Some people can go a long time without an attack, but when it comes on, treatment is critical. Over-the-counter NSAIDs (such as ibuprofen) and prescription-strength narcotics can reduce pain during an attack.

NSAIDs can also help prevent future attacks by lowering uric acid levels. Long-term gout medication — such as allopurinol (Zyloprim) — can help too.

1. Rest

Rest can reduce swelling and pain. If your gout flare is severe, you may need to stay home and rest until the pain subsides. During this time, ice packs and cold compresses can help. These should be applied for 20 minutes at a time. Drinking water is also helpful because dehydration can increase uric acid levels. Avoid alcohol and food that is high in purines, such as red meat, some seafood, and fructose-sweetened drinks.

Getting enough sleep can also reduce inflammation and swelling from gout. It is important to go to bed at the same time each night and to try to get seven to eight hours of sleep. You should also minimize TV, phones, and other screens one to two hours before bed. People with gout are also more likely to have sleep apnea, so it is important to get tested and treated for this condition.

2. Ice

Ice is one of the most common remedies for gout pain. It reduces swelling and inflammation by decreasing blood flow to the affected area. It also increases tissue elasticity and stimulates circulation. Ice is most effective if applied early, so it should be used right after any high-intensity activity.

A gout attack is often triggered by eating foods with a high purine content, such as organ meats, shellfish, beer, and sugary drinks. In addition to limiting these items, it is important to drink plenty of water to prevent dehydration, which can increase the levels of uric acid in the body.

If you notice a gout attack starting, apply a cold compress or ice pack to the affected joint immediately. It’s recommended to leave the ice pack on for 20 minutes at a time and repeat as needed until tenderness, swelling, or inflammation subside. Elevating the affected joint with pillows or cushions will also help reduce discomfort and pressure.

3. Take NSAIDs

Gout pain is usually strongest in the big toe, but it can also affect the side of the foot, ankle, knee, wrist, and hand. During a gout attack, a person can take anti-inflammatory drugs (NSAIDs) to reduce the swelling and pain. These include over-the-counter NSAIDs like ibuprofen or naproxen sodium, and prescription drugs such as indomethacin. If an attack is severe, a doctor may prescribe oral or injected corticosteroids.

Gout attacks occur most often at night or early morning. This is believed to be because the body temperature is lower and dehydration prevents excess uric acid from being flushed out of the system.

For long-term relief, patients can start a drug regimen known as urate-lowering therapy. These medications help reduce uric acid levels to prevent future attacks. Examples of these medications include allopurinol (Aloprim, Zyloprim) and febuxostat (Uloric). Other drugs that can be used are colchicine, lesinurad, pegloticase, and probenecid.

4. Take Tramadol

Many people we spoke to found that taking a short course of tramadol (1.2 mg at the first sign of an attack, followed by 0.6 mg every hour for six doses) helped ease their pain during gout attacks. The medication is in a class of drugs called opiate (narcotic) analgesics, and works by changing how your body responds to pain.

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In a study published in Arthritis Care and Researchopens in a new window, researchers found that 28 percent of people discharged from hospital or the emergency department with a gout attack left with an opioid prescription. This was despite the fact that these medications can cause serious side effects, including confusion and dizziness. Some patients also had enough tablets to last 14 days, which is longer than a gout attack typically lasts.

5. Drink Water

During a gout flare, drinking water can help reduce pain. This is because the body uses water to transport waste products in and out of cells. In a gout attack, this process is accelerated because of an increased concentration of uric acid.

Water can also help reduce the frequency of gout attacks. People should try to drink water during a flare, but should also avoid sugary drinks and alcohol. In addition, it is important to eat food that is low in purines. This includes foods like red meat, organ meats and seafood.

Gout patients should also take medication that lowers uric acid levels long-term. This can be done with a combination of diet and exercise and/or a pill that is prescribed by a doctor. If the uric acid level is too high, it can lead to a flare. The goal of a long-term treatment is to prevent future gout attacks.

6. Exercise

Gout is a painful condition that requires treatment. A doctor can diagnose it with a physical exam. They may also take blood to find out how much uric acid is in the body. Uric acid is a naturally occurring substance that is excreted by the kidneys. But if there is too much of it in the body, crystals form and attack joints.

A patient will likely be prescribed a medication to reduce the levels of uric acid in the body. Medications include allopurinol and febuxostat. These medications can help prevent future attacks. However, they can also increase the risk of flares in the short term.

Exercise is important to help manage gout. Cardiovascular exercises like walking can help control uric acid levels and promote weight loss. Water-based exercises, like swimming or water aerobics can be beneficial because they use buoyancy to decrease the stress on joints. Strength training, especially for the lower extremities can also be helpful.