Does Gout Go Away? What Happens With and Without Treatment
A flare clears in a week or two. The condition behind it is a different story, and it is the part treatment can change.
Does gout go away? The flare does. Left alone, the hot, swollen joint usually settles within about 1 to 2 weeks, and between flares you can feel completely normal. Gout itself, a buildup of uric acid crystals in and around the joints, does not go away on its own: the crystals stay put, and new ones keep forming while uric acid in the blood stays high. What makes gout go quiet is bringing that level down and keeping it down.
Below: what happens with and without treatment, how long each part takes to go away, whether gout can be cured, and what diet really changes. For the hour-by-hour course of a single attack, see the gout attack timeline.
ASG Foot & Ankle patient education. Updated October 27, 2026. General information, not a diagnosis.
The short answer
Does gout go away? A single flare usually settles on its own in about 1 to 2 weeks, but gout itself does not go away by itself: the uric acid crystals behind it stay in the joint, so flares tend to return, often within 6 to 12 months, and more often over time. It can be put into long-term remission by keeping blood uric acid below 6 mg/dL with daily urate-lowering medicine, which slowly dissolves the crystals over 3 months to almost 3 years. Diet and weight loss help, but diet changes alone lowered uric acid by less than 1 mg/dL in a large feeding trial.
Get Seen Urgently If
A joint infection can look just like a gout flare. Get same-day care, rather than waiting a flare out, if you have sudden joint pain and swelling and:
- •The pain is getting worse instead of settling
- •You have a high temperature, or feel hot, cold or shivery
- •You feel sick or cannot eat
- •You have diabetes or neuropathy and the foot is hot and swollen, even if it hardly hurts
See a doctor soon, though not as an emergency, if this is your first ever flare or your usual treatment is not helping.
Does Gout Ever Go Away? The Flare vs the Disease
Gout has two layers, and they behave very differently.
The flare: goes away
The attack is the body's inflammation reacting to urate crystals in the joint. It settles by itself, usually in about 1 to 2 weeks untreated. Treated early, the pain often eases within 12 hours and is mostly gone within 48.
The disease: stays
Underneath is a high level of uric acid in the blood, which lets urate crystals build up in and around joints. UK guidance explains that gout progresses without treatment because high uric acid keeps forming new crystals. This part does not go away by itself.
So the honest answer to "will gout go away by itself?" is: the pain will, the gout will not, unless uric acid comes down. Gout affects about 3.9% of US adults, and it is often left untreated between flares: in one large UK trial, only about 40% of people with gout were taking urate-lowering medicine at the start.
If you are in a flare right now, the practical steps are in gout in the big toe: relief and prevention, and an ankle flare is covered in gout in the ankle.
Will Gout Go Away on Its Own? What Happens Without Treatment
Each flare can go away on its own; the disease usually does not, and its pace varies a lot. The NHS notes gout can come back every few months or only after years, and more often when untreated. The usual course when uric acid is left high:
The First Flare Settles
- A sudden, hot, swollen joint, often just one, and often starting at night
- Without treatment it usually settles in about 1 to 2 weeks
- Afterward the joint can feel completely normal
The Quiet Gap
- No symptoms, but urate crystals are still in and around the joint
- While blood uric acid stays high, new crystals keep forming
- Many people have another attack within 6 to 12 months; some go years
Flares Come Back More Often
- Without treatment, flares tend to recur more often, and later ones may last longer
- Each flare still settles, and the gaps can be long, so the progress is easy to miss
Chronic Gout
- Hard lumps of urate called tophi can form under the skin, often on the ears, fingers or elbows
- Ongoing inflammation can cause lasting joint damage and loss of movement
- Kidney stones, and in some people urate deposits in the kidneys
- Not everyone reaches this stage, and lowering uric acid can shrink tophi
What untreated gout can lead to
| Complication | What it means |
|---|---|
| More frequent, longer flares | Untreated gout recurs more often, and later attacks may last longer. |
| Tophi | Hard lumps of urate under the skin, often on the ears, fingers or elbows, after many years of gout. |
| Joint damage | Chronic gouty arthritis, with damage and loss of motion. The NHS calls this rare. |
| Kidney stones | Listed by both the NHS and MedlinePlus as a complication of gout. |
| Kidney problems | Urate deposits in the kidneys can lead to chronic kidney failure. |
None of this is inevitable: the crystals behind it can be dissolved.
