Medical cannabis treatments for gout

Gout is a painful form of inflammatory arthritis brought on by excess uric acid forming crystals in your joints. Medical cannabis may help to alleviate certain associated symptoms, such as pain, inflammation or sleep-related issues. 

What is gout? 

Gout is a type of arthritis associated with feelings of sudden, severe pain in joints around the body. 

The condition develops when high levels of uric acid build up over a long period of time, resulting in the formation of small needle-shaped crystals in and around the joints. This then leads to inflammation and arthritis, which can be very painful. 

While gout can affect multiple areas of the body, it mainly impacts joints in the lower limbs. The base of the big toe is the most commonly affected area, but gout can also develop in your other toes, knees, ankles, fingers and wrists. 

You may also experience severe pain in one or more of your joints, with each flare-up typically lasting for up to two weeks. 

You are also more likely to experience gout if you: 

• are a man

• are overweight 

• drink alcohol

• regularly eat high-purine foods in your diet, such as red meat, offal and seafood

• have pre-existing kidney problems 

• take medicines like diuretics 

• are related to somebody with gout

Treatment usually focuses on two goals: easing pain during a gout attack and lowering uric acid over the long term to reduce future flares. 

What causes gout? 

Gout develops when uric acid levels in the blood become too high, leading to what’s known as hyperuricaemia. 

We all produce uric acid when our body breaks down purines, a chemical compound found naturally in the body as well as in certain foods, including red meat, offal, seafood and oily fish.

Usually, our kidneys can filter uric acid from the blood. But if we produce too much or our kidneys can’t remove it quickly enough, this can lead to the formation of small needle-shaped crystals in and around certain joints. 

When this happens, our immune system may recognise these crystals as a threat and trigger several inflammatory processes within the affected joint. It’s this response that can lead to the sudden, intense pain, swelling, heat and redness so commonly associated with gout flare-ups.

What does gout feel and look like? 

If you’ve ever experienced a gout flare-up, you’ll know already that there is very little that compares to the intensity of the pain.

Gout pain is often described as sudden, severe and hot. It typically starts off as a tingling sensation that later becomes very painful, swollen and extremely tender within the affected joint.

The area may also look red, with visible swelling and shiny skin. In more advanced forms of gout, hard chalky lumps called gouty tophi may develop under the skin around the joint as well.

For these reasons, early-stage gout symptoms are sometimes mistaken for injuries, especially when the first flare-up affects joints like the foot, ankle or knee. 

It can be tempting to ignore gout symptoms too, since the initial pain usually settles down again after a few days. But it’s important to get it checked. 

Gout flare-ups can become more frequent over time and impact other joints in the body when the condition isn’t managed effectively. 

How long does a gout attack last?

A typical gout attack can last anywhere from a few days to 2 weeks without treatment. In fact, the longer you go without treating gout, the longer your future flare-ups might become.

For many people, gout pain becomes severe within hours of an attack, which is why getting an early treatment plan in place is so important.

Is gout a form of arthritis?

Yes, gout is classified as a form of inflammatory arthritis. 

Unlike osteoarthritis, which is caused by the breakdown of protective cartilage around the joint, gout is caused by urate crystal deposits that trigger inflammation.

That said, gout still sits within the wider arthritis family because it affects the joints and leads to symptoms like pain, swelling and reduced movement. 

To learn more about how different types of arthritis can affect your day-to-day life, take a look at our dedicated condition page on arthritis and medical cannabis.

What causes gout in women? 

While gout affects approximately 4.3 times as many men and is often referred to as the “disease of kings”, women can develop it too. 

In fact, research has shown that the risk of gout in women increases substantially following menopause.

Before menopause, oestrogen helps the body remove uric acid more effectively, flushing it out through the urine. When this oestrogen level starts to decline following menopause, uric acid levels can start to creep up again, increasing the likelihood of urate crystals forming.

However, unlike men who commonly experience gout in the big toe, women tend to gradually develop it in several joints over time. This means gout in women is often seen in areas like the knees, toes, wrists or ends of fingers. 

Gout is still a lot less common in women than it is in men, but the symptoms it causes can be just as painful and require early intervention. 

Where does gout affect the body?

Gout can strike any joint in the body, but some are much more vulnerable than others. 

Generally speaking, gout most commonly affects the big toe and an area called the first metatarsophalangeal joint. When acute attacks occur here, they are referred to as podagra.

However, gout can affect several other areas of the body as well, such as: 

• the rest of the foot (including the other toes)

• ankles

• knees

• hands

• fingers

• wrists

• thumbs 

• elbows 

• heels

For many people, gout symptoms will start in just one of these joints. They may then appear in other areas of the body if left untreated.

Gout in the feet, toes, and big toe

The big toe is the most common site for a first gout attack. This is known medically as podagra, or “foot-grabber” in Greek, and usually affects the first metatarsophalangeal joint, where the big toe joins the foot.

