Gout cannot be cured, but it can be controlled

There is no cure for gout arthritis. Once you have had a gout attack, you are at risk for more. What you can do is prevent future attacks, reduce how often they happen, and manage the pain when one occurs. Most people with gout live without attacks for months or years at a time when they follow a treatment plan with their doctor.

Gout happens because your body builds up uric acid — a waste product that forms needle-like crystals in your joints. These crystals trigger sudden, severe pain, usually in the big toe. The goal of treatment is to lower the amount of uric acid in your blood so crystals do not form. This takes time and usually requires medication.

Key Takeaways

  • Gout attacks can be prevented with daily medication that lowers uric acid levels, typically taken for months or years.
  • During an active attack, anti-inflammatory drugs like indomethacin or colchicine can reduce pain and swelling within hours to days.
  • Changing what you eat and drink — especially limiting red meat, organ meats, alcohol, and sugary drinks — lowers your risk of future attacks.
  • Your doctor will order a blood test to measure uric acid and may adjust your medication based on results.
  • Attacks that do not improve within a few days, or attacks that happen more than twice a year, mean your current treatment needs to change.

Medications that stop attacks and prevent new ones

Two types of medication work on gout. One type stops an attack that is already happening. The other type prevents attacks by lowering uric acid over time.

Medications for an active attack work fastest if you take them as soon as pain starts. Colchicine reduces inflammation and can stop an attack within 12 to 24 hours if taken early. Nonsteroidal anti-inflammatory drugs (NSAIDs) like indomethacin, naproxen, or ibuprofen also reduce pain and swelling. If you cannot take NSAIDs because of kidney or stomach problems, your doctor may prescribe corticosteroids instead. These medications do not lower uric acid — they only ease the current attack.

Medications to prevent future attacks lower the amount of uric acid your body makes or help your kidneys remove it. Allopurinol is the most common choice and is taken once daily. Febuxostat is another option. These medications take weeks or months to work, and you take them every day even when you feel fine. Your doctor will order blood tests to check your uric acid level and adjust your dose if needed. The goal is usually to keep uric acid below 6 mg/dL.

When you first start a uric acid-lowering medication, you may have more attacks for a few weeks because crystals are breaking up. Your doctor may prescribe colchicine or an NSAID to take during this time to prevent attacks while the medication is working.

What you eat and drink makes a real difference

Diet alone cannot cure gout, but it can reduce how often attacks happen and may lower how much medication you need. Certain foods and drinks raise uric acid levels in your blood.

Foods and drinks to limit or avoid: Red meat and organ meats (liver, kidney, brain) are high in purines, which your body breaks down into uric acid. Shellfish, especially anchovies and sardines, have high purine levels. Beer and spirits raise uric acid more than wine does. Sugary drinks and foods with high-fructose corn syrup increase uric acid. Avoid or cut back on these as much as you can.

Foods that may help: Low-fat dairy products, cherries, and coffee have been linked to lower uric acid levels in some studies. Drinking plenty of water helps your kidneys flush uric acid. Aim for at least 2 to 3 liters a day unless your doctor tells you otherwise.

Weight loss also helps if you are overweight. Losing weight slowly — about 1 to 2 pounds per week — can lower uric acid without triggering attacks. Rapid weight loss can actually cause attacks, so avoid crash diets.

When to call your doctor about an attack

Call your doctor if you have sudden severe pain, redness, and swelling in a joint, especially if this is your first attack. Your doctor can confirm it is gout with a blood test or by examining fluid from the joint. Do not wait to see if it goes away on its own.

Seek urgent care or go to an emergency room if an attack does not improve after three days of medication, if you develop fever along with joint pain, or if the pain spreads to multiple joints. These can be signs that something else is happening or that your gout needs stronger treatment right away.

If you are having more than two attacks per year, or if attacks are getting worse even though you are taking medication, tell your doctor at your next visit. Your medication dose may need to be higher, or you may need to switch to a different medication.

Blood tests show whether your treatment is working

Your doctor will order a blood test to measure your uric acid level. This test is usually done a few weeks after you start a new medication, then every 6 to 12 months once your level is stable. The test shows whether your current dose is keeping uric acid low enough to prevent attacks.

Your doctor may also check your kidney function and liver function, especially if you are taking allopurinol or febuxostat long-term. These medications are safe for most people, but your doctor needs to make sure they are not causing problems.

Bring your blood test results to your appointments. Ask your doctor what your uric acid number is and what the target is for you. If your number is higher than the target, your medication dose may need to go up.

Questions to ask your doctor

Before you leave your appointment, make sure you understand your treatment plan. Here are questions that matter:

  • Do I need to take medication every day, or only when I feel an attack coming on?
  • What is my target uric acid level, and how often will you check it?
  • What side effects should I watch for, and which ones mean I should call you?
  • If this medication does not work or I cannot tolerate it, what is the next option?
  • Are there foods or drinks I should avoid, or is diet change enough on its own?
  • How long do I need to take this medication — is it temporary or lifelong?

Frequently Asked Questions

Can I stop taking gout medication once I feel better?

No. If you stop taking uric acid-lowering medication, uric acid builds back up and attacks will return. Most people need to take this medication long-term, possibly for life. Your doctor will tell you if it is ever safe to stop or reduce your dose.

Will gout go away on its own if I just wait?

A single attack will go away on its own in days to weeks, but you will have more attacks without treatment. The longer you wait between attacks, the more uric acid builds up in your joints. Over time, repeated attacks can damage the joint permanently.

Is gout the same as regular arthritis?

No. Gout is caused by uric acid crystals and usually affects one joint at a time. Osteoarthritis and rheumatoid arthritis are different conditions with different causes and treatments. Your doctor can tell which type you have with blood tests and imaging.

Can I take over-the-counter pain medicine instead of prescription medication?

Over-the-counter NSAIDs like ibuprofen can help with pain during an attack, but they do not lower uric acid and do not prevent future attacks. You need prescription medication to prevent gout long-term. Talk to your doctor before taking any over-the-counter pain reliever, especially if you have kidney problems.

What happens if I ignore gout and do not treat it?

Repeated untreated attacks can damage your joints permanently, causing chronic pain and loss of movement. Uric acid can also form stones in your kidneys. Treatment prevents this damage and lets you live without frequent attacks.