How Long Does It Take for Gout to Go Away?
It depends which part you mean. A flare is measured in days. Clearing the crystals that cause flares is measured in months to years.
| What is going away | Typical time | Detail |
|---|---|---|
| A flare, untreated | About 1 to 2 weeks | Later untreated flares may last longer. |
| A flare, treated early | Working within about 2 days | Pain often eases within 12 hours; most is gone within 48. |
| Reaching the uric acid target | Often within a year | About 95% were below target at 1 year in one trial. |
| Crystals clearing from the joint | 3 to 33 months | Longer in people who have had gout longer. |
| Tophi shrinking | Over 1 to 2 years | Largest lump shrank from about 17 mm to 3 mm on average in one trial. |
| Flares settling down | Often by the second year | Flares can increase in the first months before they fall. |
| Anti-inflammatory cover when starting | At least 3 to 6 months | Blunts those early flares. |
How long does a gout flare up last without medication?
Usually about 1 to 2 weeks, according to the NHS, and later untreated flares may last longer. Medicine taken early (an anti-inflammatory painkiller, colchicine or a short steroid course) usually starts working within about 2 days. Meanwhile, ice wrapped in a towel for up to 20 minutes at a time, rest, and raising the joint help.
The day-by-day course of a flare is in the gout attack timeline. If a flare is not settling, a steroid injection into the joint is another option; see what to expect after a cortisone shot.
Can Gout Go Away for Good? Remission With Uric Acid Treatment
In the way that matters most, yes: flares can stop and tophi can disappear. The key is a number. The American College of Rheumatology strongly recommends a treat-to-target approach to urate-lowering medicine: start low, raise the dose until blood uric acid is below 6 mg/dL, and keep it there. UK NICE guidance uses the same target (360 micromol/L) and a lower one, below 5 mg/dL, for people with tophi, chronic gouty arthritis, or flares that continue despite reaching 6.
What happens to the crystals
Urate crystals are not permanent. In a study that sampled fluid from a gouty joint every 3 months, crystals disappeared in all 18 patients once uric acid was brought down to normal. It took 3 to 33 months, longer in people who had had gout longer: one more reason not to wait for the fifth flare.
What treating to target achieved in a 2-year trial
A UK trial of 517 people with gout compared nurse-led care, with education and uric acid medicine raised to target, against usual care from family doctors. After 2 years:
Uric acid below 6 mg/dL
95% vs 30%
Treat-to-target care vs usual care.
Two or more flares in year 2
8% vs 24%
Down from about 80% in both groups.
People with tophi
14% to 3%
No change with usual care.
Gout with and without uric acid treatment
| Uric acid left high | Uric acid kept at target | |
|---|---|---|
| Uric acid | Stays high | Below 6 mg/dL (below 5 with tophi) |
| Crystals | Stay, and new ones form | Dissolve over months to years |
| Flares | Return, more often over time | May rise at first, then fall |
| Tophi | Can form after years | Shrink, and often disappear |
| Long term | Risk of joint and kidney damage | A normal life, as MedlinePlus puts it |
So is gout curable?
Not in the sense of a course you finish. NICE describes gout as a lifelong condition that benefits from long-term treatment to clear crystals, prevent flares, shrink tophi and prevent joint damage, with the medicine typically continued for life. It is closer to blood pressure treatment than to a course of antibiotics.
Who Is Usually Offered Long-Term Treatment
Not everyone with one flare needs lifelong medicine. US and UK guidance agree on the situations where it is usually recommended:
Two or more flares a year
UK guidance phrases it as multiple or troublesome flares.
Tophi
Firm lumps of urate under the skin or around a joint.
Joint damage
Gout damage on an X-ray, or chronic gouty arthritis.
Kidney disease
Chronic kidney disease, stage 3 or worse.
Kidney stones
A history of kidney stones alongside gout.
Very high uric acid, or a water pill
Above 9 mg/dL after a first flare, or regular use of a diuretic.
After a single first flare with none of these, the American College of Rheumatology conditionally recommends against starting, while NICE suggests discussing the option with anyone who has had a flare. Either way it is a shared decision, and a uric acid blood test is a sensible first step.
How it is usually started
- 1Timing. Usually started 2 to 4 weeks after a flare has settled, or during a flare if flares are coming often.
