What to Do During a Gout Attack
A Practical, Step-By-Step Guide for Right Now
If you're in the middle of a gout attack, you want practical help fast — not a lecture. This guide covers what to do right now, when ice and rest genuinely help, what medication does (and doesn't) do, and when a swollen joint needs urgent medical attention rather than home care.
The Quick Answer
Rest the joint, keep pressure off it, and try a cold pack if it helps. Take whatever NSAID, colchicine or other flare treatment you or your doctor have already identified for an attack, started as early as you can. Keep drinking normally, unless a clinician has told you otherwise. And treat a first-ever hot, swollen joint — or one with fever, or symptoms that are rapidly getting worse — as something needing urgent same-day assessment, not home management.
None of this replaces your own treatment plan. If you already have prescribed flare medicine, using it early matters more than anything else on this page.
Rest the Joint
Reduce pressure and unnecessary movement while the flare is active.
Cool It
A wrapped ice pack or bag of frozen peas can ease pain for some people.
Take Appropriate Treatment
NSAIDs, colchicine or a corticosteroid work best started early — explained without prescribing.
Know When to Get Help
First episodes, fever or rapidly worsening symptoms need urgent assessment, not waiting.
What to Do Right Now
The first few hours of a flare are when self-care and appropriate treatment make the most difference. This isn't a guaranteed timetable — everyone's attack is a little different — but this sequence reflects what NHS and NICE guidance consistently point to.
Rest and protect the joint
Avoid unnecessary weight-bearing or movement. Raising the limb on a cushion can help too.
Keep pressure off it
Loose clothing, no tight socks or shoes, and keep bedcovers off the joint — even light contact can be painful.
Use a cold pack sensibly
A wrapped ice pack or bag of frozen peas, for short periods, can be soothing for some people.
Take appropriate treatment early
Use any prescribed or pharmacist-recommended flare treatment as early in the attack as you reasonably can.
Keep hydration normal
Drink as you normally would, unless a clinician has asked you to manage your fluids differently.
Watch for warning signs
Fever, rapid worsening or a first unexplained episode change what you should do next — see the urgent-help section below.
Medication During an Attack
UK guidelines, including NICE's gout guideline, set out three main established options for an acute flare: NSAIDs, colchicine, and a short course of corticosteroids (as tablets, or occasionally an injection into or around the joint). Which one is used — or whether a combination approach is needed — depends on your other health conditions, other medicines, and how you've responded to treatment before.
This page won't try to recreate that full explanation. If you want to understand how each option works, who they suit, and how they compare, our complete gout treatment guide covers it in depth. The point here is simpler: whatever treatment you and your doctor or pharmacist have identified for a flare tends to work best when started as early in the attack as possible.
Should I Keep Taking Allopurinol?
This depends on which situation applies to you, and it's worth being precise about the difference.
If you're already established on allopurinol, febuxostat or another urate-lowering treatment, current expert guidance is clear: keep taking it as normal during a flare. The British Society for Rheumatology's gout guideline specifically advises that patients understand the importance of continuing established urate-lowering therapy through an attack — stopping and restarting it can cause uric acid levels to swing, which doesn't help. The flare itself is treated separately, on top of your ongoing treatment, not instead of it.
If you haven't started urate-lowering treatment yet and you're currently having a flare, guidelines generally suggest waiting until the attack has settled — commonly a couple of weeks or so — before starting, since it's usually easier to begin once the acute inflammation has calmed down. Where flares are frequent, starting during a flare can sometimes be reasonable instead of waiting. Either way, this is a timing decision for your own clinician, not something to decide alone.
A flare while you're on established allopurinol isn't a sign the medicine has failed, and it isn't a reason to stop it yourself. If you're ever unsure what applies to your situation, confirm with the clinician or pharmacist managing your treatment rather than guessing. Our gout treatment guide covers urate-lowering therapy in full.
