How to Treat Gout in the Ankle

Gout is a painful type of inflammatory arthritis. It often affects the big toe, but gout can develop in any joint, including the ankle.

High uric acid levels in the body cause gout. The excess uric acid buildup will cause urate crystals to form. These crystals make their way into the synovial linings of joints leading to swelling, pain, and tenderness of the affected joint.

Fortunately, gout is treatable with medications, lifestyle changes, and at-home remedies to control pain and inflammation and prevent gout attacks. This article covers ankle gout treatment, and preventing flare-ups, as well as when to see a healthcare provider.

Symptoms of Gout in the Ankle

Healthcare providers can sometimes misdiagnose gout in the ankle as a variety of conditions, from a sprained ankle to other types of inflammatory arthritis like rheumatoid arthritis. Some symptoms might distinguish gout from other ankle conditions. These include:  

• Pain: Other ankle conditions cause ankle tenderness and pain, but gout pain is so painful that it stands out. Something as simple as a bedsheet touching the affected gout can bring on severe pain.
• Stiffness: Stiffness from gout starts as a dull, mild ache and turns severe quickly.
• Color: An ankle affected by gout is often very red. The skin of the affected ankle might appear shiny.
• Swelling: Intense swelling is common in ankle gout.
• Warmth: The inflamed ankle will be warm to the touch. 

People who experience gout in the ankle find it can affect joint movement. It makes walking painful, especially when going up and down stairs.

Ankle Gout Treatment  

If you have not been previously diagnosed with gout and start to experience severe ankle pain and swelling, it might be a good idea to visit a healthcare provider while you are having symptoms. It is sometimes easier to diagnose gout in the middle of a gout attack (also called a flare-up). Gout is a type of arthritis that flares and subsides.

The most common symptoms of a gout attack are intense joint pain and swelling that often starts in the middle of the night. A gout attack generally gets worse during the first 12 to 24 hours. It will slowly resolve soon after, but full recovery can take up to 14 days.

There is no cure for gout, but a combination of at-home remedies, medications, and lifestyle habits can help you to manage ankle pain and reduce the frequency and severity of gout attacks.

Home Remedies  

Some at-home remedies you can try to help manage the pain and swelling of a gout flare in your ankle. These include:

• Applying ice: An ice pack or other cold object wrapped in a thin towel or cloth can help reduce swelling and relieve pain.
• Elevating the ankle: Elevating your ankle might encourage blood flow away from the joint and reduce swelling and pain.
• Reducing stress: Increased stress can worsen a gout flare. While you cannot control all the sources of stress in your life, you might consider meditation, yoga, journaling, or reading.
• Taking time to recover: Gout flares are extremely painful, and if you have other stressors while you recover, a gout flare might last longer than necessary. You might consider taking time off work or asking for help with household chores or caring for loved ones, especially small children.

Medications

A healthcare provider can prescribe medications to reduce pain and swelling from an ankle gout flare.

Medicines used to treat gout include:  

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) or Aleve (naproxen) are available over the counter (OTC), and there are stronger forms that can be prescribed. NSAIDs help reduce pain and bring down inflammation. However, they should not be taken by people who have kidney disease, which can occur in people with gout.
• Tylenol (acetaminophen), which is a pain reliever that is not an NSAID, can ease some pain.
• Corticosteroids can be given orally or as an injection to bring down inflammation and reduce the severity of the flare.
• Colcrys (colchicine) is a pain reliever that targets gout pain and swelling. It might also prevent gout attacks. A healthcare provider might prescribe a low daily dose of colchicine to reduce your risk for flare-ups and until other long-term treatments can help.
• Zyloprim (allopurinol) limits the body’s uric acid production and reduces the number of crystals that form in the joints.
• Uricosurics, like Probalan (probenecid) help your body eliminate uric acid.

Lifestyle Habits  

The following lifestyle strategies may help to reduce pain and other symptoms of a gout flare in the ankle:

• Making diet changes: Your diet might increase the severity and time it takes to recover from a gout flare in your ankle. Aim to eat a diet low in purines, avoiding foods like red meat, organ meat, some types of seafood, sugary beverages, and alcohol.
• Drink plenty of water: You will want to drink plenty of water during a gout flare to avoid dehydration. Staying hydrated will also help flush urate crystals out of your body through urine.
• Stretching: Exercising an inflamed ankle can prolong swelling and cause more pain. But gently stretching the ankle might reduce stiffness and improve the range of motion in the ankle. Start slow and move the ankle joint to a comfortable limit. Repeat a few times a day and gradually increase your repetitions.
• Use a cane: Walking with a cane during a gout flare of the ankle can keep pressure off the ankle and bring down swelling much quicker. Keeping pressure off the affected joint also reduces the amount of pain you experience.

Preventing Flare-Ups  

The main goals of treating gout are to prevent flares and reduce the potential for joint damage. Even if your healthcare provider has prescribed medications to lower uric acid levels, you should also make lifestyle changes, such as the following, to reduce the frequency of gout attacks:

• Avoid certain foods: Foods high in purines can increase your risk for a gout attack. Avoid red meat, organ meats (like liver), some kinds of seafood (like sardines, anchovies, and shellfish), and sugary beverages.
• Eat foods with low levels of purine: This includes whole grains, dairy, eggs, and plant-based oils and fats. Stone fruits like cherries can help to bring down uric acid levels.
• Avoid alcohol: Alcohol, especially beer, has levels of purine. Beer is believed to be a top trigger of gout flares.
• Drink plenty of water: Research shows that adequate water consumption is associated with a significant reduction in recurrent gout attacks. The more water you drink, the more uric acid you can flush out of your body through urine. You will want to drink at least 64 ounces of water a day to help you properly stay hydrated.
• Move: Lack of exercise leads to more stiffness and pain. If pain keeps you from moving, get a cane to take pressure off any inflamed joint. Do your best to keep moving, even if you only go for short walks and stretch.

When to See a Healthcare Provider  

Many people go months and sometimes years between gout attacks. If you are someone who has two or more flares per year, talk to a healthcare provider about making changes to your treatment plan. Having frequent flares is not normal and can lead to joint damage.

A healthcare provider can prescribe medication to reduce uric acid production or medication that reduces pain and swelling should you experience a flare-up. If you have two or more flares per year, you may be prescribed daily medication for gout. The first line is Zyloprim (allopurinol), which is often a lifelong medication.

Reach out to a healthcare provider during a gout flare. They can prescribe medication to reduce the pain and swelling or give you a corticosteroid shot to reduce inflammation faster.  

Summary  

Gout is a type of inflammatory arthritis that frequently affects the big toe, but any joint can be affected, including the ankle. Gout causes flares of pain, swelling, and tenderness of an affected joint. When gout affects the ankle, it makes walking, going up and down steps, and other ankle movements difficult and painful.

While there is no cure for gout, medication, at-home remedies, and lifestyle remedies can help you manage flare symptoms and reduce the frequency of gout attacks. If you experience frequent flares, a healthcare provider can make changes to your treatment plan that might help.  

A Word From Verywell 

A gout flare-up might last for days or weeks, and most people with the condition will experience several flares a year. This means that gout is a chronic condition and requires ongoing management.

If you have not already done so, consider seeing a rheumatologist (a physician who diagnoses and treats conditions of the bones, joints, muscles, and immune system). They can offer you more advice on how to manage gout and prevent flare-ups.

It will take time to find the right combination of medicine and lifestyle changes to get uric levels under control and reduce the frequency of gout attacks.