There are a few reasons why gout is so common within this area. 

Cooler temperatures in the foot may make uric acid less soluble, making it easier for the urate crystals to form here. 

The big toe joint also takes a lot of impact when we move around each day, whether that’s from walking, standing up or pushing off the ground with every step we take.

Other conditions that affect our joints may play a role as well. The big toe is a common site for osteoarthritis, for instance, so urate crystals may build up more easily in joints where cartilage has already been affected.

Developing gout in the big toe doesn’t mean it’ll always stay there, either. 

In recurrent cases of gout, the condition can go on to affect the ball of the foot, arch, heel or ankle. It can also affect joints in both feet, but this tends to be less common.

Gout in the ankle and knee

Experiencing gout in the knee or ankle can be particularly painful, since both joints are involved in important day-to-day processes, like standing and walking. 

When gout affects the knee, it may result in the traditional symptoms, such as swelling, heat, redness and stiffness. The joint may also become difficult to bend, especially if fluid or crystals have built up inside it.

For this reason, some people may need short-term support, such as crutches, to manage the pain until it settles.

Gout in the ankle can be harder to recognise. In fact, many people often mistake it for a sprain, strain or injury, particularly during their first attack. 

It’s important to have any painful symptoms you’re unsure about assessed by a medical professional. 

Gout in the hands, fingers, wrist and thumb

Developing gout in the hands and fingers is less common, but it can still happen, particularly if uric acid levels have remained high for a long period and the initial attacks haven’t been managed effectively.

Early-stage gout in the fingers will typically look like a mild swelling, redness or tenderness around the knuckles. Over time, this can lead to the development of firm lumps of urate crystals that build up under the skin, known as gouty tophi.

Gout in the wrist can cause significant pain, swelling and discomfort, and is more likely to occur when earlier gout attacks have not been properly treated. 

In fact, research suggests that around 19–30% of people with untreated gout may go on to develop gout in the wrist during their lifetime.

Gout in the thumb is much less common and is typically a more advanced form of gout that can affect fine motor tasks like writing, using cutlery or holding a phone.

Gout in the elbow, heel and less common joints

Gout can appear in almost any joint, including the olecranon bursa, which is the joint that sits at the point of the elbow. 

Left untreated, gout in the elbow can lead to further complications, such as the development of gout tophi and potential permanent joint damage.

Gout in the heel often mimics plantar fasciitis or Achilles tendinopathy. For this reason, it’s often misdiagnosed and can result in delays for patients accessing treatment. 

The key difference between gout and these conditions is that gout flare-ups often appear suddenly and can affect other joints in the body. Plantar fasciitis and Achilles tendon pain only affect the feet.

Gout can also affect other areas of the body, such as the shoulder, hips or spine. But this is much rarer. 

Why do conventional gout treatments sometimes fall short?

For many patients with gout, conventional treatments are effective at both relieving symptoms when attacks happen and preventing further flares from taking place. But they’re not for everyone.

One of the main challenges with treating gout more generally is that the condition is rarely just about its associated symptoms, and there are multiple factors to consider. 

Some patients will have been diagnosed with other conditions, such as kidney or cardiovascular disease, or be taking other medications that may make certain treatment options less viable. 

Some patients may also have been misdiagnosed with gout in the first place and be receiving the wrong type of treatment.  

There are the treatment side effects to consider as well, as we recently discussed with one of our gout patients, Scott. 

For example, while gout medications like allopurinol and febuxostat are typically very effective at reducing uric acid levels, they are also associated with certain side effects, including peripheral oedema, heart failure and atrial fibrillation. 

All of these factors have to be taken into consideration when identifying the right form of gout medication. What works well for one patient might not for another.

What are the most common gout medications?

Living with gout rarely comes down to managing one flare-up in isolation. 

For many people, treatment means controlling pain when attacks happen, lowering uric acid levels over time and understanding the lifestyle factors that may contribute to future flare-ups.

For this reason, gout treatment usually falls into one of two categories: 

• Symptom-focused treatments (such as NSAIDs, colchicine or corticosteroids), which help manage symptoms like pain and inflammation during gout flare-ups 

• Urate-lowering treatments (such as allopurinol), which aim to reduce uric acid levels and stop crystals from forming in the joints

Have a look at some of our patient stories to discover first-hand accounts of the types of pain treatments that have worked for them.

How do medical cannabis treatments help with gout pain and inflammation?

​​For some patients, prescribed medical cannabis treatments may help support gout-related pain management when conventional options have not worked well enough on their own.

While medical cannabis doesn’t specifically treat the underlying cause of gout, it can help to alleviate some of the common issues and symptoms that the condition is associated with.

It does this through the two main active ingredients it contains: tetrahydrocannabinol (THC) and cannabidiol (CBD). 