Ice and Cold Packs
NHS guidance and NICE's gout guideline both support cold therapy as a helpful addition alongside prescribed treatment — NICE notes that applying ice packs to the affected joint, in addition to medicine, may help alleviate pain. NHS self-care advice suggests using an ice pack, or a bag of frozen peas, wrapped in a towel, for up to around 20 minutes at a time.
Always wrap ice or a frozen pack in a towel or cloth — never apply it directly to bare skin. Use it for short periods rather than continuously, and stop if it increases discomfort. Cold therapy is a comfort measure alongside your treatment, not a substitute for it.
Should I Walk or Exercise With Gout?
During an active flare, the practical answer is to rest the joint. Versus Arthritis advises avoiding exercise during a gout flare-up, as it can make the pain worse, and resuming activity once the pain and swelling have settled. That doesn't mean gout is a reason to avoid exercise generally — staying active over the longer term has well-established health benefits, and most people can return to their normal activity once an attack has passed.
If the joint is in your foot, ankle or knee, that may mean genuinely limiting weight-bearing for a few days rather than pushing through discomfort. A support such as a raised cushion at night, or a "bed cage" to keep bedcovers off the joint, can help you rest it more comfortably.
Food and Alcohol During an Attack
There's no single food that will stop a flare once it's started, so this isn't about finding a magic fix. Normal, sensible eating is a reasonable approach during an attack. A few things are worth being mindful of: very heavy or high-purine meals and binge drinking are recognised triggers for some people, and alcohol — beer especially — is worth avoiding or minimising while a flare is active. Sugary drinks are also worth limiting, since they can raise uric acid, though cutting them out won't resolve today's attack on its own.
For the fuller picture on eating with gout, see our complete diet guide, our foods to avoid guide, and our dedicated guide to alcohol and gout.
Hydration During an Attack
Maintaining normal hydration during a flare is a sensible, low-risk habit if you have no medical reason to limit fluids. What water won't do is stop an attack once it's underway — there's no good evidence that drinking large amounts flushes out uric acid or clears a flare faster. The priorities during an attack are resting the joint, following your treatment plan, and staying sensibly hydrated — not forcing down extreme quantities of water in the hope of a shortcut.
If you've been medically advised to restrict or manage your fluid intake, follow that guidance rather than general advice. Our hydration and gout guide covers this in full detail.
When to Seek Urgent Medical Help
A hot, swollen, intensely painful joint usually does mean gout if you've had it before — but not always. The same picture can occasionally be caused by a joint infection (septic arthritis) or another condition that needs urgent assessment and is treated very differently from gout. A previous gout diagnosis doesn't automatically mean every future swollen joint is gout again.
You have a hot, swollen, painful joint together with a fever or feeling generally unwell or shivery; the pain and swelling are rapidly getting worse; you're unable to move or bear any weight on the joint; or this is your first time experiencing symptoms like this and you don't already have a gout diagnosis. If in doubt, treat sudden severe joint pain and swelling as something needing same-day assessment rather than waiting to see if it settles.
In the UK, this generally means contacting your GP practice for a same-day appointment, calling NHS 111 for urgent advice outside GP hours, or attending A&E if you feel very unwell. Outside the UK, the equivalent is your own local urgent or same-day medical care — the important thing is being seen quickly, not which specific service gets you there.
What Not to Do
- Don't stop or change prescribed gout medicine on your own — check with your prescriber first
- Don't take extra medication beyond what's prescribed or recommended, even if pain is severe
- Don't rely on supplements or home remedies as a substitute for acute treatment
- Don't assume every painful, swollen joint must be gout, especially the first time
- Don't try to "flush" gout away with extreme amounts of water
- Don't push through pain with exercise or walking on the affected joint
How Long Will This Attack Last?
NHS guidance puts an untreated gout attack at commonly settling within one to two weeks, though this varies between people and between individual attacks. Appropriate treatment, started early, often helps symptoms improve considerably sooner than that. There's no way to give you an exact countdown for your specific attack — everyone's course is a little different. For a closer look at the typical timeline and what affects it, see our full guide to how long a gout attack lasts.
