Arthritis Today

Managing a Gout Attack

Gout attacks are unexpected and painful; here’s how to get a handle on them.


Few things in life are more painful than a gout attack, so if you’re awakened in the wee hours by a joint that is tender, swollen, red and radiating heat, you’ll want to act fast. Here’s what you can do when a gout attack starts to ease the pain of the attack and reduce the risk of others.

Take medicine you have on hand. Start treatment immediately with over-the-counter ibuprofen (Motrin, Advil) or naproxen (Aleve), but never take aspirin, which can actually worsen an attack.  If you have had an attack before and your doctor has prescribed an anti-inflammatory medication to take in the event of another, take your prescribed medication as your doctor directed. If you are already taking a uric acid-lowering drug to reduce the risk of attacks, continue to take that drug through this attack.

Ice down. Applying an ice pack to the painful joint may help ease pain and inflammation. Wrap a pack (a bag of crushed ice or frozen peas will also do) in a dish cloth and apply to the area for 20 to 30 minutes at a stretch several times a day.

Call your doctor.  Let your doctor know what is going on right away. She may prescribe a new medication or have you come to the office for a joint fluid test (to confirm the gout diagnosis) or an injection of a corticosteroid to start relieving inflammation quickly. Getting treatment within the first 24 hours of the start of an attack can lessen its length and severity.

Drink plenty of fluids. Staying hydrated helps flush out uric acid (the cause of your joint pain) and prevent kidney stones, another possible problem associated with high uric acid levels.  Aim for eight to 16 cups of fluids a day, at least half of them water.

Avoid alcohol. Although it may be tempting to have a drink to relax when you’re in pain, it’s important to avoid alcohol, especially beer, which contains high levels of purines. The body creates uric acid when it metabolizes purines. Furthermore, alcohol inhibits the excretion of uric acid from your body.

Get a cane. Walking with a cane during an acute gout attack can help keep pressure off your painful joint.

Elevate your foot, if affected. Raising your foot with pillows so it’s higher than your chest may help lessen swelling.

Tame your sheets. Even the weight of your bed sheets can be unbearable to an inflamed, gouty toe. Tuck the sheet in on the sides so its end falls at calf level, leaving your painful toe free.

Create gout-friendly socks. Cut the big toe out of cheap socks or cut the toe section off completely so you can have warm feet without toe pain.

Chill out. Try to relax if you can; stress can aggravate gout. Watch a movie, talk to a friend, read a book or listen to music

Revamp the menu. Stop eating troublesome high-purine foods, such as shellfish, red meat, sweetbreads and gravies.