Right now
During a flare
If this might be a flare, the useful next step is a clinician, not a new stack of products. While that care is happening, rest, ice, and elevation are the home measures with a real basis.
Last reviewed
What clinicians commonly choose
The 2020 American College of Rheumatology guideline recommends an anti-inflammatory approach for a gout flare, chosen with the patient. Clinicians commonly choose among colchicine, an NSAID (a nonsteroidal anti-inflammatory), or a steroid (a glucocorticoid). The 2016 EULAR recommendations name the same kinds of medicines for a flare. How each is given, and who may not be able to take each, is on Flare medicines compared.
A steroid may be a pill, or a clinician may give it as an injection. Which kind, and whether any of the three is even appropriate, depends on the person. Kidneys, stomach ulcers, bleeding risk, diabetes, infection, other medicines, and pregnancy all change the choice. Those facts are reasons to talk to a clinician. They are not reasons to pick “the other one” from a list on your own.
| Medicine | What it is | What this page will not do |
|---|---|---|
| Colchicine | An anti-inflammatory used for gout flares. | No dose, no schedule, and no advice to finish someone else’s tablets. |
| An NSAID | A nonsteroidal anti-inflammatory. | No product to buy, and no amount. |
| A steroid | A glucocorticoid. A pill, or an injection a clinician gives. | No instruction to start a pack you already have at home. |
This site will not tell you which medicine, what amount, or when to take it. Do not start a leftover steroid or anyone else’s prescription because a page listed the name. Do not take more than the clinician already told you to take.
Rest, ice, elevation
NIAMS describes three things people can do while a flare is being treated. The ACR guideline treats topical ice as an add-on for a flare, not as the treatment.
- Rest the joint. Walking on a hot foot because you should push through makes a bad day worse. If you cannot bear weight, that is also a reason to get care, not a test of toughness.
- Ice the area. A cloth between the ice and the skin protects the skin. Ice can ease pain and swelling. It is not a treatment for the crystals, and it does not replace the anti-inflammatory plan.
- Elevate it when you are lying down, if you can, so the limb is above the level of the heart. A pillow or a stack of folded blankets is enough. Elevate means the limb is up, not merely that the shoe is off.
Roomier footwear, or no shoe, matters if the foot is swollen. A tight shoe is pressure on an already angry joint. It is not a special kind of shoe that treats gout. More on that is on Living with gout and Home measures.
Do and don’t
Do
- Contact a clinician, including for a first flare that is already easing.
- Ask that clinician before changing a prescribed urate-lowering medicine. As a long-term plan, the 2020 ACR guideline favors continuing it indefinitely over stopping it.
- Rest, ice with a cloth, and elevate.
- Note which joint, when it started, and whether you have a fever.
Don’t
- Start someone else’s medicine, or a leftover steroid pack.
- Quit urate-lowering medicine because a flare showed up.
- Treat the flare with a new supplement stack.
- Decide it is “just gout” if you have a fever, cannot bear weight, or this feels different.
A flare is not proof the long-term medicine failed
Do not decide a flare means a urate-lowering medicine “isn’t working,” and do not decide that on your own. A flare can still happen in someone who is being treated, especially early on. That pattern is a reason to call, not a reason to quit. The longer version is on Staying well.
Do not start a supplement stack in the middle of a flare and call it treatment. Tart cherry, vitamin C, apple-cider vinegar, baking soda, herbal teas, and “flush” powders do not take the place of care for an inflamed joint. This site does not give recipes for any of them.
Get care now if this is not a familiar flare
Seek urgent care for a hot, swollen joint with fever, if you cannot bear weight, or if this is unlike your usual flares. A joint infection can look similar and can be dangerous. So can other problems this page will not try to list.
If you have never had gout confirmed, do not settle the question yourself from a description that sounds familiar. What to tell the clinician, in ordinary language, is on Living with gout.
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Clinical claims on this page follow the sources.