How to Stop a Gout Flare Fast: Immediate Steps + Long-Term Prevention

If you are in the middle of a gout flare right now, here is what to do immediately: take an anti-inflammatory medication (NSAIDs like ibuprofen or naproxen, or colchicine if you have it prescribed), ice the affected joint for 20 minutes on and 20 minutes off, elevate the joint above heart level, and drink plenty of water. Do not apply heat, do not try to “walk it off,” and do not take aspirin (it can worsen uric acid levels at low doses).

The first 12 to 24 hours of treatment matter most. The sooner you intervene, the shorter and less severe the flare will be.

What Should You Do Right Now During a Flare?

Anti-Inflammatory Medication

The most effective immediate intervention is appropriate anti-inflammatory medication. The options, which you should discuss with your doctor before you need them, include:

NSAIDs (nonsteroidal anti-inflammatory drugs) such as naproxen (Aleve) or indomethacin are often the first-line treatment for acute gout. Take the full recommended dose at the onset of symptoms. Ibuprofen (Advil, Motrin) works as well but may require higher doses. Avoid aspirin, as low-dose aspirin can impair uric acid excretion and potentially worsen the underlying condition.

Colchicine is most effective when taken within the first 12 hours of a flare. The current recommended dosing is lower than the older high-dose regimens: typically 1.2 mg at the first sign of a flare, followed by 0.6 mg one hour later. This low-dose protocol has been shown to be as effective as higher doses with far fewer gastrointestinal side effects. Colchicine requires a prescription and works best if you have it on hand before a flare starts.

Corticosteroids like prednisone may be prescribed by your doctor when NSAIDs and colchicine are not suitable, for example in patients with kidney disease, stomach ulcers, or those on blood thinners. These are available only by prescription.

If you do not have any of these medications available and cannot reach a doctor quickly, over-the-counter naproxen (Aleve) is the most accessible first step. Follow the label dosing and contact your healthcare provider as soon as possible.

Ice and Elevation

Apply ice wrapped in a cloth or towel to the affected joint for 20 minutes, then remove it for 20 minutes, and repeat. Direct ice on skin can cause damage, so always use a barrier. Ice reduces inflammation and provides meaningful pain relief.

Elevate the affected joint above the level of your heart when possible. If your big toe or ankle is affected, lie down and prop your foot on pillows. Elevation helps reduce swelling by encouraging fluid drainage away from the inflamed area.

Hydration

Drink water aggressively. Aim for significantly more than your normal intake during the acute phase. Hydration helps your kidneys flush uric acid and may help accelerate the resolution of the flare. Water is ideal. Avoid alcohol and sugary drinks entirely during a flare, as both can elevate uric acid levels and prolong the attack.

Protect the Joint

Gout flares make the affected joint exquisitely sensitive. Even the weight of a bed sheet can cause significant pain. Keep pressure off the joint. If your foot is affected, avoid wearing tight shoes, and consider wearing a loose slipper or going barefoot at home. Do not attempt to massage the joint or apply heat, as both can increase inflammation.

Rest

This is not the time to push through. Rest the affected joint and limit activity until the acute pain subsides. Forcing a joint through a flare can prolong the attack and potentially cause additional crystal deposition.

What Happens if You Don’t Treat a Flare?

An untreated gout flare will eventually resolve on its own, typically within 7 to 14 days, though severe episodes can last longer. For a detailed look at timelines, see our guide on how long a gout flare lasts. The body’s inflammatory response gradually clears the crystals, and the flare subsides. However, leaving flares untreated has consequences beyond the immediate pain.

Each untreated flare can deposit additional uric acid crystals in and around the joint, building up deposits called tophi over time. These deposits do not dissolve on their own and can cause joint damage. Untreated gout also tends to progress, with flares becoming more frequent, lasting longer, and affecting additional joints.

Prompt treatment of each flare and, more importantly, a long-term management plan to prevent future flares are both important for protecting joint health.

How Do You Prevent Future Flares?

The immediate flare will pass, but the underlying condition remains. Long-term prevention involves addressing the factors that allowed uric acid to accumulate to the point of crystallization.

