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.
- Learn self-management skills. Join a self-management education class, which helps people with arthritis and other chronic conditions—including gout—understand how arthritis affects their lives. In these classes, people increase their confidence in controlling their symptoms and living well. Learn more about the CDC-recognized self-management education programs.
- Go to a physical activity program that is proven to improve your health. For people who worry that physical activity may make arthritis worse or are unsure how to exercise safely, participation in physical activity programs can help reduce pain and disability related to arthritis and improve mood and the ability to move. Classes take place at local Ys, parks, and community centers. These classes can help people with arthritis feel better. Learn more about CDC-recognized physical activity programs.
- Get physically active. Experts recommend that ideally adults be moderately physically active for 150 minutes per week, like walking, swimming, or biking 30 minutes a day for five days a week. You can break these 30 minutes into three separate ten-minute sessions during the day. Every minute of activity counts, and any activity is better than none. Regular physical activity can also reduce the risk of developing other chronic diseases such as heart disease, stroke, and diabetes. Learn more about physical activity for arthritis.
- Talk to your doctor. You can play an active role in controlling your gout by attending regular appointments with your health care provider and following your recommended treatment plan. This is especially important if you also have other chronic conditions, like diabetes or heart disease.
- 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.
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remission—weeks, months, or years—without symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the other toe joints, the ankle, and the knee.
Symptoms in the affected joint(s) may include:
- Pain, usually intense
The following can make you more likely to develop hyperuricemia, which causes gout:
- Being male
- Having obesity
- Having certain health conditions, including:
- Congestive heart failure
- Hypertension (high blood pressure)
- Insulin resistance
- Metabolic syndrome
- Poor kidney function
- Using certain medications, such as diuretics (water pills).
- Drinking alcohol. The more you drink, the higher the risk of developing gout. Tips for reducing how much you drink.
- Eating or drinking food and drinks high in a specific type of sugar, called fructose. Foods and drinks that are high in fructose include soda or pop and candy.
- Having a diet high in purines, which the body breaks down into uric acid. Foods high in purines include red meat, organ meat (like liver, kidney), and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout, and tuna.
- National Institute of Arthritis and Musculoskeletal and Skin Diseasesexternal icon [En Español]external icon
- American College of Rheumatologyexternal icon
- National Library of Medicine—MedlinePlus—Acute Goutexternal icon [En Español]external icon
- National Library of Medicine—MedlinePlus—Chronic Goutexternal icon [En Español]