What Do You Do During a Gout Attack?

It’s the holidays and the temptation to eat and drink anything that comes your way will be at an all-time high. Of course, you’re only human which also means you’re not perfect.

If you’re like most people, gout sufferers included, it can be easy to stumble and fall into this inviting cave of temptation.

Then, of course, comes the difficult part, when you’re sitting in your bed at 3 a.m., writhing in pain from the gout flare-up you most likely caused. How can you deal with this gout attack and relieve the excruciating pain?

At this point, you’re feeling guilty and sorry for yourself, and you’re promising yourself that this will be the last time you overindulge. Ah, it’s the classic challenge of going through the holiday season as a gout sufferer.

Well lucky for you, I’ve been around the block a few times and I’ve been a gout patient for many years. The fact that gout currently doesn’t have a cure doesn’t stop me from enjoying my holiday season with my friends and family.

In this article, I’m going to do a deep dive into how to stop a gout attack. I will be sharing tried and proven tips that have personally helped me stop gout attacks in their tracks. So, without further ado, let’s look at my top tips for stopping your horrible gout attacks.

Risk Factors That Contribute to Gout Flare-Ups

Despite the advances in our understanding of gout, experts do not fully understand why some people get gout and others do not. Nonetheless, many gout causes and risk factors are well established. Let’s look at some of the most common risk factors that can result in gouty arthritis.

  • Excess Weight: According to research, people who are overweight are more likely to develop gout. Gout is also more likely to strike them earlier in life.
  • Diet: Consumption of purine-rich foods and beverages, such as alcohol, sugary foods and drinks, meat, and seafood, increases the risk of a gout flare-up. Although beans, fruits, and vegetables are high in purines, studies have shown that they do not appear to increase the risk of gout.
  • Intake of Alcoholic Beverages: If you drink beer, wine, or liquor, you are more likely to get gout. One to two alcoholic drinks increased the likelihood of a flare-up by 36%, according to a study of 724 people with gout.
  • Sex: According to experts, men are four to ten times more likely than women to have gout. In addition, because estrogen appears to have protective effects, women’s risk of developing gout increases during menopause.
  • Age: Many people first develop gout between the ages of 30 and 50, and the risk of gout increases with age. Gout affects approximately 3% of men under the age of 50 and nearly 12% of men aged 70 to 79.
  • Race: According to studies, African American men are nearly twice as likely as Caucasian men to have had gout.
  • Family History: Certain genes that influence kidney and gut function, according to research, increase the risk of developing gout. These genes may predispose the body to uric acid accumulation and the formation of uric acid crystals, resulting in gout.
  • Medications: Certain medications may increase the likelihood of hyperuricemia and gout attacks. Diuretics, low-dose aspirin, and cyclosporine are common examples of these medications.This is not a comprehensive list. People who take medications or supplements should consult their doctor or pharmacist about how their medications may affect gout risk.
  • Persistent Renal Failure: Persistent, or chronic, renal failure means that the kidneys are no longer fully functional. Gout can develop when the kidneys’ ability to flush out uric acid is impaired.
  • Medical Event: A gout flare-up can be brought on by specific events that cause a change in the body’s chemistry. These occurrences can be infections, traumatic injuries, surgeries, illnesses, or even drastic weight loss.

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The Warning Signs of an Impending Gout Attack

First of all, there are some warning signs of a gout flare-up attack that are associated with gout attacks. These may include a burning, itching, or tingling sensation in the joint as a warning sign.

When a gout attack occurs, your joint might feel a little stiff or a little sore. Most likely, the affected joint will be extremely painful, swollen, and red. The big toe is where the attacks usually start, but they can also happen at the elbow, wrist, ankle, or knee.

These symptoms, according to patients, typically start an hour or two before the gout flare-up actually starts. However, I’ve experienced those feelings a day or two before as well. If you experience attacks frequently, you will become familiar with your body’s warning signs.

In some cases, however, people with gout have no early warning signs that a flare is about to begin. They could simply wake up in the middle of the night with a painful joint. It hurts so much that anything that touches the joint feels so painful.

