Below is a small excerpt from an excellent paper on why gout flares occur and why and how they stop. Link to full paper below quote. ABN
Pathogenesis of chronic tophaceous gout
One of the most intriguing observations in gout is that inflammation resolves quite rapidly despite the sustained presence of the triggering factor, namely MSU crystals. In contrast to other forms of inflammatory disease affecting the musculoskeletal system, such as rheumatoid arthritis or spondyloarthritis, the symptoms of an acute gout attack cease after a few days, suggesting that the body mounts effective mechanisms to stop inflammation. It needs to be mentioned that inflammation does not resolve because it effectively clears MSU crystal deposits and hence removes the triggering factor. In fact, the body manages to turn down inflammation despite the fact that MSU deposits are still present, which is a remarkable process. Imaging studies by dual-energy CT have impressively underlined this finding and have shown that profound MSU crystals deposits can be observed in articular and periarticular structures despite the absence of clinical signs of inflammation.8 ,9 Clinically, this stage of the disease is known as chronic tophaceous gout, which can be clinically silent for rather longer periods before a flare reoccurs.10
Why does the gout attack stop? A roadmap for the immune pathogenesis of gout
