Gout

Gout causes sudden severe joint pain. It does not cause lasting damage to joints if you get treatment when you start feeling pain.

Symptoms

Non-urgent advice: Talk to your GP if you have:

  • sudden severe pain in any joint - usually the big toe, or fingers, wrists, elbows or knees
  • red, hot, swollen skin over the affected joint

Ask for an urgent GP appointment if the pain is getting much worse and you have a very high temperature. This could mean you have an infection inside the joint.

Diagnosis

Gout can be hard to diagnose as symptoms are similar to other conditions.

Your GP may ask about your diet and if you drink beer or spirits. You might be sent for a blood test, ultrasound or x-ray.

Sometimes a thin needle is used to take a sample of fluid from the affected joint to test. The tests will find out how much of a chemical called uric acid is in your body. Having too much uric acid can lead to crystals forming around your joints. This is what causes the pain.

Causes of gout

Gout sometimes runs in families. It's more common in men, especially as they get older.

Other people at risk include:

  • women after menopause
  • people who take medicines such as diuretics (water tablets) for blood pressure, or have high levels of cholesterol
  • people who are overweight and who drink alcohol, especially beer

Read how diet and nutrition helps your health

Treatment to reduce pain and swelling

Gout is usually treated with anti-inflammatory medicine like ibuprofen.

If the gout does not improve after 3 to 4 days, you might be given steroids as tablets or an injection.

You should:

  • take any medicine you've been prescribed as soon as possible, it should start to work within 3 days
  • rest and raise the affected limb
  • keep the joint cool – apply an ice pack, or a bag of frozen peas wrapped in a towel, for up to 20 minutes at a time
  • drink lots of water, unless advised not to by your GP
  • try to keep bedclothes off the affected joint at night

Do not knock the joint or put pressure on it.

Prevention

Gout can come back every few months or years or more often over time if not treated.

If you have frequent gout attacks, or you have a high level of uric acid in your blood, your GP might prescribe a medicine. This is to lower the levels of uric acid and may need to be taken for a long period of time.

Take uric-acid-lowering medicine regularly, even when you no longer have symptoms.

Things you can do to stop gout coming back

Making lifestyle changes might stop or reduce further attacks.

Do

  • get to a healthy weight, but avoid crash diets or high-protein or low-carbohydrate diets

  • have at least 2 alcohol-free days a week

  • drink water - up to 2 litres a day

  • exercise regularly – but avoid intense exercise or putting lots of pressure on joints

  • stop smoking

  • ask your GP about vitamin C supplements

Don't

  • do not eat a lot of red meat, kidneys, liver or seafood

  • do not drink more than 14 units of alcohol a week and don't have it all on 1 or 2 days

  • do not eat sugary drinks and snacks

  • do not eat full-fat dairy products

  • do not eat more than 2 servings of low-fat dairy foods a day

  • do not eat a lot of fatty foods

Urgent advice: Talk to your GP immediately if:

  • you feel you are about to have a gout attack

Complications of gout

It's rare to get lots of attacks, but if you do, you can develop permanent damage to the joint (chronic gout).

Chronic gout can also cause tiny white lumps (tophi) to appear under your skin, especially on your ears, fingers or elbows. This is where urate crystals form under the skin. They can be painful.

Fingers of person with gout
fingers of person with gout

You can get kidney stones if your uric acid levels are very high, so you'll need treatment to reduce the levels.


Content supplied by the NHS and adapted for Ireland by the HSE

Slaintecare logo
This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.