A big-toe joint that turns suddenly and severely painful, swollen and red overnight may be gout. The UK National Health Service (NHS) describes gout as a type of arthritis causing sudden, severe joint pain, caused by too much uric acid in the blood forming crystals around joints. Untreated, an attack usually lasts 1 to 2 weeks, and untreated gout can damage joints. Here is the NHS guidance on attacks, prevention and when to get urgent help.
1. Usually the big toe — also feet, ankles, hands, wrists, elbows, knees. Untreated, 1 to 2 weeks.
2. In an attack: medicine straight away, rest and raise, ice up to 20 minutes at a time, plenty of water.
3. With a high temperature, shivering or feeling sick: urgent help — it could be a joint infection.
Symptoms — NHS
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| Pain | Sudden, severe joint pain, usually the big toe; also feet, ankles, hands, wrists, elbows, knees | — |
| Skin | Hot, swollen, red skin over the joint | Redness can be harder to see on black or brown skin |
| Length | Untreated, an attack usually lasts 1 to 2 weeks | Untreated gout can damage joints |
When to get help — NHS
| Situation | NHS advice | Worth noting (ours) |
|---|---|---|
| Gout symptoms for the first time | See a GP | In Korea, a local clinic or rheumatology |
| Usual treatment isn’t helping | See a GP | — |
| Sudden joint pain and swelling getting worse | Urgent help | — |
| Plus a very high temperature, hot or shivery, sick or can’t eat | Urgent help — possible joint infection | The page gives no separate 999 criteria |
A GP may ask about diet and alcohol and test your blood uric acid; if it’s unclear, a rheumatologist may take fluid from the joint or arrange a scan.
During an attack — NHS
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| Medicine | Take prescribed medicine straight away; it should work within 2 days | Treat as soon as an attack starts |
| Rest | Rest and raise the limb; avoid pressure on the joint | — |
| Ice | Ice pack or wrapped frozen peas, up to 20 minutes at a time | — |
| Water | Plenty of water unless a GP says otherwise | — |
| Night | Keep bedclothes off the joint | — |
Treatment — NHS
Attacks are usually treated with an NSAID such as ibuprofen; if pain and swelling don’t improve, steroids may be given as tablets or an injection. Frequent attacks or high uric acid may need uric acid-lowering medicine, which the NHS stresses should be taken regularly, even without symptoms.
Causes and triggers — NHS
It runs in families and is more common in men, especially with age. Being overweight, drinking alcohol, the menopause, diuretics or some blood pressure medicines (ACE inhibitors), high cholesterol, high blood pressure, kidney problems, osteoarthritis, diabetes, or past surgery or injury raise the risk. Attacks can be triggered by an illness with a high temperature, heavy drinking or a very large meal, dehydration, joint injury or some medicines.
Preventing attacks — NHS
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| Weight | Lose weight if overweight, but avoid crash diets | — |
| Food | A healthy diet; follow any list from your doctor. Avoid sugary drinks and snacks | — |
| Alcohol | Some alcohol-free days a week; 14 units or fewer a week | About 2 units a day on average (our sum); see the calculator below |
| Water, exercise | Plenty of fluids; regular exercise, avoiding intense exercise or heavy joint loading | — |
| Other | Consider stopping smoking; ask a GP about vitamin C supplements | — |
Units per drink can be worked out in the alcohol unit calculator. Long-term untreated gout can lead to joint damage, hard painful lumps (tophi) on the ears, fingers or elbows, kidney stones and, rarely, chronic arthritis, says the NHS.
Checklist
- ☐ First symptoms: see a doctor and get uric acid checked
- ☐ In an attack: medicine at once, rest, raise, ice up to 20 minutes
- ☐ Fever, shivering or sickness too: urgent help
- ☐ Uric acid-lowering medicine: take it even without symptoms
- ☐ 14 units a week or less, no sugary drinks, no crash diets
Questions that remain
Which foods should I avoid?
This page only says eat healthily and follow any list from your doctor. We didn’t reproduce a high-purine food list.
Can I stop the medicine once symptoms go?
The NHS says to keep taking uric acid-lowering medicine even without symptoms. Talk to a doctor before stopping.
Sources
- NHS — Gout — source (page shows: reviewed 24 August 2023, next review due 24 August 2026 (past at the time we checked); checked 19 October 2026). Symptoms, GP and urgent criteria, diagnosis, causes, risk factors and triggers, self-care in an attack, treatment, prevention, complications.
- Not read. A purine food list; Korean gout guidance.
- What we added. The “worth noting” column and the Korean care gloss.
Where to check further
- A rheumatologist — uric acid and medicine.
Written on 19 October 2026. The content is from the NHS; the glosses are ours.
