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:

The pain of a gout attack can also 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. Tophi occur most often in these parts of the body:

  • hands
  • feet
  • wrists
  • ankles
  • 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. This causes damage and eventual joint destruction.

If the cause of gout isn’t 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.

Arthritis caused by gout may lead to bone erosion and cartilage loss leading to complete destruction of the joint.

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 chronic kidney disease (CKD). This sometimes ends in kidney failure.

However, there are conflicting opinions as to whether or not the preexisting kidney disease creates the high uric acid levels that cause gout symptoms.

Other medical conditions associated with gout include:

  • cataracts, or the clouding of the lens of the eye; this impairs vision
  • dry eye syndrome
  • uric acid crystals in the lungs; this complication is rare

If diagnosed early, most people with gout can live a normal life. If your disease has advanced, 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.