Gout in the Knee: Symptoms, Triggers and What Helps

Gout is often linked with the big toe, but it can also affect the knee. An attack usually comes on suddenly, often at night, and the pain can be so strong that even the weight of a blanket feels like too much. This article explains how gout in the knee usually shows itself, what can trigger an attack and what helps. It cannot replace a visit to the doctor, especially the first time.

How gout develops

Gout is a form of inflammatory arthritis. It happens when there is too much uric acid in the blood. Uric acid is a normal waste product, but when the amount stays high for a long time, tiny crystals can form in a joint. The body responds to these crystals with a sudden, strong inflammation. That is a gout attack.

Gout is more common in men, and in women it usually appears after menopause. Excess weight, high blood pressure, kidney problems and some medicines, for example certain diuretics, can raise the risk. A tendency to gout is also often found in close relatives.

What a gout attack in the knee looks like

• pain that starts suddenly and becomes very strong within a few hours,
• a knee that is swollen, warm and often red or shiny,
• pain at the slightest touch or movement,
• sometimes a slightly raised temperature and a feeling of being unwell.

Without treatment, an attack usually calms down within a few days to about two weeks. Between attacks, the joint can feel completely normal for months. That is exactly why gout is easy to ignore. But if the amount of uric acid stays high, attacks often come back more often and can damage the joint over time.

Important: a hot, swollen knee always needs a check

The symptoms of a gout attack are very similar to those of a joint infection, and that is an emergency. If your knee suddenly becomes hot, red and very swollen, especially with fever or chills, see a doctor the same day. Only a doctor can confirm gout, often with a joint puncture or a blood test. More reasons to be careful are in our article on when knee pain needs a check-up.

Common triggers

An attack often follows something that briefly raises the amount of uric acid or puts the body under stress:

• alcohol, especially beer and spirits,
• large meals with a lot of red meat, offal or seafood,
• sweet drinks with a lot of fructose,
• drinking too little water, for example on hot days,
• a sudden illness, an operation or a strict diet.

Not every trigger affects everyone in the same way. It can help to write down what you ate and drank in the days before an attack.

What helps during an attack

• Rest the knee and avoid putting weight on it as much as you can.
• Raise the leg on a pillow when you sit or lie down.
• Cool it: a cold pack wrapped in a cloth, for 15 to 20 minutes at a time, can ease the pain. Heat is usually not a good idea on a hot, inflamed joint. More about this in our article on heat or cold for knee pain.
• Drink enough water, unless your doctor has told you otherwise.
• Talk to your doctor about medicines. There are effective medicines for a gout attack, and they usually work best when they are started early.

During an acute attack, the knee is usually too sensitive for any kind of compression, so leave the sleeve aside until the worst has passed.

Between attacks: how to avoid the next one

The most important step is to lower the amount of uric acid over the long term. If attacks are frequent, your doctor may suggest a medicine that does exactly that. It is usually taken every day, even when you feel well. In addition, these habits can help:

• drink water regularly throughout the day,
• drink less alcohol, especially beer,
• eat less red meat, offal and seafood,
• replace sweet drinks with water or unsweetened tea,
• if you are overweight, lose weight slowly, without strict diets,
• stay active with gentle movement, such as walking, cycling or swimming.

Once the knee has calmed down, a soft knee sleeve can give a pleasant feeling of support and keep the knee warm during everyday activities. If you do not know where your swelling comes from, our article on a swollen knee explains other common causes, and our article on rheumatoid arthritis and osteoarthritis explains two other kinds of arthritis.

A sleeve you will actually wear

The best sleeve is the one that does not end up in a drawer. The KeenTrove Bamboo Knee Sleeve is made for exactly that:

• soft, breathable bamboo, comfortable even in summer
• fits snugly but does not dig in behind the knee
• does not lock the knee, so you move naturally
• wear it under your clothes during the day and in bed at night

With 60 days to get your money back, you have nothing to lose.

See the bamboo knee sleeve →

Note: this article is for information only and does not replace an examination by a doctor. If you have circulation problems or diabetes, or have recently had knee surgery, talk to your doctor before wearing compression.