Gout Pain Relief: What Can Help During a Gout Attack?

Quick Answer

During a gout attack, the priority is to reduce pain and inflammation as quickly as possible.

Resting and raising the affected joint, keeping pressure off it and using a wrapped ice pack for up to 20 minutes at a time can help. Gout attacks are commonly treated with anti-inflammatory medicines such as an NSAID, colchicine or corticosteroids, depending on what is medically suitable for you. nhs.uk

If this is your first suspected gout attack, or your normal gout treatment is not working, contact your GP. A hot, swollen and extremely painful joint can occasionally be caused by something other than gout.

Why Is Gout So Painful?

Gout isn't simply an aching joint.

It occurs when monosodium urate crystals accumulate in and around a joint and trigger a powerful inflammatory response. During a flare, this can produce sudden severe pain, swelling, heat and redness. Nice

The big-toe joint is particularly well known for gout attacks, although gout can also affect the feet, ankles, knees, hands, wrists and elbows. nhs.uk

For some people, even the pressure of a bedsheet against the affected joint can feel extremely painful.

What Can You Do Immediately During a Gout Attack?

If you've already been diagnosed with gout and have been given medication for attacks, follow the instructions you've been given and take it as directed.

There are also several practical things you can do alongside your treatment.

1. Rest the painful joint

Avoid unnecessarily walking on or putting pressure through the affected joint.

The NHS recommends resting the affected limb during an attack. nhs.uk

If gout is affecting your foot or big toe, this might mean reducing walking for a while and keeping weight off the painful area as much as reasonably possible.

2. Raise the affected limb

Try elevating the affected foot or limb while resting.

This can be particularly useful when there is considerable swelling around the joint, and elevation forms part of NHS self-care advice during a gout attack. nhs.uk

3. Use an ice pack

Cold therapy can be one of the simplest ways to help manage gout pain.

NICE advises that applying an ice pack to the affected joint, in addition to prescribed medicine, may help alleviate pain. Nice

The NHS suggests using an ice pack — or even a bag of frozen peas — wrapped in a towel for up to 20 minutes at a time. nhs.uk

Never put ice directly against your skin.

4. Keep pressure away from the joint

A severely inflamed gout joint can become incredibly sensitive.

If your big toe is affected, tight shoes, socks or even bedding may make the pain worse. The NHS specifically suggests trying to keep bedclothes away from the affected joint at night. nhs.uk

This is also why a roomy slipper or open footwear may sometimes be more comfortable than squeezing a swollen foot into a normal shoe.

What Medicines Are Used for Gout Pain?

The best treatment depends on your individual circumstances.

Common treatments for an acute gout flare include:

NSAIDs – non-steroidal anti-inflammatory medicines reduce inflammation as well as pain. The NHS gives ibuprofen as one example used for gout attacks. nhs.uk

Colchicine – another anti-inflammatory treatment specifically used in conditions including gout.

Corticosteroids – steroid tablets or, in some circumstances, injections may be considered when other treatments aren't appropriate or haven't been effective. Royal Devon NHS

These treatments aren't interchangeable for everyone. Your medical history, kidney function, other conditions and medicines can affect which option is appropriate. For example, NICE's evidence review notes that NSAIDs can be unsuitable for some people with conditions including chronic kidney disease, peptic ulcer disease and severe heart failure. Nice

If you're unsure which pain relief is safe for you, speak to a pharmacist or GP rather than guessing.

Should I Drink More Water During a Gout Attack?

Avoiding dehydration is sensible during a gout flare.

The NHS advises drinking plenty of water during an attack unless a GP has told you not to. nhs.uk

That final point matters. Some people have medical conditions where their fluid intake needs to be controlled, so individual medical advice should take priority.

How Quickly Should Gout Pain Improve?

An untreated gout attack usually lasts around 1 to 2 weeks, according to the NHS. nhs.uk

With appropriate treatment, symptoms may begin improving sooner. The NHS says prescribed medicine taken during an attack should start working within around 2 days. nhs.uk

If your usual treatment isn't helping, contact your GP rather than simply continuing to endure severe pain.

Does Allopurinol Stop the Pain of an Attack?

This is an important distinction.

Allopurinol is a long-term urate-lowering medicine — it isn't a painkiller for an acute gout attack.

It lowers the amount of uric acid in the body and is used to help prevent future gout attacks. If you're already prescribed allopurinol, the NHS advises not to stop taking it unless your doctor tells you to. nhs.uk

Managing the immediate painful attack and controlling uric acid over the longer term are therefore two different parts of gout treatment.

When Should You Seek Medical Help?

Contact your GP if you have gout and your normal treatment isn't helping, or if you think you may be experiencing gout for the first time. nhs.uk

More urgently, seek an urgent GP appointment or contact NHS 111 if you have sudden joint pain and swelling and:

• the pain is getting worse
• you have a very high temperature or feel hot, cold or shivery
• you feel sick or cannot eat.

These symptoms can sometimes indicate an infection inside the joint rather than gout, which needs urgent medical attention. nhs.uk

Pain Relief Is Only Half the Gout Story

Once the immediate attack has passed, it's worth thinking about why the flare happened and how another one might be prevented.

Repeatedly treating painful attacks without addressing the underlying urate level may leave the underlying gout uncontrolled. People with recurrent attacks or high blood uric acid may be offered urate-lowering treatment. nhs.uk

This is where understanding your uric acid level, possible triggers and longer-term treatment becomes important.

The Bottom Line

During a gout attack:

Treat the flare early, rest and elevate the joint, keep pressure off it and use cold therapy alongside appropriate medication.

Gout pain can be severe, but effective treatments are available. Once the attack settles, consider discussing your uric acid level and longer-term gout management with your healthcare professional rather than simply waiting for the next flare.

Next: Understanding Uric Acid →
Related: First Gout Attack → | Understanding Gout → | Food & Gout →

Medical disclaimer: This article provides general information and is not a diagnosis or individual medical advice. Medicines used for gout are not suitable for everyone. Speak to a GP or pharmacist about treatment appropriate for you, and seek medical advice for a first suspected gout attack.