How Gout Is Treated

Managing Symptoms and the Underlying Triggers

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Gout is a form of arthritis caused by the buildup and crystallization of uric acid in a joint. Depending on the severity of an attack, treatment may involve over-the-counter (OTC) anti-inflammatory drugs to alleviate pain, as well as behavioral modifications (such as dietary and alcohol restrictions) to reduce the frequency of attacks. Chronic attacks may require prescription medications to help reduce uric acid levels in the blood.

Home Remedies and Lifestyle

Gout symptoms are caused by the excessive accumulation of uric acid, a condition known as hyperuricemia. Over time, the build-up can lead to the formation of uric acid crystals in and around a joint, triggering severe and protracted bouts of pain and inflammation.

Gout attack common symptoms

As such, gout treatment is focused on two things: the reduction of uric acid and the alleviation of gout pain.

Pain Management

There are a number of home treatments and lifestyle adjustments that can help.

A gout attack will usually last from three to 10 days. The pain during the early part of the attack (typically the first 36 hours) will typically be the worst.

Among the home treatment options:

  • An ice pack or cold compress may provide ample relief of a mild attack. Be sure to wrap the ice pack in a thin towel and apply to the joint for only 15 to 20 minutes to prevent frostbite. You can do this several times a day.
  • Rest the joint. Since the big toe is most often affected, elevate the foot to alleviate the swelling. Keep off your feet as much as possible, and, if you need to move about, consider using a cane or crutches.
  • Tylenol (acetaminophen) or another over-the-counter pain relief medication can be used in milder cases. While it doesn't have the anti-inflammatory properties of NSAIDs, it can help relieve pain.
  • Weight loss in patients with gout who are obese or overweight can help alleviate pressure on the affected joints.

Dietary Interventions

Hyperuricemia can be linked to the foods we eat. Some contain high levels of an organic compound known as purine which, when broken down, is converted into uric acid. Others contain substances that impair the excretion of uric acid from the kidneys.

While there is little evidence dietary interventions can reduce the severity or duration of a gout attack, changes may help reduce the risk of future attacks.

To this end, you would need to make the following changes to avoid hyperuricemia:

  • Avoid or limit drinking alcohol of any sort, especially beer.
  • Avoid or limit high-purine foods.
  • Avoid or limit fructose-sweetened drinks, which impair uric acid excretion.

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Prescription drugs are often used if dietary and lifestyle interventions don't provide adequate relief and/or there is evidence of increasing joint damage. The prescription medications used to treat gout can be broadly broken down into two types: anti-inflammatory and uric acid-reducing.

Anti-Inflammatory Drugs

The prescription anti-inflammatory drugs commonly used to treat gout are either prescribed on an ongoing basis or used when needed to alleviate acute symptoms.

Among the options:

  • Colchicine is an oral anti-inflammatory drug used to prevent and treat acute gout attacks. Colchicine can be used on its own but is more commonly prescribed alongside a uric acid-reducing drug like allopurinol. Side effects of colchicine include diarrhea, nausea, and abdominal cramps.
  • Corticosteroids, taken either orally or by injection into a joint, offer short-term relief of acute symptoms. The drugs work by suppressing inflammation and tempering the immune system as a whole, and are generally not used as a form of ongoing therapy.

Overuse of any form of corticosteroid can lead to weight gain, easy bruising, osteoporosis, eye problems, high blood pressure, and an increased risk of infection.

Oral treatment (usually with the drug prednisone) may be prescribed over several days to weeks. Corticosteroid injections are most commonly used when only one joint is involved or there is a need to avoid systemic (body-wide) effects of oral corticosteroids.

Uric Acid-Reducing Drugs

If other interventions fail to reduce uric acid levels, healthcare providers will often turn to medications that can either decrease the production of uric acid or increase the excretion of uric acid from the body. The 2020 gout treatment guidance from the American College of Rheumatology recommends these urate-lowering therapies as the first-line option in most patients who have the condition.

There are currently five drugs approved by the U.S. Food and Drug Administration (FDA) to reduce uric acid levels.

Commonly prescribed urate-lowering therapies include:

  • Zyloprim (allopurinol) is an oral xanthine oxidase inhibitor (XOI) that reduces the body’s production of uric acid. This medication is taken once daily and is typically recommended as a first-line treatment for most patients with gout. Symptom flares can occur during early treatment, so the drug is often prescribed at lower doses and then gradually increased. In addition, allopurinol is typically given with colchicine to reduce the short-term risk of a gout attack. Allopurinol side effects include stomach upset and rare, but often serious, skin reactions. Ask your prescribing provider if you are at risk for severe allopurinol reactions. Side effects are far less extensive than other uric acid-reducing drugs and may include rash and stomach upset. Stomach problems usually go away as your body adjusts to the medication.
  • Uloric (febuxostat) is another XOI treatment option that reduces the body’s production of uric acid. This medication is primarily prescribed for people who cannot tolerate allopurinol. Taken daily, Uloric can reduce the severity and frequency of attacks. Flare-ups are common when first starting treatment. Even if they occur, you should continue to take the medication as prescribed.
    Common side effects include nausea, joint pain, and muscle aches. Do not take Uloric if you are using azathioprine (used to treat rheumatoid arthritis) or mercaptopurine (used to treat lymphoma, Crohn's disease, or ulcerative colitis).
  • Krystexxa (pegloticase) is a newer biologic drug delivered by intravenous infusion into a vein and is only used when other treatments have failed. Krystexxa works by converting uric acid into a substance called allantoin, which is easily expelled from the body. It is administered every two weeks at a clinic and is therefore reserved for only the most severe cases.
    Common side effects include short-term flare-ups, nausea, bruising, sore throat, constipation, chest pain, and vomiting. After repeated doses, serious allergic reactions may occur.
  • IL-1 inhibitors, including anakinra and canakinumab, are a class of treatment options recommended for patients in whom anti-inflammatory drugs are ineffective, poorly tolerated, or contraindicated.

Other complementary drugs may be used in gout treatment, including Cozaar (losartan), an antihypertensive drug, and Tricor (fenofibrate), a lipid-lowering drug. Both can aid in the reduction of serum uric acid levels.

Frequently Asked Questions

  • What medications treat gout pain?

    Over-the-counter analgesics like Tylenol (acetaminophen), Advil (ibuprofen), or Aleve (naproxen) may help to relieve the pain from a mild case of gout, but most often prescription anti-inflammatories or corticosteroids are used to treat a gout attack. Your healthcare provider will also likely prescribe medication to lower uric acid levels.

  • How do you stop gout pain at home?

    To treat an acute gout attack at home, try ice and elevation to relieve the pain. Apply an icepack or cold compress to the affected joint for 15 to 20 minutes several times a day—just be sure to keep a towel between your skin and the ice. Staying off your feet can also help to relieve the pain. 

  • How do you flush uric acid out of your body?

    Drinking lots of water is the best way to flush uric acid out of your system. During a gout attack, drinking 16 8-ounce glasses of water daily is recommended. To keep uric acid levels low to prevent attacks, stay hydrated with at least eight glasses of water a day.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Arthritis Foundation. Managing a Gout Attack.

  2. Centers for Disease Control and Prevention. Gout. Updated January 28, 2019.

  3. American College of Rheumatology. Gout. Updated March 2019.

  4. FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care Res (Hoboken). 2020;72(6):744-760.

  5. Arthritis Foundation. Gout diet: Dos and don’ts.

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