Sudden pain, swelling and warmth in your big toe or another joint may be symptoms of gout. At Republikas laukuma klīnika in central Riga, Latvia, adults can consult Dr. Aleksandra Bukina, an English-speaking rheumatologist, about suspected gout, recurring attacks and long-term treatment.
Whether you live in Latvia or are visiting Riga, contact the clinic to check appointment availability and arrange a private consultation.
Dr. Aleksandra Bukina
What is gout?
Gout is a form of inflammatory arthritis caused by urate crystals accumulating in joints. These crystals can trigger episodes of intense pain, swelling and tenderness.
Uric acid is produced when the body breaks down substances called purines. If too much uric acid builds up, crystals can form. Kidney function, genetics, certain medicines and lifestyle all influence this process.
Gout is not simply the result of eating certain foods. Understanding your individual risk factors is an important part of treatment.
Gout symptoms: what does a gout attack feel like?
A gout attack, also called a flare, often begins suddenly, sometimes during the night. Typical symptoms include:
- Severe joint pain, commonly at the base of the big toe.
- Swelling and warmth around the affected joint.
- Redness, which may be less visible on darker skin.
- Extreme tenderness — even light contact from a sock or bedsheet may hurt.
- Difficulty walking or moving the joint.
Although the big toe is a common site, gout can also affect the ankles, knees, hands, wrists and elbows.
Symptoms may disappear between attacks. However, recurring flares need medical assessment, even if you feel well between episodes.
When does a swollen joint need urgent medical attention?
A hot, swollen joint accompanied by fever, chills, worsening pain or feeling generally unwell needs urgent medical assessment.
A joint infection can resemble gout and requires prompt treatment. Do not wait for a routine rheumatology appointment if these symptoms occur.
A first episode of sudden joint swelling should also be assessed rather than assumed to be gout.
What causes gout?
Gout develops when uric acid accumulates and urate crystals form. Factors that can increase the risk include:
- A family history of gout.
- Reduced kidney function.
- Excess body weight.
- Alcohol consumption, particularly beer and spirits.
- Certain medicines, including some diuretics.
- Other health conditions, such as high blood pressure.
Dehydration, illness or changes in alcohol intake can trigger an attack in someone who already has gout. Your doctor can review possible triggers and medicines without making unnecessary changes to your existing treatment.
How is gout diagnosed?
A rheumatologist reviews your symptoms, examines the affected joints and considers your medical history.
Blood tests may include serum urate — the uric acid level in your blood — and kidney function.
Two points are especially important:
- High uric acid alone does not establish a diagnosis of gout.
- A normal or lower uric acid result during an attack does not rule gout out.
If gout is still suspected, your doctor may repeat uric acid testing at least two weeks after the attack has settled.
If the diagnosis remains uncertain, joint fluid analysis for urate crystals or imaging may be needed. Your doctor will explain which investigations are appropriate and where they can be arranged.
Gout treatment: relieving pain and preventing future attacks
Gout treatment has two main aims: controlling inflammation during an attack and reducing the risk of future attacks.
Treatment during a gout attack
Depending on your health, kidney function and other medicines, a doctor may prescribe:
- Colchicine.
- A non-steroidal anti-inflammatory drug.
- A corticosteroid.
The choice of medicine is individual. A treatment that suits one person may be unsuitable for someone with kidney disease or other medical conditions.
Resting the affected joint and applying a cold pack wrapped in a towel may also help relieve discomfort.
Long-term uric acid control
For patients who need urate-lowering treatment, medicines such as allopurinol or febuxostat help reduce uric acid levels.
The usual treatment target is below 360 µmol/L (6 mg/dL). A lower target may be considered in more severe gout.
Follow-up blood tests help the doctor adjust treatment. Urate-lowering medicines are often needed long term, even when joint pain has disappeared.
Feeling better does not necessarily mean that urate crystals have cleared. Discuss any changes to your treatment with your doctor.
Diet and lifestyle with gout
Lifestyle changes can support gout treatment and improve general health. Useful measures include:
- Following a balanced diet.
- Limiting alcohol and sugary drinks.
- Maintaining a healthy weight.
- Avoiding dehydration.
- Losing excess weight gradually rather than following crash diets.
Diet and lifestyle measures may not be enough to reach the uric acid target. When medication is prescribed, these measures support treatment rather than replace it.
Gout consultation for English-speaking patients in Riga
If you are looking for gout treatment in Riga or an English-speaking rheumatologist in Latvia, you can arrange a private consultation at Republikas laukuma klīnika.
Dr. Aleksandra Bukina consults adults aged 18 and over in English, Latvian and Russian.
During the consultation, the rheumatologist can:
- Assess joint pain, swelling and previous attacks.
- Review uric acid results and your medical history.
- Consider other possible causes of joint inflammation.
- Recommend appropriate investigations.
- Discuss treatment and follow-up.
Bring previous blood tests, relevant medical reports and a list of your medicines. Results issued abroad are also useful: if your uric acid result uses mg/dL rather than µmol/L, bring it as issued.
If you are visiting Riga for a short period, tell the clinic when booking so that investigation and follow-up arrangements can be discussed.
Appointment details
Clinic: Republikas laukuma klīnika
Specialist: Dr. Aleksandra Bukina, rheumatologist
Consultation fee: €70, as listed on the clinic’s rheumatology page. Confirm the current fee and any investigation costs when booking.
Address: Republikas laukums 3-18, Riga, LV-1010, Latvia
Entrance: On the side facing the Ministry of Agriculture
Telephone: +371 28002363
Email: info@republikaslaukumaklinika.lv
Book an English-speaking rheumatologist consultation
Learn more about rheumatologist consultations at Republikas laukuma klīnika
Frequently asked questions about gout
Which doctor treats gout in Riga?
A rheumatologist assesses gout and other causes of joint inflammation. Adults can book a consultation with Dr. Aleksandra Bukina at Republikas laukuma klīnika in central Riga.
Can I have gout with a normal uric acid result?
Yes. Uric acid may be lower during an attack. Your doctor interprets the result alongside your symptoms and may recommend repeat testing after the attack has settled.
Does gout only affect the big toe?
No. The big toe is a common site, but gout can affect other joints, including the ankles, knees, hands, wrists and elbows.
Can gout be managed with diet alone?
Lifestyle changes can help, but they may not lower uric acid sufficiently. Some patients need long-term medication to prevent further attacks and complications.
Can I arrange a consultation in English?
Yes. Dr. Aleksandra Bukina offers consultations in English. Use the online booking link or contact the clinic to check availability.
Can I book if I am visiting Latvia?
You can contact the clinic to arrange a private appointment during your stay in Riga. Bring your medical records and medication list, and mention your travel dates when booking.
Questions about your health?
Specialist doctors see patients at Republikas laukuma klīnika in central Riga. Our reception will help you choose the right specialist and time.
