of Ultrasound in Medicine.

Siddharth Tambar, MD

Board Certified Rheumatologist

Expert Answer

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Drinking heavily or eating significant amounts of red meat will increase your risk of developing gout. Those with chronic kidney disease and metabolic syndrome also have increased risk.
Question

How do I treat gout on the back of my heel?

Luba Lee, FNP-BC, MS
Board-Certified Family Nurse Practitioner
Luba Lee, FNP-BC is a Board-Certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006.

Luba Lee, FNP-BC, MS

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Try applying ice or heat, whichever works best for you. Elevate your foot, and stay off it as much as possible. Drink plenty of fluids to stay hydrated, and stick to your low-purine diet, as explained above.

Warnings

Gout is associated with an increased risk of kidney stones.

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Recurrent bouts of acute gout can lead to a degenerative form of arthritis called gouty arthritis.

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