Managing Gout: Practical Steps to Cut Flares and Protect Joints

Gout attacks come on fast and hurt more than you expect. The good news: many people can cut how often attacks happen and how bad they are with simple changes, the right medicines, and a plan with their doctor. This page gives clear, usable steps you can try right away.

Short-term flare control

When an attack starts, act quickly. Over-the-counter NSAIDs like naproxen or ibuprofen often work well if you can take them safely. If NSAIDs aren’t an option, doctors commonly prescribe colchicine (best started early) or a short steroid course. Ice the joint, keep it elevated, and rest. If pain or swelling doesn’t improve in a day or two, or if you have fever or very bad pain, see a doctor—sometimes joint aspiration is needed to rule out infection.

Long-term prevention and daily habits

If you’ve had more than one gout attack, talk with your doctor about prevention. Urate-lowering therapy (ULT) such as allopurinol or febuxostat lowers blood uric acid and reduces future flares. The goal is to reach and maintain a uric acid level your doctor sets—often below 6 mg/dL. Starting ULT can trigger flares at first, so short-term preventive colchicine or low-dose NSAIDs are sometimes given during the first months.

Lifestyle changes matter. Cut back on alcohol—beer is the worst offender for gout—limit sugary drinks and foods high in fructose, and avoid or reduce organ meats, anchovies, sardines, and other very high-purine foods. That doesn’t mean starving yourself: choose more low-purine options like vegetables, whole grains, low-fat dairy, and lean proteins. Losing weight slowly helps; rapid weight loss can trigger flares.

Stay hydrated. Drinking water helps kidneys flush uric acid. Some people find cherries or cherry extract helpful—research suggests they may lower flare risk for some people, though they don’t replace meds. Vitamin C supplements can modestly lower uric acid for some adults, but check with your doctor first, especially if you have kidney issues.

Watch other drugs and health conditions. Certain meds and medical problems raise uric acid—diuretics, some blood pressure medicines, and kidney disease are examples. Allopurinol interacts with azathioprine and 6-mercaptopurine; always tell your provider about every medicine and supplement you use.

Follow-up matters. Regular blood tests track uric acid and kidney function, and dose adjustments are common. If attacks keep happening despite lifestyle changes and ULT or if you have joint damage, ask for a referral to a rheumatologist—specialists can tailor treatment and consider other options.

You don’t have to accept frequent, crippling flares as normal. With quick treatment for attacks, steady prevention, and a few diet and lifestyle moves, most people cut attacks dramatically and protect their joints for the long run. If you’re unsure where to start, bring this list to your next appointment and make a simple plan with your clinician.