- 2Start low, go up. A low dose, raised using monthly uric acid blood tests until the target is reached.
- 3The usual first choice is allopurinol. Febuxostat is the main alternative.
- 4Cover for the early flares: an anti-inflammatory such as colchicine, usually for at least 3 to 6 months.
- 5Once at target, a yearly uric acid check is usually suggested.
- 6Keep going. It is continued after the target is reached, typically for life, and taken regularly even when you feel fine.
Why Gout Can Seem Worse Before It Gets Better
The first year of treatment is often uneven. In the 2-year trial above, more people in the treat-to-target group had two or more flares in year 1 than with usual care (54% vs 40%). By year 2 the picture had flipped: 8% vs 24%.
- •It is expected. Early flares are the reason the American College of Rheumatology strongly recommends anti-inflammatory cover for at least 3 to 6 months when starting.
- •It is not a sign the medicine has failed. The payoff shows up in the second year.
- •Take it regularly, even when you feel fine. If flares are a problem, talk to whoever prescribes it rather than stopping on your own.
Can Gout Go Away With Diet and Lifestyle Alone?
Obesity, beer and sugary drinks are all linked to gout, and NICE advises that excess weight and excessive alcohol can make flares worse. But measured effects on uric acid are modest, and NICE notes there is not enough evidence that any specific diet prevents flares or lowers uric acid.
| Change | Measured effect | Evidence |
|---|---|---|
| DASH-style diet (fruit, vegetables, low-fat dairy, less saturated fat) | 0.25 mg/dL lower on average after 8 weeks; 0.73 mg/dL lower in people starting at 8 mg/dL or higher | Feeding trial, 327 adults, weight held steady |
| More fruit and vegetables alone | 0.17 mg/dL lower, a borderline result | Same trial |
| Losing weight (about 7 to 75 lb across studies) | From about 2.8 mg/dL lower to slightly higher; 0% to 60% reached target | Review of 10 studies in gout; 6 of 8 found fewer attacks |
| Cutting back on beer | Beer is linked to a bigger rise in gout risk than wine or spirits | Population studies |
| Dropping sugary sodas | Two or more a day are linked to higher risk in men; diet sodas are not | Population studies |
Putting the numbers together
The target is below 6 mg/dL. Someone at 9 mg/dL needs a drop of more than 3 mg/dL, several times what the DASH diet achieved even in people who started high, and weight loss results varied widely. So lifestyle change is worth doing, since obesity, high blood pressure and kidney disease are gout risk factors too, but it is usually paired with medicine when flares keep coming.
Worth doing
- Lose weight gradually if you are overweight
- Limit sugary drinks and snacks
- Keep alcohol to no more than 14 UK units a week, with some alcohol-free days
- Drink plenty of fluids, unless your doctor has told you otherwise
- Exercise regularly, and stop smoking
Watch out for
- Crash diets, which the NHS advises against
- Very rapid weight loss: after weight-loss surgery, uric acid and attacks tended to rise in the short term
- Intense exercise that puts heavy load on the affected joints
- Water pills (diuretics), which are linked to gout. Do not stop a prescribed medicine yourself; ask your doctor
Which foods and drinks to cut back on during and after a flare is covered in gout in the big toe: relief and prevention.
Diabetes, Neuropathy and a Hot, Swollen Foot
Gout is not the only cause of a hot, red, swollen foot. When diabetes has damaged the nerves in the feet, an active Charcot foot, where the foot's bones and joints start to break down, typically shows up as a markedly swollen, warm, often red foot with only mild to modest pain, usually several degrees warmer than the other foot. An expert review in Diabetes Care notes it resembles cellulitis, a blood clot or acute gout, and can be misdiagnosed as any of them.
- •Do not assume a hot, swollen foot is gout because you have had gout before
- •Little pain is not reassuring when feeling in the foot is reduced
- •Get seen without delay if one foot is swollen and warmer than the other
More in Charcot foot recovery, is my foot infection serious? and diabetic foot care.
When to Book a Visit About Gout
The weeks after a flare, when you feel fine, are often the best time. Book a visit if:
- It was your first flare, or flare treatment is not helping
- You have had two or more flares in a year
- You notice a firm lump near a joint or on an ear, finger or elbow
- You have gout plus kidney disease or kidney stones
Uric acid can read normal during a flare. NICE advises repeating the test at least 2 weeks after the flare has settled, so a normal result mid-attack does not mean gout has gone.
