What should you know about untreated gout?

Gout develops when urate crystals collect in and around a joint, triggering intense inflammation. Without a plan to control the underlying urate level, attacks may return and involve more than the first joint. Pain and swelling can affect the big toe, ankle, knee, or another joint; see [Joint Pain](/symptoms/joint-pain/) and [Joint Swelling](/symptoms/joint-swelling/).

Over time, firm crystal deposits called tophi can form under the skin or around joints. Ongoing inflammation may limit movement and damage joint surfaces. Gout can also occur alongside health problems such as chronic kidney disease or obesity, which should be discussed rather than assumed to be the cause.

Book a medical review if attacks recur, last longer, or leave swelling between flares. A clinician may examine the joint, review medicines and health conditions, and use blood tests or joint-fluid testing when the diagnosis is uncertain. Treatment can address the current flare and reduce future crystal build-up; do not start, stop, or change prescription medicine without guidance.

During a flare, rest the joint, keep it raised when practical, and use a cool pack wrapped in cloth for short periods. Hydration advice should fit your kidney and heart health.

Get urgent medical help for a hot, swollen joint with fever, chills, feeling very unwell, or rapidly worsening pain. Infection can resemble gout and needs prompt treatment. Seek advice quickly if you cannot move the joint, cannot keep fluids down, or have a new severe attack.

Ask what confirms gout, whether your medicines affect urate, how to handle the next flare, and whether kidney function needs review. Ask how follow-up will show that crystal deposits are reducing and which activities are reasonable between attacks.