Getting rid of gout requires a two-part approach: stopping the intense pain of an active flare and then lowering uric acid levels long-term so flares stop coming back. An untreated gout attack can last up to 14 days, but with proper treatment, most flares resolve within three to seven days. The good news is that gout is one of the most manageable forms of arthritis when you treat the root cause, not just the symptoms.
What’s Actually Happening in Your Joint
Gout pain comes from tiny needle-shaped crystals that form inside your joints when uric acid levels in your blood stay too high for too long. Your body produces uric acid when it breaks down purines, compounds found naturally in your body and in certain foods. When uric acid exceeds a saturation point, it solidifies into crystals, most commonly in the big toe, ankle, or knee.
Once those crystals are present, your immune system treats them as foreign invaders. White blood cells swarm the joint and engulf the crystals, triggering a cascade of inflammation that causes the redness, swelling, heat, and severe pain of a gout flare. This is why gout attacks often seem to strike out of nowhere: the crystals may have been building up silently for months or years before your immune system finally reacts.
How to Stop a Flare Fast
The single most important thing during an active attack is starting treatment at the first sign of pain, not waiting to see if it gets worse. Anti-inflammatory medications are the standard first-line option. Over-the-counter options like naproxen or ibuprofen can help with mild flares, though prescription-strength doses are often needed for a full-blown attack.
For people who can’t take anti-inflammatories due to stomach, kidney, or heart problems, a medication called colchicine is an alternative. It works best when taken within the first 12 hours of a flare. After taking it for one attack, you need to wait at least three days before using it again. Colchicine isn’t safe for everyone, particularly people with severe kidney or liver disease, and it interacts with a long list of other medications.
Corticosteroids, taken as pills or injected directly into the affected joint, are a third option. Your doctor will typically choose a treatment based on how many joints are involved, how severe the flare is, and what other health conditions you have. During any flare, rest the joint, apply ice for 20 minutes at a time, and stay hydrated.
The Real Fix: Lowering Uric Acid
Treating flares only addresses the symptom. To actually get rid of gout, you need to bring your serum uric acid level below 6 mg/dL and keep it there. This is the threshold recommended by the American College of Rheumatology, and it’s the level at which existing crystals in your joints slowly dissolve and new ones stop forming. Think of it like draining a bathtub: you need to get the level low enough that the crystals can’t survive.
Urate-lowering therapy is the cornerstone of this approach. The most commonly prescribed medication works by blocking the enzyme that produces uric acid. Treatment typically starts at a low dose and gets adjusted upward over several weeks until blood tests confirm your uric acid is consistently below that 6 mg/dL target. This “treat to target” strategy produces better long-term outcomes than simply taking a fixed dose and hoping for the best.
One important detail many people don’t expect: starting urate-lowering therapy can actually trigger flares in the first few months. As crystals begin dissolving, they can temporarily irritate the joint lining. This doesn’t mean the medication isn’t working. Your doctor will often prescribe a low-dose anti-inflammatory or colchicine alongside it during this transition period. Sticking with treatment through this phase is critical.
Foods and Drinks That Trigger Flares
Diet alone rarely causes gout, but it absolutely makes it worse. Certain foods are high in purines, and eating them raises uric acid production. The biggest offenders include:
- Organ meats like liver, kidney, and sweetbreads, which have the highest purine levels of any food
- Certain seafood including anchovies, sardines, shellfish, and codfish
- Red meat like beef, lamb, and pork (smaller portions matter here)
- Beer and liquor, which both raise uric acid levels and slow its elimination through the kidneys
- High-fructose corn syrup, found in sodas, sweetened cereals, baked goods, and many processed foods
You don’t need to eliminate all of these permanently, but during active gout or while trying to get uric acid under control, cutting back significantly helps. Wine appears less problematic than beer or spirits, though moderation still applies. Foods that seem to help include low-fat dairy, cherries, and most vegetables, even those that contain moderate purines like asparagus and spinach, which studies have not linked to increased flare risk.
Why Cherries Keep Coming Up
Tart cherries are one of the few home remedies with real evidence behind them. A study of 633 gout patients found that cherry consumption was associated with a 35% reduction in the risk of gout flares. The effect likely comes from compounds in cherries that reduce inflammation and may modestly lower uric acid. Tart cherry juice or cherry extract supplements are the most practical forms. Cherries aren’t a replacement for medication in people with frequent flares, but they’re a reasonable addition to your overall plan.
Hydration Makes a Measurable Difference
Water helps your kidneys flush uric acid out of your bloodstream. People with gout or high uric acid are generally advised to drink 2,000 to 3,000 milliliters of water daily, roughly 8 to 12 cups, spread evenly throughout the day rather than consumed all at once. Dehydration concentrates uric acid in the blood, which is one reason gout attacks often strike at night (when you haven’t been drinking water for hours) or after heavy alcohol consumption.
Gout Rarely Travels Alone
If you have gout, you’re statistically likely to have other health issues that need attention. Hypertension is the most common, present in over half of men with gout and nearly 70% of women with gout. People with gout are also roughly twice as likely to have chronic kidney disease compared to those without it. This overlap isn’t a coincidence: the kidneys handle about two-thirds of uric acid elimination, so anything that impairs kidney function raises uric acid, and chronically high uric acid may damage the kidneys in return.
Some blood pressure medications, particularly certain diuretics (water pills), can raise uric acid levels as a side effect. If you’re on a diuretic and getting gout flares, it’s worth discussing alternatives with your doctor. Managing these connected conditions together tends to produce better results than treating each one in isolation.
When Standard Treatment Isn’t Enough
About 3% of people with gout don’t respond to standard urate-lowering medications, either because of drug intolerance, contraindications, or the medications simply not bringing levels down far enough. For these cases, an intravenous treatment called pegloticase is available. It’s an enzyme that directly breaks down uric acid in the blood and can rapidly lower levels in people who have failed other options. It requires infusions every two weeks and carries a risk of infusion reactions, particularly when uric acid levels creep back above 6 mg/dL between treatments. Monitoring blood levels before each infusion helps identify when the medication is losing effectiveness, at which point it should be stopped.
Pegloticase is a last resort, not a first step. The vast majority of people with gout can reach their target uric acid level with oral medication, dietary changes, and consistent follow-up. The key word is consistent: gout is a chronic condition, and stopping urate-lowering therapy once you feel better almost guarantees the flares will return. Staying on treatment, keeping uric acid below 6 mg/dL, and giving your body time to dissolve the crystal deposits is what it takes to make gout attacks a thing of the past.