A gout flare can be intensely painful, but a new hot, swollen joint is not automatically gout. NICE says clinicians should consider septic arthritis and other inflammatory conditions, with immediate referral when septic arthritis is suspected.
What established guidance says
NICE lists an NSAID, colchicine or a short course of oral corticosteroid as first-line treatment options, chosen around other conditions, medicines and preferences. Ice packs may help pain alongside prescribed medicine.
After the flare
NICE suggests follow-up after a flare to measure serum urate, review risk factors and medicines, and discuss long-term urate-lowering treatment where appropriate.
Primary source
Evidence reviewed September 2026. General information only; not medical advice.