Living With Arthritis
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Gout treatment

Gout treatment has two parts: managing the acute attack, and lowering uric acid long term to prevent further attacks and joint damage. This page is educational UK guidance only — not a prescription or diagnosis. Your GP, rheumatology team or pharmacist decides what is safe for you.

Treatment approaches

NSAIDs during attacks

Often first-line for people who can take them — start early in an attack if your clinician has advised this class.

Colchicine

Used for acute attacks when NSAIDs are unsuitable; dosing and kidney checks are clinician decisions.

Short steroid course

Sometimes used when NSAIDs and colchicine are not appropriate.

Allopurinol

Long-term urate-lowering therapy — the usual cornerstone of preventing future attacks once the diagnosis is confirmed.

Febuxostat

Alternative urate-lowering option when allopurinol is not tolerated — see our Febuxostat guide.

Lifestyle measures

Weight management, alcohol moderation, hydration and a lower-purine pattern alongside medication — not instead of it.

Acute attack vs long-term prevention

Treating the painful flare and preventing the next one are different jobs. Acute medicines calm the joint for days; urate-lowering therapy (usually allopurinol, sometimes febuxostat) is started or adjusted when attacks repeat or tophi appear. Do not stop long-term urate-lowering medicine during a flare unless your clinician tells you to — that is a common myth that can prolong attacks.

If a joint is suddenly hot, red and very swollen with fever or you feel severely unwell, seek urgent care (NHS 111 / A&E) because joint infection can look similar to gout.

What UK pathways usually look like

A first suspected attack is often assessed in primary care, sometimes with joint fluid testing when the diagnosis is unclear. Repeated attacks usually trigger a conversation about long-term urate lowering and a target blood urate level. Rheumatology input is more likely when attacks are frequent, tophi are present, kidney disease complicates choices, or first-line medicines are not tolerated.

For medicine-specific reading see /guides/febuxostat-for-gout. For food patterns that support (not replace) treatment, see /conditions/gout/diet and /guides/diet.

Self-care themes between appointments

Rest and elevate the joint in a flare; ice with a cloth barrier for short spells; ask a pharmacist which short-term pain options fit your other medicines. Between attacks, keep moving with non-impact exercise once the joint settles, stay hydrated unless advised otherwise, and cut binge alcohol and sugary drinks. Track attack dates — that diary helps your GP decide when prevention is worth starting.

  • Educational only — no doses or medicine starts from this page
  • Charity 1218461 · clinical authorship HCPC PH128483
  • Motion is Lotion still applies between gout attacks

This is general information, not a substitute for personalised medical advice.

Frequently asked questions

What is the best treatment for gout in the UK?

UK treatment for gout follows NICE guidance and usually combines self-management (exercise, weight control, pacing), pain relief, and — where needed — specialist medication or therapy. There is no single "best" option; the right plan depends on the type, severity and joints involved.

Can gout be cured?

Most forms of gout cannot be cured, but they can be very effectively managed. With the right combination of exercise, medication, and lifestyle support, many people maintain a full and active life.

What painkillers help gout?

Common options include paracetamol, topical or oral NSAIDs (such as ibuprofen) and, for inflammatory types, prescription medication such as DMARDs or biologics. Always take pain relief at the lowest effective dose and ask your GP or pharmacist about interactions.

Do I need a referral to see a rheumatologist for gout?

Yes — in the UK, you'll usually need a referral from your GP to access UK healthcare rheumatology services. If your GP suspects an inflammatory arthritis, NICE recommends urgent referral so that treatment can start early.

Are there free UK healthcare resources for gout treatment?

Yes. UK healthcare physiotherapy, occupational therapy, pain clinics and self-management programmes are available — many free at the point of use. Ask your GP or check the UK healthcare system website for services in your area.