The truth is that most gout attacks tend to be severe. So much so that the patient can’t even bear the pain of your bedsheets touching the inflamed joint. To make matters worse, a gout attack can last anywhere from hours to days. And that’s assuming that it gets treated quickly.

If left untreated, a gout attack can potentially last for weeks! To best mitigate the pain, it’s best to get your gout treated within 36 hours! Some of you may also suffer from high fever and chills.

Gout Can Go Away or Keep Coming Back

Gout attacks almost always cause stabbing pain, redness, and swelling in the affected joint. About half of all first-time gout attacks in men involve the big toe joint. The instep, heel, ankle, and knee are also frequently affected joints.

After the initial gout attack, the condition can have various effects on individuals:

  1. Some people may go weeks, months, or even years without experiencing another gout attack. In extremely rare circumstances, they may never experience another one.
  2. Others will start to have gout attacks on a regular basis. These attacks could eventually develop into more frequent and protracted ones. Chronic gout may result in disability and permanent joint damage. Fortunately, joint damage can be avoided by promptly treating the underlying cause of gout, which is a buildup of uric acid in the blood.

Experts are unable to predict who will experience a one-time attack versus chronic gout. If you’ve had an attack, it’s worth your time and effort to make changes that will help you avoid a painful flare-up in the future.

Make Sure to Have These Handy!

If your doctor has diagnosed you with gout and prescribed medication to treat a flare-up, take the medication as directed when you notice one. In most cases, that will be as soon as the first signs appear.

What you need handy at home is some colchicine and/or some ibuprofen like Advil or Motrin. I tell my doctor to always prescribe me colchicine and have it ready during a gout attack. That’s because you don’t want to be stuck with your doctor being away during the holidays or away on vacation.

If you’re taking allopurinol or febuxostat as a long-term uric acid-lowering therapy, you’re probably taking a specific dose every day. As a result, you’re probably always carrying that medication with you.

Colchicine

Colchicine, a well-known gout medication, is an exception to this rule. The medication is stopped once the gout symptoms have subsided.

Colchicine is effective when taken within 12 to 24 hours after your gout attack. Colchicine can cause major gut problems if taken in a high dose. Keep in mind that it is critical to adhere to your doctor’s recommended dosage. For most people, this means taking no more than two to four tablets a day.

Ibuprofen

Got no colchicine? Then ibuprofen is a must since it’s available at your local pharmacy over the counter. Take it to take the sting out of your pain; it makes it much easier to move around while you wait for your doctor to prescribe you remedies such as colchicine and NSAIDs.

NSAIDs

Your doctor might give you a prescription for nonsteroidal anti-inflammatory drugs (NSAIDs), such as celecoxib, indomethacin, meloxicam, or sulindac. They may also advise you to take NSAIDs that are available over the counter, such as naproxen or ibuprofen.

Your doctor may advise steroids or other anti-inflammatory drugs like the previously mentioned colchicine. Of course, the type of medical advice given will be dependent on your your medical history.

Tolerance and Medication

These medications may still be effective even though you may experience flare-ups. You might experience an attack during the first few months of treatment as your body gets used to the medication. If this occurs, your doctor most likely also gave you a medication to take.

Call your doctor if you’ve been taking preventive gout medication for a while and you’re experiencing flare-ups for the first time in a while. They might discuss adjusting your medication or dosage with you.

Depending on the severity of your gout, they may even give you additional advice and medication. Whatever you do, do not take aspirin since it can affect your uric acid level by worsening your attack.

Minimizing Pain Without Medications

Medications are by far the most effective way to alleviate the agonizing symptoms of a gout attack. However, taking medications frequently entails visiting a doctor, receiving a recommendation and prescription, and then going to a local pharmacy to obtain said medication.

These are obviously not the kinds of activities you want to engage in while experiencing a gout attack. Fortunately, I am going to share some home remedies I personally use to bring some relief to my gout symptoms.

To be clear, these probably won’t give you the immediate relief that you want. But, they do help you maintain your sanity during a flare-up. Best of all, you don’t even need to leave your house or order anything from your local pharmacy.

