Gout can be treated and managed with medications and healthy lifestyle habits. Your doctor or nutritionist can help you develop the best treatment strategy for you.
Gout is a general term for a variety of conditions caused by a buildup of uric acid. This buildup usually affects the feet.
If you have gout, you’ll probably feel swelling and pain in the joints of your foot, particularly your big toe. Sudden and intense pain, or gout attacks, can make it feel like your foot is on fire.
Some people have too much uric acid in their blood but no symptoms. This is called asymptomatic hyperuricemia.
For acute gout, symptoms come on quickly from the buildup of uric acid crystals in your joint and last for 3 to 10 days.
You’ll have intense pain and swelling, and your joint may feel warm. Between gout attacks, you won’t have any symptoms.
If you don’t treat gout, it can become chronic. Hard lumps called tophi can eventually develop in your joints and the skin and soft tissue surrounding them. These deposits can permanently damage your joints.
Prompt treatment is important to prevent gout from turning chronic.
Some home remedies may help lower uric acid levels and prevent gout attacks. The following foods and drinks have been suggested for gout:
- tart cherries
- diluted apple cider vinegar
- nettle tea
- milk thistle seeds
But these alone may not be enough to manage gout.
If left untreated, gout can eventually lead to gouty arthritis, which is a more severe form of arthritis. This painful condition can leave your joint permanently damaged and swollen.
The treatment plan your doctor recommends will depend on the stage and severity of your gout.
Medications to treat gout work in one of two ways: They relieve pain and bring down inflammation, or they prevent future gout attacks by lowering uric acid levels.
Drugs to relieve gout pain include:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (Bufferin), ibuprofen (Advil, Motrin), and naproxen (Aleve)
- colchicine (Colcrys, Mitigare)
Drugs that prevent gout attacks include:
- xanthine oxidase inhibitors, such as allopurinol (Lopurin, Zyloprim) and febuxostat (Uloric)
- probenecid (Probalan)
Along with medications, your doctor may recommend lifestyle changes to help manage your symptoms and reduce your risk of future gout attacks. For example, your doctor may encourage you to:
- reduce your alcohol intake, if you drink
- lose weight, if you’re overweight
- quit smoking, if you smoke
In addition a few complementary therapies have also shown promise.
Gout can typically be treated without surgery. But after many years, this condition can damage the joints, tear the tendons, and cause infections in the skin over the joints.
Hard deposits, called tophi, can build up on your joints and in other places, like your ear. These lumps may be painful and swollen, and they can permanently damage your joints.
Three surgical procedures treat tophi:
- tophi removal surgery
- joint fusion surgery
- joint replacement surgery
Which one of these surgeries your doctor recommends depends on the extent of the damage, where the tophi are located, and your personal preferences.
The buildup of uric acid in your blood from the breakdown of purines causes gout.
Certain conditions, such as blood and metabolism disorders or dehydration, make your body produce too much uric acid.
A kidney or thyroid problem, or an inherited disorder, can make it harder for your body to remove excess uric acid.
You’re more likely to get gout if you:
- are a middle-aged man or postmenopausal woman
- have parents, siblings, or other family members with gout
- drink alcohol
- take medications such as diuretics and cyclosporine
- have a condition like high blood pressure, kidney disease, thyroid disease, diabetes, or sleep apnea
For some people, gout is caused by consuming foods that are high in gout-producing purines.
Certain foods are naturally high in purines, which your body breaks down into uric acid.
Most people can tolerate high-purine foods. But if your body has trouble releasing excess uric acid, you may want to avoid certain foods and drinks, such as:
- red meats
- organ meats
- certain seafood
Sugar-sweetened beverages and foods containing the sugar fructose can also be problematic, even though they don’t contain purines.
Some foods help reduce uric acid levels in the body and are good choices if you have gout.
Gout and alcohol
Alcohol, like red meat and seafood, is high in purines. When your body breaks down purines, the process releases uric acid.
More uric acid increases your risk of having gout. Alcohol can also reduce the rate at which your body removes uric acid.
Not everyone who drinks will develop gout. But a high consumption of alcohol (more than 12 drinks per week) can increase the risk — especially in men. Beer is more likely than liquor to influence the risk.
In surveys, people have reported that drinking alcohol triggers their gout flare-ups.
