Gout
ℹ️ This information is for general education and is not medical advice. Always talk with your own rheumatologist about your diagnosis and treatment.
Gout is a common form of arthritis caused by uric acid. When there is too much uric acid in the blood, it can form tiny, sharp crystals in a joint that trigger sudden, intense inflammation — a “gout attack” or flare. Gout is very treatable, and with the right medicine most people can stop flares from happening at all.
Who gets it
Gout is more common in men and after middle age, though it also affects women, especially after menopause. Uric acid can be raised by certain foods and drinks (red meat, shellfish, alcohol — especially beer — and drinks with high-fructose corn syrup), excess weight, some medicines (such as certain water pills), kidney disease, and family history.
Signs and symptoms
- A sudden attack of severe pain, swelling, redness, and warmth — often the big toe, but also the foot, ankle, or knee
- Pain that often starts at night and can be so intense that even a bedsheet hurts
- Flares that build over hours then settle over days to a couple of weeks
- Over years, untreated gout can form lumps of crystals under the skin (tophi) and damage joints
How it’s diagnosed
A rheumatologist diagnoses gout from your symptoms and exam. The most certain way to confirm it is to take a small sample of fluid from the joint and look for uric acid crystals under a microscope. Blood uric acid helps, but it can be normal during a flare, so a normal result does not rule gout out.
Common treatments
There are two separate goals — and this is the part that’s often misunderstood:
1. Treating the flare (fast relief). Anti-inflammatory medicines such as NSAIDs, colchicine, or steroids. These calm the attack but do not lower uric acid.
2. Lowering uric acid long-term (preventing flares). This is urate-lowering therapy, most commonly allopurinol (or febuxostat). Taken daily, it dissolves the crystals so flares stop. Your rheumatologist aims for a uric acid level below 6 mg/dL.
Important: when you first start urate-lowering medicine, flares can briefly become morecommon as old crystals dissolve. This is expected — don’t stop it during a flare; keep taking it and treat the flare separately.
Living well with gout
- Take your urate-lowering medicine every day, long-term — it only works if you stay on it.
- Stay well hydrated.
- Cut back on alcohol (especially beer), sugary drinks, and large amounts of red meat and shellfish.
- Work toward a healthy weight; review other medicines that can raise uric acid with your doctor.
Questions to ask your rheumatologist
- What is my uric acid level, and what number are we aiming for?
- Should I be on a daily medicine to prevent flares, not just treat them?
- What do I do if I flare while taking my daily medicine?
- How often do I need my uric acid checked?
When to call your doctor
Call if a flare doesn’t improve with treatment, if a hot swollen joint comes with a fever(this can look like a joint infection — an emergency), or if you have side effects from a new medicine — especially any rash after starting allopurinol.
Medications commonly used to treat gout
Allopurinol · Febuxostat · Colchicine · NSAIDs · Prednisone
Detailed medication pages are coming soon.
Patient support & community
Reviewed by Alison Bays, MD — June 15, 2026. This information is for general education only and is not a substitute for advice from your own health care provider.
Learn more: ACR Gout fact sheet (English & Spanish).