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The ancient Greek physician and “father of medicine” Hippocrates understood the severe pain brought on by a gout flare, describing it in the 5th Century BC as the “unwalkable disease”1.

A gout attack usually occurs suddenly, in the middle of the night, when you’re woken by a burning pain – most often in your big toe2. The affected joint is hot, swollen, and extremely tender so that even the weight of a bedsheet may feel excruciating2.

The cause of gout is accumulation of urate crystals in your joint, which leads to inflammation and the intense pain you feel during a gout flare2. These urate crystals can form when you have high levels of uric acid in your blood (hyperuricaemia)3.

Over time, if left untreated, the disease’s severity increases1. Flares will last longer, happen more frequently, and you’ll find that pain and stiffness become persistent1. It’s recommended that you begin treatment with anti-inflammatories within 12 – 24 hours of an attack3. Although there’s no cure for gout, there are ways to manage symptoms; consult with your healthcare provider about preventing flares with medication, appropriate diet, safe exercise, and other self-management activities4.

In the meanwhile, you can help alleviate the pain by icing and elevating the joint3.

If you have an acute gout flare, your healthcare provider will want to control your body’s inflammatory response to monosodium urate crystals as quickly as possible with anti-inflammatory drugs5.

Without medication, a gout flare can resolve within three days to two weeks, but your symptoms will improve quicker with the use of anti-inflammatories3. Take your prescribed medicines both during and after your flare – your doctor may reduce the dose when the symptoms improve5

Prescribed medication

  1. Non-steroidal anti-inflammatory drugs (NSAIDS), given for at least 3-6 months7
  2. Colchicine7
  3. Corticosteroids7
  4. If you’ve had several gout attacks during the year, your doctor may prescribe serum urate-lowering therapy (ULT) to lower your uric acid2. ULT may include medicines such as allopurinol/probenecid2

Dietary and lifestyle changes

Practical things you can do to reduce the risk of gout flares:

  • Reduce your weight3
  • Limit your alcohol intake, especially beer and wine3
  • Reduce how much purine-rich animal protein you eat, such as red meat, as well as seafoods such as sardines, which are also high in purine2
  • Restrict the amount of high fructose corn syrup you consume – present in soft drinks and fruit juices3
  • Exercise regularly2,3


  1. Croft, J.D., Clinical Aspects of Gout. Available at > ppt > icd9 
  2. Mayo Clinic. Staff overview. Available at
  3. Engel, B. et al. Treatment Options for Gout. Dtsch. Arztebl. Int. 114 (13), (2017).
  4. Centers for Disease Control. Staff overview. Available at
  5. Gaffo, A.L. Treatment of Gout Flares. Available at
  6. FitzGerald, J.D., et al. American College of Rheumatology Guideline for Management of Gout. Arth. Care Res. 72(6), (2020).