Here are some of my go-to tricks I use when at home:

  • Ice/Cold Packs: If your pain isn’t too severe, try applying cold compresses or packs to the joint to reduce inflammation and discomfort. Wrap the joint in a thin towel and apply ice to it for up to 20 minutes several times throughout the day. Avoid applying ice to your hands or feet if you have nerve problems caused by diabetes or another condition.
  • Allow the Joint to Rest: Gout can cause swelling and pain, particularly in the feet, hands, knees, and ankles. Although this is a natural reaction when experiencing a gout flare-up, you should try not using your affected joint for a while. It’s best to rest it until the pain subsides. You’re unlikely to want to move it much anyway. Elevating the affected joints is one method of reducing swelling. This forces blood and fluid away from the joint and toward the heart.An ice pack with elevation can also be used to alleviate gout symptoms. These two remedies are part of the RICE method (rest, ice, compression, and elevation).
  • Drink Plenty of Water: Your uric acid levels increase further when your body is dehydrated. To help keep those levels normal, drink plenty of water. Increased fluid consumption can stimulate the kidneys to release excess fluid, reducing swelling in gout patients.Other clear fluids to consider include broths and herbal teas. Of course, people should avoid purine-rich beverages such as alcohol and soda. Anyone with congestive heart failure or kidney disease, on the other hand, should consult their doctor before increasing their fluid intake.
  • Get Tested for Sleep Apnea: Gout can be exacerbated by untreated sleep apnea. Sleep apnea is a sleep disorder that causes the body to take in less oxygen while sleeping, which in turn causes the body to produce more purines. A continuous positive airway pressure (CPAP) machine or other device that increases oxygen intake while sleeping is typically used to treat sleep apnea.
  • Drinking Lemon Water: A 2015 study discovered that drinking 2 liters of water per day with the juice of two freshly squeezed lemons reduced uric acid in gout patients. The researchers concluded that drinking lemon water helps to neutralize uric acid in the body, thereby lowering levels.
  • Minimize Stress: Gout symptoms can be exacerbated by stress, so getting enough sleep can help people feel less stressed. While it is not always possible to eliminate all sources of stress, the following suggestions may be of assistance. If the pain does not prevent you from moving, you can try exercising. Try requesting time off from work. Reading a favorite book or journaling. Also, meditating can be incredibly fun and beneficial too!
  • Losing Weight: As with most foot and ankle issues, it’s crucial to keep a healthy weight. There is less pressure on your lower extremities the lighter you are. Losing a few pounds can help people with gout symptoms feel less swollen and can also lessen the severity of other conditions like plantar heel and diabetic foot problems.
  • Drink Coffee: Some people believe that drinking coffee reduces the risk of developing gout. According to a 2016 review and meta-analysis, those who drank more coffee were less likely to have gout. This may be because coffee can lower uric acid levels. We’ve also discussed gout and coffee.A 2019 study found that coffee consumption reduces the risk of gout and may do so without lowering serum uric acid levels. However, just because the study found a link between higher coffee consumption and a lower risk of gout does not mean that coffee is to blame.
  • Consuming a Well-Balanced Diet: A well-balanced diet rich in nutrient-dense, minimally processed foods can help lower uric acid levels and reduce the risk of gout flares.Plant-based diets can be especially beneficial for gout patients. Many fruits and vegetables are high in antioxidants, which can aid in the reduction of inflammation.
  • Avoiding Meats High in Purine: Purines are abundant in organ meats such as kidneys and liver, as well as game meats such as venison and wild-caught birds.
  • Seafood and fish: Crab, shrimp, and other shellfish can aggravate gout flare-ups, but trout, anchovies, and mackerel can also raise uric acid levels. However, oily fish, such as salmon, have excellent health benefits and contain lower levels of purines than other fish, so eating them in moderation can be beneficial.
  • Spices and Minerals: A variety of minerals and spices, which can be found in your kitchen cabinets or as supplements at your local pharmacy, can help to reduce inflammation and gout pain.For immediate relief, ginger paste can be consumed. Its ability to lower serum uric acid levels has been demonstrated in numerous credible studies.Magnesium is a fantastic mineral that works similarly to ginger in that it reduces inflammation.Similar benefits of neutralizing acid can be obtained by adding turmeric or lemon juice to your beverage.
  • Complex Carbs: Individuals suffering from gout should consume more whole grains, fruits, and vegetables, as well as less refined carbohydrates such as cakes and white bread. Avoid high-fructose corn syrup-containing foods and beverages and limit your intake of naturally sweet fruit juices.

