Gout

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Your big toe just doubled in size and turned purple overnight. You know you didn’t stub it, but it feels like you’re walking on broken glass.

There’s no doubt about it — gout can be excruciating. And when this type of inflammatory arthritis flares up, it can make your daily activities feel impossible. All you want is relief from the searing pain and rapid swelling.

We’re here to help make that happen. We understand how painful gout flares can be. Our healthcare providers know what it takes to accurately diagnose, treat and manage your gout.

Why Choose Cleveland Clinic for Gout Care?

Expert providers:

Our care team includes board-certified and fellowship-trained rheumatologists and other skilled providers who are experienced in identifying and treating gout so you can get pain relief. Meet our team.

Collaborative care:

We work as a team to provide the best possible care — throughout the whole process of diagnosing, treating and managing the causes of your joint pain. We’re here to help relieve your symptoms so you can move freely.

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Virtual visits:

When you’re going through treatments, you might not always feel up to leaving the house. We offer virtual visits for some appointments so that you can meet with your providers one-on-one from the comfort of your couch on a smartphone, tablet or computer.

Gout Diagnosis at Cleveland Clinic

Gout typically affects your big toe, but it can also affect other joint areas like your ankle, knee, elbow, hand and wrist. Our providers will talk with you about your symptoms and perform a physical exam. They’ll also do testing to confirm the diagnosis so they can move forward in crafting a personalized treatment plan.

Blood tests for gout

Specialists draw a blood sample to measure the amount of uric acid in your blood. A high uric acid level doesn’t mean you’ll develop gout, but it may put you at higher risk for the condition. Our healthcare providers rely on more than just this blood test to diagnose gout.

Imaging tests for gout

Our imaging specialists use advanced techniques to see detailed views of uric acid crystals within your joints and in the surrounding tissue. These crystals cause joint swelling and inflammation. We may use a dual energy CT-scan (DECT). This specialized CT-scan uses two different energy types to see crystal formations. We may also use:

Ultrasound.
X-ray.

Synovial fluid analysis for gout

A thick liquid called synovial fluid cushions the joints in your body. We may draw some fluid from the affected joint and examine it under a microscope to look for uric acid crystals. We numb your skin with local anesthesia before inserting a needle into your joint to make the process is as comfortable as possible.

Providers Who Treat Gout

Locations

Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and in London.

Gout Treatment at Cleveland Clinic

Cleveland Clinic rheumatology specialists treat the symptoms of gout during flares to help relieve pain and swelling.

Medication to lower uric acid levels

Because gout is related to a high uric acid level in your body, your providers might treat you with urate-lowering therapy. They do this by using medications that keep your body from producing uric acid (urate) or that remove it from your body. These medications don’t help with the pain and inflammation of current gout flares, but they can help prevent the needle-shaped uric acid crystals from forming in your bloodstream.

Over time, keeping your urate levels below 6 mg/dL will reduce and dissolve uric acid deposits. This will ultimately stop the gout flares from happening. It’s important to understand that this treatment is lifelong, and you’ll need to see your provider periodically so they can monitor your urate level.

If you have high uric acid levels, you may also be at risk for developing:

Medication to manage gout flares

To reduce pain and swelling during gout flares, we may prescribe:

Colchicine (medication that helps prevent gout).
Corticosteroids.
Non-steroidal anti-inflammatory drugs (NSAIDs).

Lifestyle Changes to Lower Your Risk of Gout

Gout causes can include certain foods and drinks that increase uric acid levels. These foods contain purines, a substance your cells use to make DNA. To lower your risk, consider limiting your intake of:

Alcohol, especially beer.
Drinks and foods that contain high fructose corn syrup.
Red meat and organ meats.

Our providers will discuss other changes you can make to help prevent or lessen gout flares that are unique to you.

Taking the Next Step

Constantly living with painful toes and other joints can be physically and emotionally exhausting. So can the uncertainty of wondering how long it will be until your next flare. We know feeling like yourself again is important. That’s why we take the time to listen to you and create a personalized gout treatment plan. These plans aim to reduce or eliminate your flares so you can live with more confidence and less pain.