When to worry about joint pain with gout

Gout happens when urate crystals irritate a joint, often causing sudden severe pain, warmth, swelling and tenderness. An attack may affect the big toe, ankle, knee or another joint. Pain that feels different from earlier attacks, follows an injury, or does not begin to settle deserves a clinical review because infection, injury or another form of arthritis can look similar.

Rest the affected joint, raise it when possible, and use a wrapped cold pack for short periods. Drink normally unless a clinician has restricted your fluids. Take your prescribed flare medicine as directed; do not start, stop or change urate-lowering treatment without advice. Arrange an appointment if attacks are recurring, treatment is not helping, or pain is limiting walking or sleep.

Seek urgent medical assessment for fever, chills, feeling faint, confusion, spreading redness, pus, severe pain after an injury, or inability to move the joint. Seek emergency help for breathing difficulty, facial swelling or a widespread allergic rash after medicine. Contact a clinician promptly when swelling persists, the joint becomes increasingly hot, or symptoms do not match your usual gout pattern.

Ask whether the episode needs testing to distinguish gout from infection, how to use your flare medicine safely, and whether your urate-lowering plan should be reviewed. Tell them which joints are affected, when the pain began, any fever or injury, and every medicine or supplement you take.