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Published on: 2/24/2026
A sudden, red, swollen, intensely painful joint is often a gout flare caused by uric acid crystals, usually in the big toe, and it is highly treatable with the right plan.
Start care promptly with doctor guided anti inflammatory meds, rest, ice, and hydration, and consider long term uric acid control and lifestyle changes to prevent damage and future attacks; there are several factors and urgent red flags like fever that can change your next steps, so see the complete guidance below.
If you've ever woken up with a joint that feels like it's on fire—red, swollen, and so painful that even a bedsheet brushing against it hurts—you may be experiencing a gout attack.
Gout is a common and treatable form of inflammatory arthritis. It can be intensely painful, but with the right care and long-term plan, it's highly manageable. Understanding what causes gout, why attacks happen, and what you can do next is the first step toward relief.
Gout is a type of arthritis caused by a buildup of uric acid in the blood. When uric acid levels get too high, sharp crystals can form inside a joint. Your immune system sees these crystals as a threat and launches an inflammatory response—leading to sudden, severe pain and swelling.
While gout most often affects the big toe, it can also involve:
Gout is common, especially in adults over 40, and it affects men more often than women (though women's risk increases after menopause).
Uric acid forms when your body breaks down substances called purines, which are found naturally in your body and in certain foods. Normally, uric acid dissolves in your blood, passes through your kidneys, and leaves in your urine.
A gout attack can happen when:
When uric acid builds up, crystals can form in a joint. The immune reaction to those crystals causes the painful flare.
Even if you've had gout for years, attacks can seem to come out of nowhere. But common triggers include:
Sometimes, no clear trigger is identified.
A gout flare typically:
The pain is often worst within the first 24 hours. Without treatment, a flare may last several days to two weeks.
If left untreated long term, gout can become more frequent and affect multiple joints. In advanced cases, visible lumps called tophi (uric acid deposits under the skin) can develop.
Not all red, swollen joints are caused by gout. Other conditions can look similar, including:
If you're experiencing these symptoms and want to understand what might be causing them, you can use a free AI-powered symptom checker for Gout / Pseudogout to help identify whether your symptoms align with gout or a related condition.
However, severe joint pain with fever, chills, or feeling very unwell could signal an infection. That requires urgent medical care.
If you believe you're having a gout flare, here's what doctors recommend:
Early treatment shortens the attack and reduces pain. A healthcare professional may prescribe:
These medications reduce inflammation and are most effective when started early.
If pain is severe, worsening, or accompanied by fever, speak to a doctor immediately. Joint infections can be life threatening if not treated quickly.
Applying an ice pack for 15–20 minutes at a time can help reduce inflammation and discomfort.
Drink plenty of water unless your doctor has restricted fluids. Hydration helps your kidneys flush uric acid.
If you've had one gout attack, there's a higher chance of having another—especially within the first year. That's why long-term management matters.
A blood test can measure uric acid levels. For people with gout, most guidelines recommend keeping levels below 6 mg/dL to prevent crystal formation.
If you have:
Your doctor may prescribe long-term medications such as:
These medications reduce uric acid production or improve removal. They do not treat an active flare but help prevent future ones.
Importantly, stopping and starting these medications without guidance can trigger attacks. Always follow your doctor's instructions.
Diet alone usually doesn't cure gout, but it can help reduce flares.
Helpful strategies include:
Crash dieting and fasting can actually trigger gout, so steady, sustainable changes are best.
Excess body weight increases uric acid production and decreases elimination. Gradual weight loss can lower uric acid levels and reduce flare frequency.
Avoid extreme or rapid weight loss programs, as they can worsen gout temporarily.
Most gout flares are not life threatening, but untreated or poorly controlled gout can lead to:
Additionally, people with gout often have other health conditions such as:
That's why gout management is about more than joint pain—it's part of your overall health picture.
If you experience:
Speak to a doctor immediately to rule out infection or other serious causes.
If your joint feels like it's on fire, gout may be the reason. The pain can be intense, but the condition is treatable and manageable with proper care.
Here's what matters most:
If you're unsure whether your symptoms match gout or pseudogout, take a few minutes to complete this AI-powered Gout / Pseudogout symptom checker to gain clarity before your doctor's visit.
Most importantly, speak to a doctor about any severe, persistent, or unusual joint pain—especially if you have fever or feel unwell. Joint infections and other serious conditions can be life threatening if ignored.
Gout may feel dramatic in the moment—but with the right plan, it doesn't have to control your life.
(References)
* Singh JA, et al. Diagnosis and management of gout: a review. JAMA. 2022 Jun 21;327(23):2343-2356. doi: 10.1001/jama.2022.9551. PMID: 35727289.
* Abhishek A, et al. Gout: pathophysiology, diagnosis and management. BMJ. 2021 Jun 22;373:n1743. doi: 10.1136/bmj.n1743. PMID: 34158223.
* FitzGerald JD, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Part 2: Therapy for Acute and Prophylaxis of Intercritical Gout. Arthritis Rheumatol. 2020 Jun;72(6):847-862. doi: 10.1002/art.41168. PMID: 31923049.
* Bardin T, et al. Gout management: an update. Rheumatology (Oxford). 2023 Feb 1;62(2):503-516. doi: 10.1093/rheumatology/keac392. PMID: 36728362.
* Kim SC, et al. Management of Gout: A Narrative Review. Ann Intern Med. 2023 Feb 21;176(2):ITV16766. doi: 10.7326/AITC220025. PMID: 36812239.
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