Gout is the painful and acute onset of an inflammatory arthritis. It’s caused by the buildup of uric acid in the blood. Many people who experience one gout attack never have a second attack. Others develop chronic gout or repeated attacks that happen more often over time. Chronic gout can lead to more severe problems, especially if left untreated.

Talk to your doctor if you have any concerns about gout or the complications it can sometimes cause.


Gout attacks most often come on at night and may wake you from your sleep. Continued pain can also keep you from falling back to sleep. A lack of sleep can lead to a variety of issues including fatigue, increased stress, and mood swings.


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, or tophaceous gout. These occur 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 surrounding skin and tissues of the joints, causing damage and eventual joint destruction.

If the cause of gout is not treated, 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. Joints can eventually come out of alignment and become immobile.

The same urate crystals that cause the painful symptoms of gout can also form in the kidneys. These can create painful kidney stones. High concentrations of urate kidney stones can interfere with kidney function.

According to the National Kidney Foundation, many people with gout also have kidney disease. This sometimes ends in kidney failure. However, there are conflicting opinions as to whether or not the pre-existing kidney disease creates the high uric acid levels that cause gout symptoms.

Gout is common among people with high blood pressure, coronary artery disease, and heart failure.

Other medical conditions associated with gout include:

  • cataracts or the clouding of the lens of the eye, which impairs vision
  • dry eye syndrome
  • uric acid crystals in the lungs (rare)

If diagnosed early, most people with gout can live a normal life. If you have advanced disease, lowering your uric acid level can improve joint function and resolve tophi. Medication and lifestyle or dietary changes can also help ease symptoms and reduce the frequency and severity of gout attacks.