Gout Flare: Symptoms, Fast Relief, and Keeping It From Coming Back

A gout flare causes sudden, severe pain, swelling, warmth and redness in a joint, most often the big toe, and it often starts at night. It's caused by uric acid crystals building up in the joint. Treatment started early in a flare, such as an anti-inflammatory medicine or a short course of steroids, can ease it within a day or two. A hot, swollen joint with a fever needs to be checked the same day, because a joint infection can look like gout.

Gout symptoms

• Sudden, intense joint pain, often waking you up at night
• Swelling, warmth and redness, or a purple or darker color on darker skin
• A joint so tender that even a bedsheet touching it hurts
• Most often the big toe, but also the ankle, top of the foot, knee, wrist, elbow or fingers
• Pain that peaks within 12 to 24 hours and fades over one to two weeks

What causes gout

Uric acid is a normal waste product, but when there's too much of it, it can form needle-like crystals in a joint. You're more likely to get gout if you:

• Are male, or a woman after menopause
• Have a family history of it
• Carry extra weight
• Have high blood pressure, diabetes or kidney disease
• Take certain medicines, such as some water pills (diuretics)

Common triggers for a flare

• Alcohol, especially beer and liquor
• Red meat, organ meats and shellfish
• Sugary drinks and foods sweetened with high-fructose corn syrup
• Dehydration, including at altitude or after heavy exercise
• An illness, surgery or injury
• Starting or changing gout medicine

What helps a flare

• Start treatment early. Anti-inflammatory medicine such as ibuprofen or naproxen, if it's safe for you, works best in the first day.
• Rest the joint and raise it
• Ice: 20 minutes at a time, with a cloth between the ice and your skin
• Drink plenty of water
• Avoid alcohol and trigger foods during the flare

A clinician may prescribe a short course of steroids or another anti-inflammatory medicine, especially if you can't take ibuprofen because of kidney problems, stomach ulcers or a blood thinner.

Keeping it from coming back

If you have frequent flares, a primary care provider can prescribe daily medicine to lower uric acid and check your levels with blood tests. Cutting back on alcohol and sugary drinks, staying hydrated and keeping a healthy weight also help.

When to get seen

Come in for a first-time hot, swollen joint, a flare that isn't improving after a day or two, or if you can't take over-the-counter anti-inflammatories. A clinician can examine the joint, rule out injury or infection, and start treatment. At an AfterOurs clinic, a standard self-pay visit is $175, and a self-pay in-clinic visit never costs more than $330. A telehealth visit is $75 for a flare you've had before. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. See the cost and insurance page and our post on joint pain and swelling.

Go to the ER if a hot, red, swollen joint comes with a fever or chills, you feel very unwell, the redness is spreading up the leg or arm, or you can't move the joint at all. These can be signs of a joint infection, which needs urgent treatment.

Where to find us

Four clinics across metro Denver, all ages welcome, se habla español:

• Hampden (Southeast Denver): 8 AM–11 PM daily
• Littleton: 8 AM–11 PM daily
• Thornton: 8 AM–11 PM daily
• Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM

Walk in, or book online.