Medication Compliance

If your doctor has prescribed urate-lowering therapy (allopurinol, febuxostat, or probenecid), consistent daily use is the single most effective prevention strategy. These medications work by either reducing uric acid production or increasing excretion, with the goal of maintaining levels below 6.0 mg/dL.

A common mistake is stopping medication when you feel better. Gout is a chronic condition, and urate-lowering therapy typically needs to be continued indefinitely to maintain low uric acid levels. Stopping and restarting medication can actually trigger flares due to rapid uric acid fluctuations.

Hydration

Consistent adequate hydration is one of the simplest and most effective preventive measures. Water helps your kidneys filter and excrete uric acid more efficiently. Most guidelines suggest aiming for at least 2 to 3 liters of water daily, more in hot weather or during exercise. Dehydration is one of the most common preventable gout triggers.

Dietary Awareness

Rather than following a rigid avoidance diet, understanding which specific foods and drinks affect your uric acid levels is more practical and sustainable. The highest-impact dietary factors for most gout sufferers are:

• Sugary drinks and foods high in fructose - Fructose both increases uric acid production and impairs excretion.
• Beer and spirits - Alcohol impairs uric acid excretion; beer adds purines as well.
• Organ meats and certain shellfish - The highest dietary purine sources.

Notice that this is a shorter list than the multi-page avoidance sheets many doctors hand out. Most regular foods, including most meats, fish, and all vegetables, can be part of a gout-friendly diet in reasonable portions. The key is knowing which specific items affect you personally.

Tracking Your Triggers

This is where long-term management gets personal. Consistent gout tracking reveals that the factors that trigger your flares may be different from someone else’s. Some people find that dehydration is their primary trigger. Others discover that fructose from sugary drinks matters more than dietary purines. Some find that poor sleep combined with stress creates a flare-prone state regardless of diet.

The only way to identify your personal pattern is to track multiple factors over time and correlate them with your flare events. Urica was designed specifically for this purpose. Daily tracking of meals (via photo-based AI analysis), hydration, sleep, and stress creates the dataset needed for correlation analysis. When you log a flare, the app examines your recent data across all tracked categories to surface patterns that might explain what triggered the attack.

Each documented flare, while painful, becomes a data point that improves your understanding of your own gout. Over several months of tracking, these patterns become increasingly clear and actionable.

Weight and Metabolic Health

Excess weight, particularly visceral fat, is strongly associated with insulin resistance, which directly impairs uric acid excretion. Gradual weight loss (if overweight) can significantly improve uric acid levels and reduce flare frequency. However, rapid weight loss or crash diets can temporarily increase uric acid through increased cellular breakdown, potentially triggering flares. Slow, sustainable weight management is the safer approach.

Metabolic syndrome (the combination of obesity, high blood pressure, insulin resistance, and elevated triglycerides) is one of the strongest risk factors for gout and creates a metabolic environment that impairs uric acid handling at multiple levels. Addressing metabolic health through diet, exercise, and medication when needed can have a profound impact on gout outcomes.

When Should You Seek Emergency Medical Care?

Most gout flares can be managed at home with appropriate medication. However, seek immediate medical attention if:

• You have a fever above 101 degrees Fahrenheit (38.3 degrees Celsius) along with a hot, swollen joint, as this can indicate a joint infection that mimics gout but requires urgent different treatment.
• You have never been diagnosed with gout and are experiencing your first episode of severe joint pain. A proper diagnosis is important because several other conditions can mimic gout symptoms.
• Your flare is not responding to treatment after several days.
• You cannot tolerate any medications due to allergies or other health conditions.
• The pain is so severe that it is not manageable with available medications.

Gout is a manageable condition. The acute pain of a flare is temporary, and with appropriate medication, lifestyle adjustments, and an understanding of your personal triggers, most people can significantly reduce flare frequency and live comfortably. The key is treating it as the chronic metabolic condition it is rather than as isolated, unpredictable events.

This article is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider for diagnosis and treatment of gout, especially during an acute flare. Do not start or stop medications without medical guidance.