Both of these can target pain and inflammation via the body’s endocannabinoid system, but work in slightly different ways:

• THC acts on CB1 receptors in the nervous system to reduce pain perception and induce relaxation

• CBD is non-intoxicating and works on immune cells (CB2 receptors), helping dampen inflammation and immune overactivity

To learn more about these cannabinoids, our medical cannabis knowledge hub contains several detailed guides to answer all the questions you might have about THC and CBD.

What does the research say?

The relationship between gout and medical cannabis has been discussed in clinical literature for millennia. 

In fact, it’s even mentioned within the earliest recorded mention of cannabis’ medicinal application, dating all the way back to 2737 BC when the Chinese Emperor Shen Nung touted cannabis as a treatment for a multitude of ailments, including gout. 

Clinical research has advanced a lot since that time. Today, medical cannabis treatments may be considered for some eligible patients as part of a wider plan to manage gout-related pain and inflammation. 

That said, research into gout and medical cannabis specifically remains very limited, and there have been no large clinical trials to date. 

However, since gout is a form of arthritis, we can look at related clinical evidence within this area and assess the impact medical cannabis may have on gout-related symptoms like pain and inflammation.

Here’s a quick overview of some of the key pieces of clinical research to have been published in recent years:

All in all, the current research landscape suggests that cannabis-based medicines may have a role in managing pain, inflammation, sleep and quality of life in some joint-related conditions. 

But gout-specific clinical evidence remains limited, so it’s important to always speak with a medical professional when considering medical cannabis as an alternative treatment. 

CBD vs. THC for gout

Since CBD and THC work differently in the body, if your specialist considers it appropriate for you, they will prescribe medical cannabis at a ratio that’s relevant to your unique needs and symptoms. 

• CBD is non-intoxicating and is most often prescribed for the anti-inflammatory effects it’s associated with. For gout patients, this may be more appropriate as a treatment between gout attacks, supporting ongoing inflammation-related discomfort without causing the same “high” as you’d associate with THC.

• THC is different. It acts more strongly on pain perception and may help some gout patients manage other symptoms they’re experiencing, such as severe pain or sleep disruption. 

There is no one-size-fits-all approach when it comes to gout and medical cannabis. If you’re eligible, finding the right THC: CBD ratio will depend on individual factors like your symptoms, lifestyle choices and medical history. 

Are there side effects of medical cannabis?

Like any prescribed medication, medical cannabis may cause side effects in some people. 

For patients using it to help manage gout-related pain, the most common side effects are usually:

• drowsiness

• dry mouth 

• dizziness

Some people may also experience changes in appetite, nausea, diarrhoea, mood changes or a “high” feeling, particularly with treatments that contain THC.

Your likelihood of experiencing side effects will often depend on the dose, the type of product and the balance of THC and CBD. In other words, two patients with gout may respond very differently to the same treatment.

Your consultant will usually start you on a low dose, increasing it gradually where needed, and regularly review how well the treatment is working alongside any other gout medications you have been prescribed.

Gout diet, food triggers, and lifestyle

Can changing your diet help to prevent gout attacks? For many patients: yes, it can. 

Research has shown that diet and lifestyle changes can help reduce uric acid spikes and lower the risk of future gout flare-ups. But it’s important to be realistic, as these changes are often not sufficient to replace medication on their own.

Which foods can cause gout?

There are a wide variety of foods that are well-known for triggering gout due to the high levels of purines they contain. 

Once ingested, purines are broken down into uric acid, so eating a lot of high-purine foods can make gout more difficult to control.

With this in mind, the main foods and drinks to either avoid or limit your intake of include:

• red meat

• offal or organ meats like liver, kidney or game 

• oily fish like sardines and anchovies

• shellfish

• alcohol, such as beer and spirits

• sugary fizzy drinks

• fruit juice with added sugar

• high-fructose processed foods

Which foods should you eat if you have gout?

Maintaining a gout-friendly diet is not about restricting yourself and making drastic dietary changes. It’s about making smarter choices when it comes to the types and quantities of food you eat.

Here are some useful ideas to think about:

• Prioritise low-purine foods: this includes most vegetables and various other foods like whole grains, eggs, low-fat dairy products, nuts, beans and lentils 

• Reconsider what you drink: try to limit your intake of alcohols like beer and spirits, and cut back on the sugary fizzy drinks

• Keep hydrated: drinking enough water (the NHS recommends 6 to 8 cups or glasses per day) supports kidney function and can help the body remove uric acid effectively

• Consider vitamin C products (or supplements): vitamin C has been shown to offer a modest benefit in managing uric acid levels, but you should speak to a medical professional to see if they’re right for you

Adopting these natural lifestyle changes may help lower your uric acid level and reduce the frequency of gout attacks. 

