Gout, sometimes called gouty arthritis, is a common type of inflammatory arthritis. With gout, uric acid crystals build up and form needle-like structures in the joints. These crystals cause swelling, intense pain and joint damage from arthritis.
Gout is common in the joints of the feet, especially the big toe, but it can also affect other joints such as the other toes, knees, ankles, elbows, wrists and fingers. Gout may also develop in your kidneys, the membranes around your tendons and your bursa (tiny sacs between bones and other tissues).
There are several stages of gout:
Pseudogout (or calcium pyrophosphate dihydrate deposition disease (CPPD)) is another type of crystalline arthritis where crystals affect the joints. However, in CPPD, the crystals are made from calcium phosphate, not uric acid. It’s more common in your wrist or knee than in your big toe. CPPD is treated very differently than gout as CPPD does not respond to most gout medication.
You can develop gout if your body either produces too much uric acid (hyperuricemia) or doesn’t get rid of enough uric acid. Your body naturally creates uric acid when it processes purines (chemical compounds found in some foods).
Your body contains some purines naturally, and you create more of them when you eat or drink purine-rich foods or beverages, such as:
Normally, your kidneys process uric acid, and it leaves your body in your urine. When this process doesn’t work correctly, however, the uric acid forms crystals in your joints.
You’re at higher risk for gout if you:
Gout symptoms usually appear suddenly. The pain may wake you up at night. The joint can be so sensitive that the weight of your sheet or the pressure of a sock causes pain.
Common symptoms of gout include:
You’re more likely to have gout attacks at night. Certain foods, alcohol and stress can trigger them. Symptoms usually come and go. Some people have flares often, and others may go years without having a flare. Most likely, once you have a gout attack, you’ll have another one within a year.
Any time you have sudden intense pain, you should contact your health care provider. If you have a fever, see your provider right away or visit an urgent care center or emergency room. Fever with joint pain could mean you have an infection.
If you think you may have gout, it’s very important to consult a health care provider as soon as possible. Your provider needs to see you while you’re having a gout flare to give you an accurate diagnosis. Symptoms usually peak in 12 to 24 hours and then slowly go away.
You may want to see a rheumatologist (a doctor who specializes in treating arthritis and inflammatory conditions). That’s because gout’s symptoms are sometimes the same as other inflammatory diseases. Once you’ve seen a rheumatologist for diagnosis and treatment, your primary care provider can help you manage your gout.
When gout is diagnosed early and treated properly, you can avoid future flares and even keep it in remission. But untreated gout can affect more joints and lead to more pain and damage to your joints.
Here are some of the ways your doctor may diagnose gout:
To help control gout, your doctor may prescribe medications that can help relieve pain, lower inflammation and manage gout symptoms.
These medications treat the pain of acute attacks:
If possible, stopping certain medications (such as diuretics) can also help prevent gout flares.
If you have gout flares several times a year or have joint damage, tophi (crystals that form under your skin), kidney stones or kidney disease, your doctor may recommend:
Gout can lead to serious health problems, including:
Joint issues:
Kidney problems:
Metabolic and cardiovascular conditions:
Other complications:
Gout is a type of arthritis that causes pain and swelling, often in the joints of the feet, especially the big toe. It occurs when uric acid builds up in the body, leading to the formation of sharp crystals in the joints. While gout flare-ups can be sudden and intense, ongoing management can help prevent future attacks and complications.
Preventing gout attacks and managing the condition is very important so that you don’t damage your joints. To keep your gout under control, stay in close communication with your health care provider, have regular check-ups and take your medications as prescribed.
Gout flares usually last for a week or two. Your health care provider can offer advice on managing your pain and taking medication during flares. It can help to:
To reduce the risk of flares and manage gout long-term, you may want to:
Exercise can help keep your joints healthy. Try to get 150 minutes of physical activity a week, but don’t push your joints too hard. If exercise makes your joints sore or achy, try switching to low-impact options like walking, cycling and swimming.
It can also be helpful to pay attention to what’s going on in your life when you have a gout flare. You may be able to pinpoint certain things that make your gout worse, then make changes that lower your symptoms.
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