An intense gout attack often arrives overnight: a joint becomes hot, swollen, and so painful even a sheet hurts. That sudden pain comes from tiny uric acid crystals forming in the joint. Knowing the common triggers and quick actions you can take cuts suffering and lowers the chance of another attack.
Gout develops when your body has too much uric acid. Uric acid comes from breaking down purines, which are in some foods and inside your own cells. If your kidneys don’t remove enough uric acid, it builds up and crystallizes. High purine foods (think red meat, organ meat, shellfish), sugary drinks with high-fructose corn syrup, and excess alcohol—especially beer—are frequent culprits. Rapid weight loss and dehydration can also push uric acid up quickly.
Act fast. Move the joint as little as possible, keep it elevated, and apply a cold pack for 10–20 minutes to reduce swelling. Over-the-counter NSAIDs like naproxen or ibuprofen help many people—use them if you can and if your doctor says it’s safe. Colchicine and short courses of oral steroids are other common options your doctor may prescribe for sudden flares. If the pain or swelling is severe, or you have fever or signs of infection, get medical care right away.
Small daily changes make a big difference. Cut back on red meat, organ meats, shellfish, and sugary sodas. Limit alcohol, especially beer. Stay well hydrated—drink water throughout the day so urine is pale. Aim for steady, realistic weight loss if you’re overweight; crash diets can backfire and trigger attacks.
On the medical side, doctors often use urate-lowering drugs like allopurinol or febuxostat for people who have repeated attacks or visible joint damage. Those meds lower blood uric acid and prevent crystal buildup. Your provider will check your blood regularly and adjust doses to reach a target uric acid level—usually below about 6 mg/dL for most people.
Some supplements and foods may help a bit. Tart cherry extracts and vitamin C have shown modest benefits in lowering uric acid or reducing flare frequency for some people. Anti-inflammatory herbal options like boswellia (shallaki) can ease joint pain for some—see our article on shallaki for more on that approach. Always tell your doctor about supplements so they can watch for interactions.
Gout can be painful, but with quick action during flares and steady long-term steps—diet changes, hydration, weight management, and appropriate medication—you can cut attacks way down and protect your joints. If you’re getting repeated flares or have questions about treatment, talk to your healthcare provider and get regular blood testing to keep uric acid under control.