In a flare right now? The hour-by-hour course. Gout Attack Timeline →
Need relief for a big toe flare? What helps and what to avoid. Gout in the Big Toe: Relief & Prevention →
Flare in the ankle or heel? How long it lasts there. Gout in the Ankle →
Stiff big toe between flares? Hallux Rigidus →
Not sure it is gout or arthritis? The big toe joint is a common site for both. Foot & Ankle Arthritis →
Frequently Asked Questions
Does gout go away on its own?
The flare does, the gout does not. An untreated flare usually settles in about 1 to 2 weeks, but the uric acid crystals that caused it stay in the joint, and new ones form while blood uric acid stays high. So flares tend to return, often within 6 to 12 months, and more often over time. Lowering uric acid, usually with daily medicine, is what clears the crystals.
Does gout ever go away permanently?
It can go quiet for the long term, but it is better thought of as controlled than cured. Keeping blood uric acid below 6 mg/dL dissolves the crystals over months to a few years, and in one 2-year trial only 8% of people treated this way had two or more flares in the second year. UK guidance says the medicine is typically lifelong, because gout progresses whenever uric acid stays high.
How long does it take for gout to go away?
A single flare takes about 1 to 2 weeks untreated, and early treatment often eases the pain within 12 hours to 2 days. The disease takes longer: once uric acid is held below 6 mg/dL, joint crystals took 3 to 33 months to disappear in one study, and tophi can shrink over 1 to 2 years. The first months of treatment are often bumpy.
How long does a gout flare up last without medication?
Usually about 1 to 2 weeks, according to the NHS, and untreated flares later in the disease may last longer. Medicine taken early usually starts working within about 2 days, and pain often eases within 12 hours of starting it. A flare that keeps getting worse, or comes with a fever or shivering, needs urgent care, because a joint infection can look the same.
Can gout go away with diet and weight loss alone?
Diet and weight loss help, but the measured effects are modest. In a feeding trial, the DASH diet lowered uric acid by 0.25 mg/dL on average and by 0.73 mg/dL in people starting at 8 mg/dL or higher, while weight loss studies ranged from about 2.8 mg/dL lower to slightly higher. The target is below 6 mg/dL, so a large gap usually needs medicine as well. Avoid crash diets.
Do you have to take gout medication forever?
For most people who start it, yes. UK NICE guidance says urate-lowering medicine is usually continued after the target is reached and is typically lifelong, with a yearly uric acid check once you are stable. The extra anti-inflammatory cover used when starting is temporary, usually for at least 3 to 6 months. Talk to your prescriber before stopping anything.
Can you have gout once and never again?
Possibly, but there is no way to know after one flare. The NHS says gout can come back within months or only after years, and many people have another attack within 6 to 12 months. After a first flare without tophi, kidney disease, kidney stones or uric acid over 9 mg/dL, the American College of Rheumatology leans against starting lifelong medicine, so checking uric acid and watching is reasonable.
Sources and further reading
- NHS: Gout
- MedlinePlus: Gout
- NICE guideline NG219: Gout, diagnosis and management (2022)
- American College of Rheumatology: 2020 gout management guideline announcement
- American Family Physician: Gout, rapid evidence review (2020)
- Doherty M et al. Nurse-led, treat-to-target care versus usual care for gout. Lancet (2018)
- Pascual E, Sivera F. Time for urate crystals to disappear after urate-lowering treatment. Ann Rheum Dis (2007)
- Juraschek SP et al. Effects of dietary patterns on serum urate (DASH trial). Arthritis Rheumatol (2021)
- Nielsen SM et al. Weight loss for overweight and obese people with gout: a systematic review. Ann Rheum Dis (2017)
- Rogers LC et al. The Charcot foot in diabetes. Diabetes Care (2011)
General patient education. Your examination and individual treatment instructions take priority.
See a Podiatrist Near You
ASG Foot & Ankle has offices in Homewood, South Chicago Heights and Mokena. Our board-certified podiatrists accept most insurance. Find the office closest to you:
Had More Than One Gout Flare?
Flares that keep coming back mean crystals are still building up. ASG Foot & Ankle can examine the joint, help confirm whether it is gout, X-ray it for damage, treat the flare, and work with your primary care doctor on a long-term uric acid plan, with extra care when diabetes or poor circulation is involved.