Natural remedies and alternative treatments for gout

Some natural options may help support gout management. But it’s important to note that, despite what some online searches may suggest, there is no miracle “10-minute gout cure”. 

Here’s a closer look at some of the most commonly discussed natural approaches for supporting gout management, and what they may realistically offer.

Natural remedies can be adopted alongside a gout treatment plan, but they should never replace prescribed medication or the advice of a medical professional. 

Am I eligible for medical cannabis for gout in the UK?

Yes, gout is an eligible condition for medical cannabis in the UK through private, CQC-regulated clinics, such as us at Releaf. 

To qualify, you will need to have a confirmed gout diagnosis and have already tried at least two conventional treatments.

We always assess medical cannabis eligibility on an individual basis. That means we will take a detailed medical history from you, assessing your symptoms, previous treatments and any possible contraindications before making a decision. 

Did you know? 

Medical cannabis has been legal in the UK since November 2018, and there are a wide variety of conditions medical cannabis can be prescribed for, such as gout.

How does the Releaf process work?

Here at Releaf, our world-class clinical team of specialist medical cannabis consultants can determine whether medical cannabis may help to manage your gout-related symptoms.

As the most trusted medical cannabis clinic in the UK, we provide regulated prescriptions, consistent access to high-quality medication and a UK-based clinical and support team that always puts your health first. 

Here’s how our process works: 

• Step 1: Eligibility check
  Answer a few quick questions about your gout diagnosis, symptoms, medical history and previous treatments. 

• Step 2: Book a consultation
  If you’re eligible, you can book a private video consultation with one of our UK-registered specialists.
  

• Step 3: Receive your prescription (if appropriate)
  If medical cannabis is clinically appropriate, your doctor will create a personalised treatment plan based on your symptoms, lifestyle and previous treatments. 

• Step 4: Delivery
  Once approved, you can order your prescription through the Releaf platform and have it delivered directly to your door.

• Step 5: Ongoing care and follow-up support
  Your clinical team will review your progress, adjust your treatment where needed and support you throughout your medical cannabis journey.

If you’re eligible for medical cannabis treatment, you can also join Releaf+ to receive free follow-up consultations, free prescription charges and free delivery.

Frequently asked questions about gout and medical cannabis

If you’ve got more questions about medical cannabis and gout, we’re here to help. Listed below are some of the questions our consultants are asked about most often. 

Can medical cannabis help with gout?

Medical cannabis treatment may help some eligible patients manage gout-related symptoms like pain, sleep disruption and inflammation-related discomfort, particularly in cases where conventional treatments haven’t proved effective. 

That said, medical cannabis does not treat the underlying cause of gout and should only be taken under medical supervision as part of a holistic treatment plan. 

This involves taking conventional treatments as recommended by a healthcare professional, as well as making any relevant lifestyle changes or dietary recommendations.

Is gout hereditary?

Yes, gout can run in families, so having somebody you know with gout may increase your own risk of developing the condition. 

That’s not to say this means you definitely will develop gout. While having a family history of the condition may increase your risk, several other factors play an important role as well. 

Can gout be cured?

There is currently no cure for gout, but having the right treatment approach can allow you to manage it much more effectively. 

For many people with gout, the main goal of treatment is to achieve long-term remission by reducing their uric acid levels enough to stop the formation of crystals in the affected joints. 

In doing so, this can help reduce the likelihood of flare-ups and potential joint damage. 

Does gout go away on its own?

The symptoms and pain associated with gout attacks may subside and settle on their own within a few days, but the condition will usually remain until it’s treated. 

If your uric acid level remains high without any intervention, or you don’t address the associated symptoms when they appear, gout attacks can happen at any point and may become more frequent over time. 

This is why it’s so important to have a treatment approach in place that not only reduces your likelihood of attacks but also helps manage the symptoms when you do. 

How quickly can I get a medical cannabis prescription for gout?

Here at Releaf, we’ve designed our medical cannabis eligibility checker to take less than 30 seconds. Yes, really.

If you’re deemed to be a suitable candidate, you’ll be able to book a consultation with one of our specialists within a matter of days. 

A medical prescription will then be sent out to you as early as the very same day as your consultation, as long as your specialist deems it to be a clinically appropriate treatment option for your condition.

Is medical cannabis legal in the UK?

Yes, medical cannabis has been legal in the UK since 2018. But it can only be prescribed by a specialist doctor at a private clinic, such as Releaf. 

When you receive your prescription from a CQC-regulated private clinic like us, you can feel rest assured that your medical cannabis is completely legal and has been administered to you under strict clinical supervision. 

Should you decide to become a Releaf+ patient, you’ll also receive access to Releaf Protect, a 24/7 legal support hotline designed to help you understand some of the common legal issues that can arise in connection with lawful medical cannabis treatment in the UK.