Overview
Gout is a type of inflammatory arthritis. It happens when urate crystals form in and around a joint, causing sudden severe pain, swelling, warmth, and redness. The big toe is common, but other joints can be affected.
How common is it?
Gout is common and is more likely with age. It affects people of all genders and can occur alongside high blood pressure, kidney problems, diabetes, or obesity.
Causes and risk factors
A high uric-acid level in the blood can allow crystals to form. This can be linked to the body making more uric acid, the kidneys clearing less, certain medicines, alcohol, dehydration, illness, injury, and genetic factors.
Common risk factors
- Previous gout attacks or a family history
- Kidney disease, high blood pressure, diabetes, obesity, or high cholesterol
- Regular alcohol intake, dehydration, crash dieting, or a very large meal
- Some medicines, including diuretics and low-dose aspirin
Symptoms
- Sudden severe pain in one joint, often overnight
- A hot, swollen, tender joint; redness can be harder to see on brown or black skin
- Pain that makes walking or using the joint difficult
- Hard lumps under the skin called tophi after long-standing uncontrolled gout
When to see a doctor
See a clinician for a first suspected attack or if your usual treatment is not helping. Get urgent same-day advice if a painful swollen joint is getting worse or you have a high temperature, feel shivery, or feel very unwell, because a joint infection needs urgent treatment. Seek emergency help if you are severely unwell.
Diagnosis
A clinician considers the pattern of symptoms and examines the joint. Blood tests can check uric acid and kidney function, but a normal uric-acid level during an attack does not rule gout out. Sometimes joint fluid is tested to look for crystals and exclude infection.
Treatments
Treating an attack
A clinician may recommend an anti-inflammatory medicine, colchicine, or a short course of steroids. The safest choice depends on your kidney function, stomach health, heart health, and other medicines.
Preventing future attacks
People with frequent attacks, tophi, kidney stones, or persistently high uric acid may be offered a urate-lowering medicine such as allopurinol. It is taken regularly, including between attacks, unless your prescriber advises otherwise.
Reviewing triggers and medicines
Your clinician can check for contributing conditions and whether any medicine needs review. Do not stop prescribed medicines yourself.
Self-care and lifestyle
- Rest and raise the affected limb during an attack
- Use a wrapped cold pack for short periods if it helps
- Drink enough fluid unless you have been told to limit fluids
- Aim for gradual weight loss if recommended; avoid crash diets
- Limit alcohol and sugary drinks, and follow individual diet advice rather than relying on a single food list
Prevention
Medicine that lowers uric acid, when indicated, is the most reliable way to prevent recurrent gout. Staying hydrated, avoiding crash diets, and addressing weight and alcohol intake can also help.
Sources and review
Last reviewed: 1 August 2026 by Living Diabetes Editorial Team. This guide was checked against current patient and professional guidance. It is educational and does not replace care from your own healthcare team.