GoutOverview

Gout causes sudden severe joint pain. See a GP for treatment to help during an attack and to stop further attacks.

See a GP if you have:

  • sudden severe pain in any joint – usually the big toe, or fingers, wrists, elbows or knees
  • red, hot, swollen skin over the affected joint

Gout doesn't cause lasting damage to joints if you get treatment straight away.

Ask for an urgent appointment or call 111 if:

  • the pain is getting much worse and you have a very high temperature (you feel hot and shivery)

This could mean you have an infection inside the joint.

What happens at your appointment

Gout can be hard to diagnose as symptoms are similar to other conditions.

Your GP may ask about your diet and if you drink beer or spirits.

You might be sent for a blood test, ultrasound or X-ray. Sometimes a thin needle is used to take a sample of fluid from the affected joint to test.

The tests will find out how much of a chemical called uric acid there is in your body.

Having too much can lead to crystals forming around your joints and causing pain.

Treatment to reduce pain and swelling

Attacks of gout are usually treated with anti-inflammatory medicine like ibuprofen.

If the gout doesn't improve after 3 to 4 days, you might be given steroids as tablets or an injection.

Do

  • take any medicine you have been prescribed as soon as possible – it should start to work within 3 days
  • rest and raise the limb
  • keep the joint cool – apply an ice pack, or a bag of frozen peas wrapped in a towel, for up to 20 minutes at a time
  • drink lots of water (unless advised not to by your GP)
  • try to keep bedclothes off the affected joint at night

Don't

  • do not knock the joint or put pressure on it

Treatment to prevent gout coming back

Gout can come back every few months or years. It can come back more often over time if not treated.

If you have frequent attacks or tests show you have a high level of uric acid in your blood, your GP might prescribe medicine called allopurinol or febuxostat.

This is used to lower the levels of uric acid and needs to be taken in the long term.

Important

It's important to take uric-acid-lowering medicine regularly, even when you no longer have symptoms.

Things you can do to stop gout coming back

Making lifestyle changes might mean you can stop or reduce further attacks.

Do

  • get to a healthy weight, but avoid crash diets – you could try the NHS weight loss plan
  • aim for a healthy, balanced diet, with plenty of vegetables and some low-fat dairy foods
  • have at least 2 alcohol-free days a week
  • drink plenty of fluids to avoid getting dehydrated
  • exercise regularly – but avoid intense exercise or putting lots of pressure on joints
  • stop smoking
  • ask your GP about vitamin C supplements

Don't

  • do not eat a lot of red meat, kidneys, liver or seafood
  • do not have lots of sugary drinks and snacks
  • do not have lots of fatty foods
  • do not drink more than 14 units of alcohol a week (and do not have it all on 1 or 2 days)

The UK Gout Society has more detailed advice on diet for people living with gout (PDF, 879kb).

Things that can trigger a gout attack

You might get an attack if you're very stressed or have had an illness.

If you injure or bruise a joint and it's more painful than you would expect after a minor bump, it could be an attack coming on.

Get treatment straight away if you feel an attack coming on.

Who gets gout

Gout sometimes runs in families.

It's more common in men, especially as they get older.

Other people at risk include:

  • women after the menopause
  • people who take medicines such as diuretics (water tablets) for blood pressure, or have high levels of cholesterol
  • people who are overweight and who drink alcohol, especially beer

Complications of gout

It's rare to get lots of attacks, but if you do, you can develop permanent damage to the joint (chronic gout).

Chronic gout can also cause tiny white lumps (tophi) to appear under your skin, especially on your ears, fingers or elbows.

This is where urate crystals form under the skin. They can be painful.

You can get kidney stones if your uric acid levels are very high, so you'll need treatment to reduce the levels.

Social care and support guide

If you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they're ill, elderly or disabled - including family members

Our guide to care and support explains your options and where you can get support.

Page last reviewed: 23/08/2017
Next review due: 23/08/2020