Gout relief comes in two phases: stopping the intense pain of an active flare, and lowering uric acid levels over time so flares stop happening. Most people searching this question are in the middle of an attack, so the fastest options come first.
Immediate Relief During a Flare
The three main medications for an acute gout attack are anti-inflammatory painkillers (NSAIDs), colchicine, and corticosteroids. All three work roughly equally well, so the choice usually depends on your other health conditions and what you tolerate best.
Over-the-counter naproxen is one of the most accessible options. In a trial of 399 people with gout flares, naproxen worked just as well as colchicine for pain relief at seven days and caused fewer side effects like diarrhea and headaches. Ibuprofen is another option, though naproxen tends to be preferred because it lasts longer per dose. Avoid aspirin, which can actually raise uric acid levels.
Colchicine is a prescription medication that works best when taken at the very first sign of a flare. The standard approach is a loading dose followed by a smaller dose one hour later, with a maximum of 1.8 mg in that first hour. Waiting even 24 hours to start colchicine significantly reduces how well it works, so timing matters more with this drug than with NSAIDs.
Corticosteroids are the go-to option if you have kidney disease or can’t take NSAIDs. They can be taken as pills or injected directly into the swollen joint. Both routes produce similar results: about 75% of people see meaningful improvement within two weeks regardless of which method is used.
What You Can Do at Home Right Now
While waiting for medication to kick in, ice and elevation provide real, measurable relief. Wrap an ice pack (or a bag of frozen peas) in a thin towel and apply it to the affected joint for 20 to 30 minutes at a time, several times a day. If the flare is in your toe or foot, prop it up on pillows so it sits higher than your chest. This helps drain fluid from the swollen area.
Stay hydrated. Your kidneys eliminate roughly two-thirds of the uric acid in your body through urine, and water intake has a direct, measurable effect on uric acid levels. A large cross-sectional study found that uric acid drops steadily as water intake increases, up to a threshold of about 7.6 mL per kilogram of body weight in plain water per day. For a 180-pound person, that works out to roughly 620 mL, or about 2.5 cups, of plain water as a minimum. Total fluid intake (including water from food and other beverages) showed a similar pattern with a threshold around 33.6 mL per kilogram, which is about 2.7 liters for that same person. Beyond these thresholds, additional water doesn’t lower uric acid much further.
Rest the joint completely during a flare. Even the weight of a bedsheet can feel excruciating on a gouty toe. Keeping a bed cradle or open-toed shoe handy can help you avoid contact with the inflamed area.
Foods That Make Gout Worse
Certain foods flood your body with purines, the compounds your body breaks down into uric acid. The biggest offenders are organ meats like liver, kidney, and sweetbreads. Among seafood, anchovies, shellfish, sardines, and codfish are the most problematic.
Sugar deserves special attention. Foods and drinks sweetened with high-fructose corn syrup, including some cereals, baked goods, salad dressings, and canned soups, raise uric acid through a different pathway than purines do. Fructose increases uric acid production directly during metabolism, so limiting all added sugars reduces your gout risk even if you’re already watching your purine intake. Beer is a double hit: it’s high in purines and the alcohol itself impairs uric acid excretion.
Tart Cherry Juice
Tart cherry juice is one of the few natural remedies with real data behind it. A study of 633 people with gout found that cherry consumption was associated with a 35% lower risk of flares. Researchers have predicted that regular cherry juice intake could reduce the yearly recurrence rate from about 11% down to roughly 2.7%. The effect likely comes from anthocyanins, the pigments that give cherries their deep red color, which lower inflammation and may help the kidneys clear uric acid. This isn’t a replacement for medication during an active attack, but it’s a reasonable addition to a prevention strategy.
Long-Term Uric Acid Control
Relieving individual flares is only half the picture. If you’ve had more than one attack per year, or if you have visible uric acid deposits (tophi), the goal shifts to keeping your blood uric acid level below 6 mg/dL permanently. This is the concentration below which uric acid crystals stop forming and existing deposits slowly dissolve. Some guidelines push for below 5 mg/dL in people with tophi.
The American College of Rheumatology recommends allopurinol as the first-choice medication for this. It works by blocking the enzyme that produces uric acid. Treatment starts at a low dose (100 mg per day or less) and gets gradually increased based on blood tests every few weeks until your uric acid hits the target. This slow ramp-up is important because starting too high can actually trigger a flare.
Febuxostat is an alternative that works through the same mechanism. In a head-to-head trial, both drugs were equally effective: over 91% of participants reached their uric acid target at one year when doses were carefully adjusted. The practical difference is cost and safety profile. Febuxostat is roughly 19 times more expensive than allopurinol, and the FDA added a boxed warning about potential cardiovascular risk, though a later European trial found conflicting results. For most people, allopurinol remains the better starting point.
One counterintuitive reality: when you first start a uric acid-lowering medication, flares often get temporarily worse. As uric acid levels drop, existing crystals shift and partially dissolve, which irritates the joint lining. This is why doctors typically prescribe a low dose of colchicine or an NSAID alongside the new medication for the first several months. The flares taper off as your uric acid stabilizes below the crystallization threshold.
Putting It All Together
For an active flare, start an NSAID or colchicine as early as possible, ice the joint, elevate it, and drink plenty of water. For prevention, the combination of a uric acid-lowering medication titrated to a target below 6 mg/dL, dietary changes that cut high-purine foods and added sugars, consistent hydration, and possibly tart cherry juice gives you the best chance of making flares rare or eliminating them entirely. Gout is one of the few forms of arthritis that can be fully controlled when uric acid stays below the crystallization point long enough for existing deposits to dissolve.