Corticosteroids will be used more often for ACUTE gout flares. Oral corticosteroids work as well as NSAIDs for pain during a gout attack and are a safer choice for some patients. For further information, see note on "Comparison of gout therapies".
Consider a corticosteroid instead of an NSAID for more patients especially those with kidney disease, cirrhosis, heart failure, etc. And be aware that a short-term corticosteroid is likely less risky than an NSAID in most patients at risk for GI bleeding. If a steroid is used, give prednisone 30 to 40 mg/day for 5 days in most cases. A taper usually isn't needed.
But it's also okay to stick with an NSAID first for many patients. Feel comfortable using ibuprofen or naproxen. There's no evidence indomethacin is more effective. Plus it's a high-risk medication in the elderly, since it has more adverse effects than other NSAIDs. Use anti-inflammatory doses, such as naproxen 500 mg BID. Continue the NSAID for about two days after symptoms resolve.
Save colchicine as a last resort for acute gout due to side effects, interactions, and cost. If colchicine is used, give just 1.2 mg followed by 0.6 mg one hour later in most cases. There isn't good evidence for continuing it longer. CONTINUE chronic gout medications (allopurinol, etc) during a flare. But generally wait one to two weeks after it resolves to start NEW treatment with chronic medications since this may trigger a flare. For further information, see note on "Recommend allopurinol instead of febuxostat for most chronic gout patients".
REFERENCES
2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017 Jan;76(1):29-42. Available at: https://ard.bmj.com/content/76/1/29.long
Qaseem A, Harris RP, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Management of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Jan 3;166(1):58-68. Available at: https://www.acpjournals.org/doi/10.7326/M16-0570?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Oral Prednisolone in the Treatment of Acute Gout: A Pragmatic, Multicenter, Double-Blind, Randomized Trial. Ann Intern Med. 2016 Apr 5;164(7):464-71. Available at: https://www.acpjournals.org/doi/10.7326/M14-2070?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
2012 American College of Rheumatology guidelines for management of gout. Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritis. Arthritis Care Res (Hoboken). 2012 Oct;64(10):1447-61. Available at: https://onlinelibrary.wiley.com/doi/full/10.1002/acr.21773