Gout: Symptoms, Causes, and Treatment

Gout is a painful condition that affects the joints, often striking suddenly and without warning. While attacks of gout can be distressing, it's a treatable condition, and there are steps you can take to reduce the frequency of flare-ups.

What is gout?

Gout is a type of arthritis that causes inflammation and intense pain in the joints. It's most commonly felt in the big toe but can also affect the fingers, wrists, elbows, knees, heels, ankles, and feet.

If you're experiencing an attack of gout, it's important to seek medical advice to help manage your symptoms effectively.

Close-up of hands massaging a swollen, bruised ankle

What are the symptoms of gout?

Gout is typically characterised by:

  • Sudden, severe pain in one or more joints – often starting in the big toe.

  • Swelling and tenderness around the affected joint.

  • Red, inflamed skin over the joint that may become itchy and start to peel.

Attacks of gout often occur at night. The pain tends to worsen over 24 hours, and an episode can last anywhere from 3 to 10 days. Severe pain may make it impossible to move the joint or even touch it. Some people also experience a fever and feel generally unwell.

When to seek immediate medical attention

If your pain is getting worse, and you have a high fever, there may be an underlying infection that requires urgent care. Contact a doctor as soon as possible.

What causes gout?

Gout occurs when uric acid levels in the body become too high. Uric acid is a natural chemical produced by the body, but when there's an excess, it can form tiny crystals around the joints, leading to pain and inflammation.

Factors that increase uric acid levels:

  • Kidney function problems — your kidneys might not filter out uric acid effectively.

  • Diet — eating foods high in purines (which break down into uric acid).

  • Excess uric acid production — some people's bodies naturally produce more uric acid.

Close-up of bare feet crossed and resting on the arm of a sofa

How is gout diagnosed?

A GP or Advanced Clinical Practitioner (ACP) can often diagnose gout based on your symptoms and a physical examination of the joint. To confirm the diagnosis, they may recommend:

  • A blood test to measure your uric acid levels, though this can sometimes be normal during an attack, so it's not used on its own.
  • A sample of joint fluid, occasionally taken and examined for uric acid crystals, particularly if the diagnosis is unclear.
  • An X-ray, sometimes used to check for joint damage if you've had gout for a long time.

Risk factors for gout

Certain lifestyle and health factors can make gout more likely:

  • Drinking too much alcohol (especially beer).
  • Not drinking enough water.
  • Taking diuretics (medications that increase urine production).
  • Being overweight.
  • Having conditions like diabetes, high blood pressure, psoriasis, or kidney disease.
  • Being male or a postmenopausal woman.

There's also evidence that gout can run in families, so genetics may play a role.

Close-up of a man's hand holding a glass of whisky while seated

Managing gout during an attack

During a flare-up, your doctor or Advanced Clinical Practitioner (ACP) will likely recommend anti-inflammatory medication:

  • Prescription-strength naproxen or over-the-counter ibuprofen are commonly used.
  • If symptoms persist, steroid tablets or a steroid injection into the joint may be prescribed.

In addition to medication, you can manage gout symptoms by:

  • Resting the affected joint and avoiding strenuous activity.
  • Keeping the joint elevated, cool, and uncovered.
  • Applying an ice pack wrapped in a towel to the joint to reduce swelling.

 

How can I avoid gout?

Making simple lifestyle changes can help lower your risk of developing gout. One of the most effective steps is to reduce your intake of foods that are high in purines, such as:

  • Organ meats: liver, kidneys.
  • Red meats: beef, venison.
  • Fish: mackerel, herring, anchovies.
  • Seafood: mussels, scallops, oysters.
  • Yeast extracts: Marmite and similar products.
  • Alcohol: especially beer, stout, and port (aim for at least two alcohol-free days per week).

Frequently asked questions

A gout attack typically peaks within 24 hours and can last anywhere from 3 to 10 days, even with treatment, though pain relief and anti-inflammatory medication can ease symptoms sooner.

A clinician can often diagnose gout from your symptoms and an examination, sometimes confirmed with a blood test for uric acid levels or, less commonly, a sample of joint fluid.

There's no permanent cure, but gout can be very effectively managed. Long-term medication to lower uric acid levels, alongside diet and lifestyle changes, can significantly reduce or even prevent future flare-ups.

Foods high in purines are worth limiting, including organ meats, red meat, certain seafood (like mussels and mackerel), and alcohol, as these can raise uric acid levels and trigger attacks.

Yes, gout is associated with conditions like high blood pressure, diabetes, and kidney disease, so managing gout is often part of a wider conversation about overall health with your doctor.

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