Gout

Gout causes sudden severe joint pain. See a GP for treatment to help during an attack and to stop further attacks.

See a GP if you have:

  • sudden severe pain in any joint – usually the big toe, or fingers, wrists, elbows or knees
  • red, hot, swollen skin over the affected joint

Gout doesn't cause lasting damage to joints if you get treatment straightaway.

Ask for an urgent appointment or call 111 if:

  • the pain is getting much worse and you have a very high temperature (you feel hot and shivery)

This could mean you have an infection inside the joint.

What happens at your appointment

Gout can be hard to diagnose as symptoms are similar to other conditions.

Your GP may ask about your diet and if you drink beer or spirits.

You might be sent for a blood test, ultrasound or X-ray. Sometimes a thin needle is used to take a sample of fluid from the affected joint to test.

The tests will find out how much of a chemical called uric acid there is in your body.

Having too much can lead to crystals forming around your joints and causing pain.

Treatment to reduce pain and swelling

Attacks of gout are usually treated with anti-inflammatory medicine like ibuprofen.

If the gout does not improve after 3 to 4 days you might be given steroids as tablets or an injection.

Do

  • take any medicine you've been prescribed as soon as possible – it should start to work within 3 days
  • rest and raise the limb
  • keep the joint cool – apply an ice pack, or a bag of frozen peas wrapped in a towel, for up to 20 minutes at a time
  • drink lots of water (unless advised not to by your GP)
  • try to keep bedclothes off the affected joint at night

Don't

  • knock the joint or put pressure on it

Treatment to prevent gout coming back

Gout can come back every few months or years. It can come back more often over time if not treated.

If you have frequent attacks, or tests show that you have a high level of uric acid in your blood, your GP might prescribe medicine called allopurinol or febuxostat.

This is used to lower the levels of uric acid and needs to be taken in the long term.

It's important to take uric-acid-lowering medicine regularly, even when you no longer have symptoms.

Things you can do to stop gout coming back

Making lifestyle changes might mean you can stop or reduce further attacks.

Do

  • get to a healthy weight, but avoid crash diets or high-protein/low-carbohydrate diets
  • have at least 2 alcohol-free days a week
  • drink water (up to 2 litres a day)
  • exercise regularly – but avoid intense exercise or putting lots of pressure on joints
  • stop smoking
  • ask your GP about vitamin C supplements

Don't

  • eat a lot of red meat, kidneys, liver or seafood – read information about how to eat well with gout
  • drink more than 14 units of alcohol a week (and don't have it all on 1 or 2 days)
  • eat sugary drinks and snacks
  • eat full-fat dairy products
  • eat more than 2 servings of low-fat dairy foods a day

The UK Gout Society and Arthritis Care have advice on living with gout.

Things that can trigger a gout attack

If you're very stressed or have had an illness you might get an attack.

If you injure or bruise a joint and it's more painful than you would expect after a minor bump, it could be an attack coming on.

If you feel an attack coming on get treatment straightaway.

Who gets gout

Gout sometimes runs in families.

It's more common in men, especially as they get older.

Other people at risk include:

  • women after the menopause
  • people who take medicines such as diuretics (water tablets) for blood pressure, or have high levels of cholesterol
  • people who are overweight and who drink alcohol, especially beer

Complications of gout

It's rare to get lots of attacks but if you do you can develop permanent damage to the joint (chronic gout).

Chronic gout can also cause tiny white lumps (tophi) to appear under your skin, especially on your ears, fingers or elbows. This is where urate crystals form under the skin. They can be painful.

You can get kidney stones if your uric acid levels are very high, so you will need treatment to reduce the levels.

Call 111

If you can’t speak to your GP or don’t know what to do next.

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