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Conditions
Gout
A form of arthritis caused by uric acid crystals in joints. Often affects the big toe, causing sudden severe pain and swelling.
Get assessed
From $24.95 · No appointment needed
6 min
avg cert turnaround
13 min
avg doctor review
2
days a week
30%
refund if declined
Symptoms
CommonsymptomsofGout
An AHPRA-registered doctor assesses these symptoms online - no in-person visit required.
Sudden severe joint pain
Swelling and redness
Most commonly affects big toe
Warmth in affected joint
Limited movement
Pain often starts at night
Our Scope
Howwecanhelp
InstantMed handles many common conditions entirely online. Here's what fits our service.
What we can help with
- Medical certificates during acute gout attacks
- Discussion of treatment options
- Advice on lifestyle modifications
- Referral for ongoing management if needed
What needs in-person care
- Joint aspiration (fluid removal for diagnosis)
- Long-term uric acid management (may need rheumatology)
Depending on your situation, an AHPRA-registered doctor may be able to issue a medical certificate or arrange a repeat prescription after reviewing your request online.
Clinical Guidance
Whentoseeadoctor
These indicators suggest you should seek professional medical advice promptly.
Signs you need a doctor
- 1First attack of gout (need diagnosis)
- 2Recurrent attacks
- 3Attacks not responding to treatment
- 4You need a medical certificate
Seek emergency care if
- Fever with joint pain
- Multiple joints affected suddenly
- Severe pain with signs of infection
Call 000 or go to your nearest emergency department
Clinical Insight
Adoctor'sperspectiveonGout
InstantMed Clinical Team
AHPRA-registered medical team · Reviewed 2026-03
Gout is one of the most painful conditions I see in practice, and it is frequently mismanaged. An acute gout attack causes sudden, excruciating joint pain - most commonly in the big toe - with swelling, redness, and heat. The pain is so severe that even a bedsheet touching the joint can be unbearable. The good news is that gout is one of the most treatable forms of arthritis. The priority during an acute attack is anti-inflammatory treatment (typically NSAIDs or colchicine), started as early as possible. The longer-term conversation is about urate-lowering therapy (allopurinol) to prevent future attacks - this is underused in Australia. Contrary to outdated advice, gout is not simply caused by 'eating too much rich food.' It is a metabolic condition driven primarily by genetics, kidney function, and medication use. Diet plays a smaller role than most patients believe.
Treatment
TreatingGout
Gout treatment has two phases: acute attack management (anti-inflammatories) and long-term urate lowering to prevent future attacks. Most Australian patients are undertreated -- only 30-40% on allopurinol achieve target urate levels. Starting urate-lowering therapy after 2+ attacks significantly reduces recurrence.
Colchicine
Colgout, Lengout
Class:Anti-inflammatory (alkaloid)
Typical dose:1mg initially, then 0.5mg one hour later (acute attack); 0.5mg daily (prophylaxis)
PBS:PBS listed for acute gout and prophylaxis during urate-lowering therapy initiation
- Most effective when taken within 12 hours of attack onset
- Lower doses now recommended (previously over-dosed causing toxicity)
- Also used as prophylaxis when starting allopurinol to prevent flares
- Narrow therapeutic window - do not exceed recommended dose
Allopurinol
Zyloprim, Progout
Class:Xanthine oxidase inhibitor (urate-lowering)
Typical dose:Start 100mg daily, titrate to 300-600mg daily (target urate <0.36 mmol/L)
PBS:PBS listed for chronic gout with recurrent attacks
- First-line long-term prevention medication for gout
- Must start at low dose and titrate up - starting too high triggers attacks
- Takes 3-6 months to fully reduce urate levels
- Lifelong therapy - stopping causes urate levels to rise and attacks to return
Naproxen
Naprosyn, Naprogesic
Class:Non-steroidal anti-inflammatory drug (NSAID)
Typical dose:750mg immediately, then 250mg every 8 hours for acute attack
PBS:PBS listed for inflammatory conditions
- First-line NSAID for acute gout attacks
- Long half-life allows less frequent dosing than ibuprofen
- Avoid in kidney impairment, heart failure, or peptic ulcer disease
- Take with food to reduce stomach irritation
Source: Therapeutic Guidelines - Rheumatology, 2024. This information is educational only and does not replace clinical assessment.
Specialist referral: Referral to a rheumatologist is recommended if gout is not controlled with allopurinol, if tophi are present, if there is significant kidney impairment, or if an alternative diagnosis (e.g. septic arthritis, pseudogout) needs to be excluded.
Gout in Australia
Gout affects approximately 1.7% of Australians - around 430,000 people
Australia has one of the highest rates of gout in the developed world
Gout is 3-4 times more common in men than women, though rates increase in women after menopause
Only 30-40% of Australian gout patients on allopurinol achieve target urate levels, suggesting under-dosing
Recovery
Whattoexpect
Typical recovery timeline and return-to-work guidance for most patients.
Typical recovery
An acute gout attack typically peaks within 12-24 hours and resolves over 7-14 days with treatment. Without treatment, attacks can last 1-3 weeks. With early anti-inflammatory treatment, significant relief often occurs within 24-48 hours.
Return to work
Desk-based work may be possible within 1-3 days with treatment and elevation of the affected foot. Physical or standing work may require 5-7 days. If the attack affects your big toe or foot, walking may be very difficult for the first few days.
When to reassess
See a doctor if this is your first gout attack (to confirm the diagnosis), if attacks are becoming more frequent (you may need preventive medication), if the joint appears infected (fever, spreading redness), or if you have kidney problems.
Self-Care
ManagingGoutathome
Evidence-based tips to support your recovery alongside medical treatment.
Apply ice wrapped in a cloth to the affected joint for 20 minutes at a time to reduce swelling
Elevate the affected limb - keep your foot raised above heart level when possible
Stay well hydrated - drink at least 2 litres of water daily to help your kidneys clear uric acid
Avoid alcohol during an attack, especially beer (high in purines)
Take anti-inflammatory medication at the first sign of an attack - do not wait for it to get worse
Wear loose footwear or go barefoot if the big toe is affected - pressure worsens the pain
FAQ
CommonquestionsaboutGout
Answers to the most common questions from patients.
Common triggers include alcohol (especially beer), red meat, seafood, dehydration, and certain medications. Stress and illness can also trigger attacks.
Yes. Acute gout can be extremely painful and make walking or standing impossible. Our doctors can provide a certificate.
Without treatment, 5-7 days. With treatment, symptoms often improve within 24-48 hours.
Limit alcohol, red meat, organ meats, and seafood. Stay well hydrated. Some people find certain foods trigger their attacks.
Ready to get help with Gout?
Australian-registered doctors review your request when available.
Full refund if the doctor declines.