Treatment Options for More Severe Cases of Gout

In severe cases of gout, doctors may recommend surgery. If gout causes severe pain, a major abnormality, or a severe infection at the site, a person may be a candidate for surgery.

Gout surgery options include:

  • Joint Fusion: Surgeons may fuse a joint together to stabilize it if chronic gout causes significant tissue damage.
  • Joint Replacement: Surgeons can replace affected joints with artificial structures after removing the affected joints.
  • Tophi Removal: Tophi can be removed by a surgeon in cases of severe discomfort, abnormality, or infection.

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Some Additional Tips

You got no colchicine AND no ibuprofen? Ooff! Make sure to rest that joint as much as possible until the pain lessens. Use some cold compresses or cold packs and place them on the affected joint to lessen the inflammation for about 20 to 30 minutes several times a day.

Drink lots of water, drinking more water will stabilize your uric acid levels, flushing the excess. Aim for 8 to 16 cups of water daily. Make sure to read my post on the water to understand its many benefits for us gout sufferers.

Watch what you eat, which entails staying away from all gout-prohibited foods like organ meats, seafood, and alcohol, particularly beer. Limit your intake of meat as much as you can and avoid foods or drinks high in high fructose corn syrup or purines.

I also suggest if you’re going to walk, walk with a cane, to keep pressure off your affected joint. I’ve done this before and helps tremendously. There are many other home remedies listed in many different posts on my website that you can check out as well.

Whatever the case may be, make sure to let your doctor know as soon as you can, and if this is the first gout attack, you’re going to need to visit your doctor to run some blood tests and suggest a urate-lowering therapy.

If your symptoms don’t somewhat improve within 48 hours, then it’s best to call your doctor and may suggest a different treatment.

Get a Proper Gout Diagnosis

If you experience sudden, severe joint pain, consult your primary care physician, who may refer you to a specialist. You might need to see a specialist because gout symptoms are broad and can be mistaken for other inflammatory conditions.

Gout is typically diagnosed under the supervision of specialized doctors who specialize in gout patients, such as rheumatologists, though your primary doctor may also be able to diagnose you. Your doctor will conduct a thorough physical examination and discuss your symptoms with you.

Your doctor may order specific tests in addition to a physical examination and evaluation of your symptoms, such as blood work to determine the level of uric acid in your blood and imaging tests like X-rays, MRIs, and ultrasounds to take images of and more closely examine the affected joints.

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    36 replies to "How to Stop a Gout Attack"

    • Monica

      My husband has been suffering from the same gout flare-up for over two months now. We have been to a podiatrist several times and urgent care. He is currently taking Colchicine at high doses, steroids, and he does take meds for HBP. He also had a steroid shot in the ankle joint last week. The pain has not lessened at all. His ankle is still swollen and hot and he still has trouble walking and having pain.
      He is miserable. What else can we do?

      • Spiro Koulouris

        Over 2 months! My goodness.

        Best to seek the advice of 2 different rheumatologists and take it from there, his gout sounds very serious.

    • Kim Donegan

      My first gout flare happened in January of this year. The doctors haven’t been able to get my initial flare under control. I have done the colchicine oral steroids for over 5 months. 2 steroid injections. Indomethacin and I’m on allopurinol. Uric acid bloodwork has always been low. I’m very frustrated and the docs have no other ideas.

      • Spiro Koulouris

        Hi Kim!

        Try and seek the advice of 2 rheumatologists instead of GPs. They are specialists of gouty arthritis and other forms of arthritis. Good luck!

    • Shweta

      My husband is 30 years old and he is suffering from gout from last 2 months. He is having allopurinol and indomethacin (as needed). The pain sometimes is less but when he tries to walk for sometime, then pain becomes very high. We tried all the home remedies as well. The doctor is suggesting to give steroid injection on the toe area as the swelling and pain is not going away from last 2 months. Please suggest something which can help to reduce pain and inflammation and also is it fine to take steroid injection or he should wait for some more time to heal? Thanks!

