Many people who experience one gout attack never have a second one, but others develop chronic gout—repeated attacks that happen more and more often over time. Especially if untreated, chronic gout can lead to more severe problems.
Gout attacks most often come on at night and wake patients from sleep. Continued pain can prevent a person from falling back asleep.
The pain of a gout attack can interfere with walking, household chores, and other everyday activities. In addition, the joint damage caused by repeated gout attacks can cause permanent disability.
Tophi are deposits of urate crystals that form under the skin in cases of chronic gout, most often in the hands, feet, wrists, ankles, and ears. Tophi feel like hard bumps under the skin and are usually not painful, except during gout attacks, when they become inflamed and swollen. As tophi continue to grow, they can erode the tissues of the joints, causing damage and eventual joint destruction.
If gout continues untreated, acute attacks happen more and more often. The inflammation caused by these attacks, as well as the growth of tophi, causes damage to joint tissues. Eventually, joints can come out of alignment and be rendered completely immobile.
The same urate crystals that cause the painful symptoms of gout can also form in the kidneys, creating painful kidney stones. High concentrations of urate kidney stones can interefere with kidney function.