Gout attack – what to do while you seek care
How to respond to a painful gout flare, why a first hot joint needs assessment and how long-term prevention differs from attack treatment.
A hot, painful joint needs the right diagnosis
Gout can cause sudden severe pain, swelling and warmth in a joint, often in the foot, but other infections and joint problems can look similar. A first attack, fever, rapidly worsening redness or feeling very unwell needs clinical assessment rather than assuming it is gout.
Attack care and prevention are different
Treatment for an acute attack is not the same as long-term urate-lowering prevention. The clinician chooses based on the joint, kidney and stomach health, other medicines, previous attacks and the diagnosis.
The formulary contains medicines used in gout care; a clinician must decide whether they are appropriate:
Colchicine — Colchicine Lennon
Acute gout attack; gout flare prophylaxis (when starting allopurinol); familial Mediterranean fever
Allopurinol — Zyloprim, Puricos, Adco-Allopurinol
Gout (long-term urate-lowering therapy); hyperuricaemia; prevention of tumour lysis syndrome
While arranging advice
- Rest the joint and avoid pressure on it.
- Use a wrapped cool pack for short periods if it feels helpful.
- Drink normally unless a clinician has restricted your fluids.
- Take only the treatment prescribed or confirmed for this attack.
- Ask how and when a prevention plan should start or continue.
Fever with a hot joint is urgent
Common questions
- What should I do during a gout attack?
- Arrange clinical advice, rest the joint, use a wrapped cool pack if comfortable and take only treatment confirmed for you. A first attack or fever needs assessment.
- Is allopurinol for a gout attack?
- Allopurinol is used for long-term urate-lowering prevention in appropriate patients, not as a universal immediate pain remedy. A clinician decides the timing and plan.
Sources
- Adult Primary Care guide: symptom-based integrated approach to the adult in primary careNational Department of Health, South Africa
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
Last reviewed 26 August 2026.