Treatment of gout in the feet

Gout develops when urate crystals collect in and around a joint. The big toe is a familiar site, but the midfoot, ankle, or knee can also become hot, swollen, and very tender. A flare can make shoes, walking, or even light contact uncomfortable. A clinician may assess the joint and review medicines, kidney health, diet, and blood tests; sometimes fluid from the joint is examined to confirm the cause. A flare is different from long-term urate management, which aims to prevent crystal build-up and repeated inflammation.

During a flare, rest the foot, raise it when possible, and use a cool pack wrapped in cloth for short periods. A clinician may prescribe an anti-inflammatory medicine, colchicine, or a corticosteroid, depending on your health and current medicines. Do not start, stop, or change urate-lowering treatment without advice. If prevention is recommended, take it regularly and attend follow-up checks. Drink fluids unless a clinician has restricted them, and discuss alcohol, sugary drinks, weight, and foods high in purines rather than making abrupt changes. Kidney disease can change which treatments are suitable; see Chronic Kidney Disease for related context.

Arrange medical advice for a first suspected flare, repeated attacks, or swelling that does not settle. Seek urgent care if the foot is rapidly worsening, you feel feverish or unwell, the skin is intensely red, or you cannot bear weight, because infection and gout can look similar. Contact a clinician promptly if a prescribed medicine causes a rash, severe diarrhoea, breathing trouble, or unusual weakness.

Ask what confirms gout, which flare treatment fits your kidney and stomach health, whether prevention is appropriate, and how you should monitor urate and medicines.