After the Attack
Getting through today's flare is only half the picture. Repeated attacks are usually a sign that the underlying uric acid problem deserves proper attention, not just repeated rounds of flare treatment. Understanding what causes gout and discussing long-term options in our gout treatment guide — including whether urate-lowering therapy is right for you — is worth doing once this attack has settled, especially if this isn't your first.
Myths About Gout Attacks
"Keep moving and it'll work itself out."
Guidance generally advises resting and protecting the joint during an active flare, and resuming normal activity once pain and swelling have settled.
"If I drink enough, it'll flush the gout straight out."
Normal hydration is sensible, but there's no good evidence that large amounts of water clear an attack faster or flush out uric acid.
"My flare's over, so that's it until next time."
Symptoms settling doesn't mean the underlying urate crystal problem has resolved. Repeated attacks are worth addressing at the source.
"I'm flaring, so I'll pause my tablets."
If you're already established on allopurinol or another urate-lowering treatment, guidance generally supports continuing it as normal through a flare.
"I'll just try a natural fix instead of taking anything."
No supplement or home remedy is an established substitute for appropriate acute treatment. They aren't a reason to delay effective care.
"I've had gout for years, so this is definitely just another flare."
A previous diagnosis doesn't rule out infection or another cause this time. Symptoms that feel different, or come with fever, need proper assessment.
Frequently Asked Questions
What should I do immediately during a gout attack?
Rest and protect the joint, keep pressure off it, try a cold pack if it helps, and take any prescribed or pharmacist-recommended flare treatment as early as you can. Watch for warning signs that need urgent assessment instead.
How can I ease gout pain at home?
Resting the joint, keeping bedcovers and tight clothing off it, and using a wrapped cold pack can all help alongside your prescribed or recommended treatment — but they support treatment rather than replace it.
Should I walk with gout?
During an active flare, it's generally best to rest and protect the joint rather than exercise on it. Once pain and swelling have settled, most people can return to normal activity.
Is ice good for gout?
NICE guidance notes that ice packs, used alongside prescribed medicine, may help ease pain for some people. Always wrap ice or a frozen pack rather than applying it directly to skin.
Should I keep taking allopurinol during an attack?
If you're already established on it, current guidance generally supports continuing as normal. If you haven't started it yet, it's usually begun once the flare has settled. Confirm your own situation with your prescriber.
What should I drink during a gout attack?
Normal fluids, mainly water, unless a clinician has told you otherwise. There's no evidence that drinking unusually large amounts speeds up recovery.
What should I eat during a flare?
Normal, sensible eating is reasonable. There's no single food that stops a flare, though very heavy or high-purine meals and heavy drinking are worth avoiding while it settles.
Should I avoid alcohol completely during a flare?
Minimising or avoiding alcohol, especially beer, during an active flare is a sensible precaution, though the bigger picture of alcohol and gout is covered in our dedicated guide.
How long does a gout attack last?
NHS guidance puts an untreated attack at commonly one to two weeks, often shorter with early treatment. It varies between people and between attacks — see our dedicated guide for the full timeline.
When should I call a doctor?
For a first-ever episode, or if usual treatment isn't controlling things. Seek urgent same-day care for fever, feeling generally unwell, or rapidly worsening symptoms.
Can a gout attack be dangerous?
Gout itself is very manageable, but symptoms that look like gout can occasionally be caused by a joint infection, which is a genuine emergency — that's why red-flag symptoms need urgent assessment.
What if my treatment isn't helping?
Contact the prescriber or pharmacist managing your treatment rather than taking extra doses. Our gout treatment guide covers what to review if flares keep recurring.
This guide is for general educational purposes and describes practical self-care during a gout attack — it is not personal medical advice and cannot tell you whether your specific symptoms are gout, or which treatment is right for you. Never start, stop or change a medicine based on this page. Always speak with your own doctor or pharmacist, and seek urgent care for the warning signs described above.