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Symptoms & diagnosis

A first possible gout attack: what to do next

Prepared 2026-10-29 · Read as Markdown

Arrange an assessment for a first sudden, painful, swollen joint. Gout is one possibility, but infection, other crystal conditions, and injury can resemble it. Family history, a recent meal, or a matching photograph cannot settle the diagnosis. [S03] [S08]

Seek urgent help if you feel feverish or unwell, symptoms are rapidly worsening, or you are concerned about infection. Suspected joint infection needs immediate assessment. A lack of fever does not rule it out. [S03] [S08]

While you arrange care

Rest and protect the joint. A cold pack wrapped in cloth may help; avoid prolonged or direct ice contact. Avoid dehydration while following any fluid limit you have been given. Ask a pharmacist or clinician whether a pain medicine is suitable for your conditions and other medicines. Do not borrow someone else’s prescription or rely on a product sold as a gout cure. S03 S08 S20

Bring a short history

Record the start time, how quickly pain increased, where it hurts, warmth or swelling, and what you can no longer do comfortably. Include any temperature you measured and recent illness, wound, injury, surgery, or joint procedure. Bring regular medicines, recent prescriptions, over-the-counter products, supplements, and previous urate or kidney-test results if available. S03 S06

What the assessment may involve

A clinician may order a urate blood test, examine fluid from the joint, or use imaging. Urate can be lower during an attack. NICE advises repeating it at least two weeks after a flare settles if gout remains strongly suspected despite a lower result. S03

Follow up even if the pain eases

Ask how confident the diagnosis is, what to do if it happens again, and whether long-term treatment is appropriate. Kidney and cardiovascular health and your urate results belong in the review. A first episode does not lead to the same plan for everyone. S02 S03

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