Gout

Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). There are times when symptoms get worse, known as flares, and times when there are no symptoms, known as remission. Having gout multiple times can lead to gouty arthritis, a form of arthritis which gets progressively worse. 

There is no cure for gout, but you can effectively treat and manage the condition with medication and self-management strategies. 

What causes gout?

Gout is caused by a condition known as hyperuricemia. This is when there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat. When there is too much uric acid in the body, uric acid crystals can build up in joints, fluids, and tissues within the body. Hyperuricemia does not always cause gout. People who have hyperuricemia but do not have gout symptoms do not need medical treatment. 

How is gout diagnosed?

A health care provider diagnoses gout by assessing your symptoms and the results of your physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint. 

Who should diagnose and treat gout?

The disease should be diagnosed and treated by a health care provider or a team of health care providers who specialize in the medical care of people with gout. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases (diseases where joints are swollen). Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a rheumatologist near you, visit the database of rheumatologists on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout. 

How is gout treated?

Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to 

• Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, or acetaminophen and the anti-inflammatory drug colchicine. Oral or injected corticosteroids may also be used.
• Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, avoiding foods high in purines (like red meat or organ meat which can cause gout flares), may help prevent future attacks. Changing or stopping medications associated with hyperuricemia (like diuretics) may also help.
• Prevent tophi and kidney stones. These stones occur because of chronically high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent flares or chronic gout, doctors may recommend taking certain drugs like allopurinol, febuxostat, and pegloticase. These drugs lower uric acid levels and can prevent future flares.

In addition to medical treatment, you can manage your gout with self-management strategies. Self-management strategies are things that you can do each day to manage your condition and stay healthy. The self-management strategies described below are proven to reduce pain and disability so that you can do the activities that are important to you. 

How can I manage my gout and improve my quality of life?

Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.

For gout in particular: 

• Eat a healthy diet. Avoid foods that may trigger a gout flare. These foods include those high in purines (like a diet rich in red meat, organ meat, and seafood) 
• Limit alcohol intake, particularly beer and hard liquor.  

• Lose weight. For people who are overweight or obese, losing weight reduces pressure on joints, particularly weight bearing joints like the hips and knees. Reaching or maintaining a healthy weight can relieve pain, improve function, and slow the progression of arthritis. 
• Protect your joints. Joint injuries can cause or worsen arthritis. Choose activities that are easy on the joints like walking, bicycling, and swimming. These low-impact activities have a low risk of injury and do not twist or put too much stress on the joints. Learn more about how to exercise safely with arthritis.