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Symptoms of Gout

Overview

Gout is a type of arthritis that develops from high levels of uric acid in your blood. Gout attacks can be sudden and painful. You may experience burning, and the affected joint can become stiff and swollen.

Keep reading to learn more about the symptoms of gout, risk factors and complications for the condition, and how to manage symptoms if you experience a gout attack.

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Symptoms

Symptoms of gout

There are different types of gout symptoms. Some people are asymptomatic. This means they have no symptoms, although they have elevated levels of uric acid in their blood. These people don’t require treatment. Others, however, have acute or chronic symptoms requiring treatment.

Acute symptoms come on suddenly and occur for a relatively short period of time. Chronic symptoms are the result of repeated gout attacks over a long period.

Acute gout symptoms

Pain, redness, and swelling are the chief symptoms of a gout attack. These can happen at night and wake you from sleep. Even a light touch to your joint can be excruciating. It can be difficult to move or bend. These symptoms typically occur in only one joint at a time, most commonly in your big toe. But other joints are frequently affected as well.

Symptoms come on suddenly and are most severe for 12 to 24 hours, but they may last as long as 10 days.

Chronic gout symptoms

The pain and inflammation associated with gout attacks typically disappear completely between attacks. But repeated attacks of acute gout can cause more permanent damage.

Along with joint pain, inflammation, redness, and swelling, gout can reduce joint mobility. As gout improves, the skin around your affected joint may itch and peel.

Gout can affect many joints throughout your body. Typically, the first gout attack occurs in the joints of your big toe. The attack can happen suddenly, with your toe appearing swollen and warm to the touch. In addition to your big toe, other joints affected by gout include:

  • ankles
  • knees
  • fingers
  • elbow
  • wrist
  • heels
  • insteps
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Risk factors

Risk factors for gout

Consuming foods and drinks that contain a high amount of purines contributes to gout. These include:

  • alcoholic beverages
  • bacon
  • turkey
  • liver
  • fish
  • dried beans
  • peas

Purines are chemical compounds in food and naturally occur in your body, which produces uric acid as it breaks down purines. Typically, uric acid dissolves in your bloodstream and exits your body through urine. But sometimes uric acid accumulates in the blood, causing a gout attack.

Gout can happen to anyone, but certain factors increase your risk. Risk factors include:

  • a family history of gout
  • obesity
  • untreated hypertension
  • diabetes mellitus
  • metabolic syndrome
  • coronary artery diseases
  • chronic renal disease
  • high alcohol consumption
  • a high-purine diet
  • certain antirejection medications if you have had an organ transplant
  • use of certain medications, such as diuretics and aspirin
  • recent trauma or surgery

The risk of developing gout is also higher if you’re a male. Lead exposure may also increase your risk for gout. Taking high doses of niacin may make cause your gout to flare up.

Your doctor can diagnose gout with a blood test and by taking fluid from an affected joint.

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Complications

Complications of gout

Acute and chronic symptoms of gout are treatable. Gout pain can be more severe than other types of arthritic pain, so see a doctor if you have sudden, sharp pain in a joint that doesn’t improve or worsens.

If left untreated, gout can cause joint erosion. Other serious complications include:

Nodules under your skin

Untreated gout can cause deposits of urate crystals under your skin (tophi). These feel like hard nodules and can become painful and inflamed during gout attacks. As tophi build up in joints, they can cause deformities and chronic pain, limit mobility, and can eventually destroy your joints entirely. The tophi may also partially erode through your skin and ooze a white chalky substance.

Kidney damage

Urate crystals can also build up in your kidneys. This can cause kidney stones and eventually affect your kidney’s ability to filter waste products out of your body.

Bursitis

Gout can cause inflammation of the fluid sac (bursa) that cushions tissues, particularly in your elbow and knee. Symptoms of bursitis also include pain, stiffness, and swelling. Inflammation in the bursa increases the risk of infection, which can lead to permanent joint damage. Signs of infection include worsening redness or warmness around joints and a fever.

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Managing symptoms

Managing symptoms of gout

Medications are available to help you manage symptoms of gout. These include nonsteroid anti-inflammatory drugs, such as indomethacin (Tivorbex), ibuprofen (Advil, Motrin IB), and naproxen (Aleve, Naprosyn). Side effects of these medications can include bleeding, stomach ulcers, and stomach pain. If your symptoms don’t respond to these medications, your doctors may recommend other drugs to stop an attack and prevent future attacks.

Colchicine (Colcrys) can reduce gout pain, but side effects may include nausea, diarrhea, and vomiting.

Corticosteroids such as prednisone also reduce inflammation and pain. These prescription medications can be taken orally or injected into your joint. Side effects include mood changes, elevated blood pressure, and water retention.

There are medications that block the production of uric acid and others that help your body remove uric acid, such as allopurinol (Zyloprim) and probenecid, respectively.

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Takeaway

The takeaway

With lifestyle changes, it’s possible to prevent future gout attacks and remain symptom-free. Take medication as directed. Limiting your intake of alcohol and beverages with high-fructose corn syrup can reduce the likelihood of an attack. You can also prevent a gout attack by increasing your intake of water and decreasing your intake of meat, poultry, and other high-purine foods. Losing excess pounds also helps maintain a healthy uric acid level.

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