Your doctor can diagnose gout based on a review of your medical history, a physical exam, and your symptoms. Your doctor will likely base your diagnosis on:
- your description of your joint pain
- how often you’ve experienced intense pain in your joint
- how red or swollen the area is
Your doctor may also order a test to check for a buildup of uric acid in your joint. A sample of fluid taken from your joint can show whether it contains uric acid. They may also want to take an X-ray of your joint.
If you have symptoms of gout, you can start with a visit to your primary care doctor. If your gout is severe, you may need to see a specialist in joint diseases.
If you need help finding a primary care doctor, then check out our FindCare tool here.
Certain foods, medications, and conditions can set off gout symptoms. You may need to avoid or limit foods and drinks like these, which are high in purines:
- red meat, such as pork and veal
- organ meats
- fish, such as cod, scallops, mussels, and salmon
- fruit juice
Some medications you take to manage other conditions increase the level of uric acid in your blood. Talk with your doctor if you take any of these drugs:
- diuretics, or water pills
- blood pressure-lowering medications, such as beta-blockers and angiotensin II receptor blockers
Your health may also be a factor in flare-ups. All of these conditions have been linked to gout:
- diabetes or prediabetes
- joint injury
- congestive heart failure
- high blood pressure
- kidney disease
Sometimes it can be hard to pinpoint which of these factors is behind your gout attacks. Keeping a diary is one way to track your diet, medications, and health to help identify the cause of your symptoms.
Here are a few steps you can take to help prevent gout:
- Limit how much alcohol you drink.
- Limit how much purine-rich food, such as shellfish, lamb, beef, pork, and organ meat, you eat.
- Eat a low-fat, nondairy diet that’s rich in vegetables.
- Maintain a healthy weight.
- Avoid smoking.
- Exercise regularly.
- Stay hydrated.
If you have medical conditions or take medications that raise your risk of gout, ask your doctor how you can lower your risk of gout attacks.
When uric acid crystals build up in joints for a long time, they produce hard deposits called tophi under the skin. Without treatment, these tophi can damage bone and cartilage and leave the joints permanently disfigured.
Tophi are swollen lumps around the joints that look like knots on a tree trunk. They occur in joints like the fingers, feet, and knees, as well as on the ears. Tophi themselves don’t hurt, but the inflammation they cause can be painful.
Sometimes tophi form in connective tissue outside the joints.
Yes, gout can be painful. In fact, pain in the big toe is often one of the first symptoms people report. The pain is accompanied by more typical arthritis symptoms, such as swelling and warmth in the joints.
Gout pain can vary in severity. Pain in the big toe can be very intense at first. After the acute attack, it may subside to a dull ache.
The pain, as well as swelling and other symptoms, are the result of the body launching a defense (by the immune system) against uric acid crystals in the joints. This attack leads to the release of chemicals called cytokines, which promote painful inflammation.
Essential oils are plant-based substances used in aromatherapy. Some oils are thought to have anti-inflammatory, pain-relieving, and antibacterial effects.
Some of the essential oils used to treat gout include:
- lemongrass oil
- celery seed oil
- yarrow oil extract
- olive leaf extract
- Chinese cinnamon
Talk with your doctor before you begin using any essential oil. Be aware that the Food and Drug Administration (FDA) doesn’t regulate the purity or quality of essential oils, so research the brand.
Be sure to follow these safety precautions when using essential oils:
- Don’t put essential oils directly on your skin. It’s important to dilute them first with a carrier oil such as coconut oil or jojoba oil. For example, for a 3 percent dilution, mix 20 drops of the essential oil with 6 teaspoons of the carrier oil.
- Don’t put essential oils in your mouth, since they’re not safe to ingest.
Store essential oils and carrier oils in a cool, dark place, away from sunlight and heat.
Gout is at least partly due to heredity. Researchers have found dozens of genes that increase people’s susceptibility to gout, including SLC2A9 and ABCG2. Genes associated with gout affect the amount of uric acid the body holds onto and releases.
Because of genetic factors, gout runs in families. People with a parent, sibling, or other close relative who has gout are more likely to get this condition themselves.
It’s likely that genes only set the stage for gout. Environmental factors, such as diet, actually trigger the disease.
Gout can often be successfully treated and managed. Your doctor may prescribe medications that help lower your uric acid levels and reduce inflammation and pain.
Your doctor or nutritionist can also recommend changes in your diet to help prevent flare-ups. Balanced eating and healthy lifestyle habits can help you successfully manage gout.