      • Spiro Koulouris

        Has he tried colchicine? That should work best! Ask your doctor to prescribe him some. If that doesn’t work then do NSAID injection. Good luck!

    • My love

      My husband is feeling his gout not in pain can we catch it in time we are on vacation and he left his medication home it’s not bad but I do wanna enjoy this last night I have 800 ibuprofen that is it he laid down for 3 hours and he did put his foot up help me please

    • RB

      All- the lifesaver for me is a methyl-prednisone seven day dose pack. As soon as you feel the onset, if you take it right away you won’t have an attack. It’s a miracle drug of sorts for gout suffers. My doc always prescribes one that I take with me everywhere.

      • My love

        Can he just take the otc medicine and can he catch it In time ? No flare up just a little sore. Help please we are on vacation.

    • Shaun Carrie

      Hi Spiros, my doctor has given me Indometacine 50mg 3xa day. Started them yesterday and so far not much change. I am being force fed water by my other half but have no appetite at all. What can I do to try to get something inside of me. Ì don’t know what to do as the pain is severe. Hope you can help me as I have not eaten anything for days..

      • Spiro Koulouris

        Hi Shaun!

        Are you saying that the medication is not doing anything? If that is the case, you have to give it a bit more time. It doesn’t work overnight, usually takes a few days to kick in for the pain to disappear.

        How come you haven’t eaten in days? Is the pain affecting your appetite?

    • Kim Parkinson

      What if I took the colchicine when I first got the itching, burning pain before the flare as I just did, will it make it
      Worse?

      • Spiro Koulouris

        It shouldn’t, colchicine is given mostly during periods of inflammation to treat the affected joint. But as you take the first one by the next day your flare-up can worsen but will probably heal faster cause of your quick reaction.

    • Rollenn

      Can I take allopurinol and Nutrigout at the same time as a daily maintenance medicine?

      • Spiro Koulouris

        Yes! Most gout sufferers take it with allopurinol, NutriGout is not a gout cure but rather a dietary supplement that is supposed to supplement your gout diet and provide the right nutrients to keep your liver and kidneys healthy which is the area of the body that is responsible for uric acid.

    • Sabin Karki

      Is it possible to have higher level of uric acid at the age of 26 ??? My uric acid level is 9.3. I am maintaining my diet/Drink but the uric acid level is increasing day by day.

    • Cek

      I’ve been suffering with gout attacks for many years and once again these past few weeks it has became worse for me. I’m currently in bed as I write this note.
      I’m on Colchicine as a prevention rememdy but it doesn’t always keep a bout of gout from recurring. What to do???

      • Spiro Koulouris

        Try and ask your doctor if you can go on allopurinol instead of colchicine which is a much harsher drug.

    • MarkH

      I am a new gout sufferer having my 1st attack in Jan 2017 and the 2nd in Feb 2017. When it hits it is in my big toe and the toe beside it. Having just come off of a round of Colchicine I decided to try drinking Tart Cherry Juice to manage some tingling that was occurring in my 2nd toe. I drank about half of the recommended serving of 175ml and later that evening had an attack of gout in my 2nd toe. This time it was not a full blown attack but painful none the less. I saw that there are 70g of sugar in the recommend serving of the Tart cherry juice so even with the reduced amount that I had I am wondering if this is too much sugar to ingest at once? The only other significant sugar I had that day would have been in the banana I have with my cereal in the morning. Any thoughts on this would be appreciated as I’m finding it tough to figure out a safe diet. BTW, I have enjoyed reading through the articles on your website. I find them helpful as I try to find a way to manage my gout.

      • Spiro Koulouris

        Hi Mark!

        Thanks for your question.

        Yes problem with drinking tart cherry juice or any other cherry juice is the sugar intake. 70 grams of sugar is on the high end. I recommend a daily intake of around 25 grams of sugar a day, since as gout sufferers we are more sensitive to sugar and how it affects our uric acid. Like I tell everyone you are better off with a Tart Cherry Extract dietary supplement. You can buy mine or anybody else’s but as long as you skip the sugar, that’s what really counts.

