Gout treatment: quick relief and long-term control

Got a hot, swollen joint and wondering what actually helps? Gout is painful but very treatable. You need two things: fast relief during a flare, and a plan to lower uric acid so flares happen less. Below I’ll walk you through practical steps you can use right away and habits that cut future attacks.

Acute flare: what helps now

If your toe or knee went red and screaming, start with simple, proven measures. Over-the-counter NSAIDs (ibuprofen, naproxen) often ease pain if you can take them safely. Your doctor may prescribe stronger NSAIDs, colchicine, or a short course of oral steroids if NSAIDs aren’t an option. Colchicine works best when started within the first 24–48 hours of a flare.

At home: rest the joint, keep it slightly elevated, and use ice for 20 minutes to reduce pain. Avoid alcohol and sugary drinks while you’re having a flare—these can make inflammation worse. Drink water to stay hydrated; dehydration can concentrate uric acid.

When to call your doctor: if the pain is severe, the joint looks infected, you have fever, or symptoms don’t improve in a couple of days despite treatment.

Long-term control: lower uric acid to stop future attacks

Controlling uric acid is the only way to prevent repeated flares and joint damage. Uric acid–lowering drugs (called urate-lowering therapy or ULT) include allopurinol and febuxostat. These are taken daily and aim to keep your blood uric acid under a target—usually below 6 mg/dL (360 µmol/L). For people with tophi or frequent flares, doctors may aim even lower.

Start ULT after discussing timing with your doctor. Some providers wait until an acute attack settles, while others start ULT right away; either way, your physician will also often give a low dose of colchicine or an NSAID during the first months of ULT to prevent flare-ups triggered by changing uric acid levels.

Lifestyle changes that really help: lose weight if you’re overweight, cut back on beer and spirits (beer is especially risky), avoid sugary sodas and fruit juices high in fructose, and moderate red meat and shellfish. Eat more low-fat dairy, vegetables, and whole grains. Some people find cherries or vitamin C helpful—cherries have small benefits in studies, but they don’t replace meds.

Watch out for medicines that raise uric acid, like some diuretics. If you have kidney disease, your doctor will tailor treatment and monitor you more closely. Regular blood tests track uric acid level and medication safety—don’t skip them.

Bottom line: treat the flare fast, then make a plan with your doctor to control uric acid long term. That combo gives the best chance to stop painful attacks and protect your joints.