        • James

          I have mild gout, but I found if I drink 2-3 cups of coffee a day with some whole milk then I avoid outbreaks. I usually have one outbreak a year from eating crawfish and drinking beer (hard to avoid in Louisiana).

    • Edmund A.

      Hi I’m currently suffering a gout attack as of the moment and I’m wondering if taking naproxen can help? I haven’t taken any medicines yet to ease the pain. What else fan you suggest? Thank you!

      • Spiro Koulouris

        Unfortunately Edmund I am not a doctor and I don’t give any medical advice since I do not even know enough about your health. Best to consult your doctor.

        Cheers!

    • Paul

      Hi!

      Just wanted to ask if exercising like riding a bike will make it worse when I am suffering from gout? I rode my bike yesterday and just endured the pain, but I think I made it worse. What do you think? Thanks

      • Spiro Koulouris

        Hi Paul!

        When suffering from a gout attack it is best not to inflame the joint any further by doing exercise cause it may push your pain and inflammation to last longer. If you want to heal quickly best to avoid exercise until you are 100% pain free.

    • kaleem mohammed

      In the case of gout, exercise naturally helps reduce uric acid levels by normalizing insulin. In general, exercise is a ‘prevent-all’ when it comes to any health issues.
      Though gout is said to partly genetic and may not be completely preventable, you can absolutely reduce the occurrence and severity of flare-ups with these natural treatments.

    • Beth

      I am very interest in purchasing some of these products for gout. However, I have a question. I take medicine for high blood pressure along with a diuretic. I read some where that a diuretic can contribute to gout. I wonder if anyone knows anything about this. Thank you so much for all the information on this site.

      • Spiro Koulouris

        Hi Beth!

        Yes it can and you can read more about it on my post about Gout and Diuretics.

        • Beth

          Thank you very much for your reply. Your site is a treasure of knowledge. I will continue to read and learn and will soon be purchasing your products.

    • […] In conclusion, a gout attack can last anywhere from a day to several weeks depending what stage you are in, diet, lifestyle and treatments all come into play. To learn more on how to stop a gout attack, make sure to read this post. […]

    • Ady Saxman

      Take a teaspoon of apple cider vinegar in a glass of water before every meal, and add a daily dose of bicarbonate of soda. Absolutely marvelous for gout sufferers! I know because I’m one myself.

    • vinz

      My Father suffering from gout since four years,at first attack we brought him to a doctor,after we discharged him from the hospital,he feels more pains to his body a severe pains to his joints,w/c bring him to trauma not to go back in the hospital because he notices that his gout makes even worse,,now still his suffering in gout,his ankle having puss already,sometimes he has fever becoz of his inflammation,and now we are so confuse of what we are going to do bcoz he really dont want to go to a doctor anymore,what he only want is to have a home effective remedy to his severe ill.Could someone give any advice’s of what some other remedies can effectively cured to my father’s gout??plzz,,more advices….God bless..

    • Donna

      Excellent article Spiro!

      I just got diagnosed with gout..me an in shape athletic type, who eats healthy, but apparently not healthy enough! I have book marked your site and will be reading your recommendations.

    • Atul Sinha

      Iam at the age of 58 years. The first gout attack on one of my ankle happened in the year 1999. After that I use to be affected with Gout pain very often and sometimes it use to effect my left ankle and sometimes to right ankle.Now a days if I am effected with Gout pain it last atleast for three days. Normally I use to take Zyloric in normal course but when the severe pain occurs I use to Colchincine and Butaproxivon as a pain killer.I avoid taking protiens food. Please suggest what else I do to avoid such pain.

      • Spiro Koulouris

        Atal just read all my posts on my website, you’ll get plenty of tips on home remedies, foods to eat and avoid, etc…You can also check out my ebook which explains my philosophy of what a gout diet should consist of and what foods you should eat more and what foods you should eat less and why.It’s great that you are avoiding foods high in protein, make sure to limit your meat intake and protein should never be more than 10% of your daily calories so about 200 calories should come from protein on daily basis. Drink plenty of water at least 8 glasses a day, you’ll notice a difference and cut out any alcohol, juices and soft drinks.

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