Gout is a painful form of inflammatory arthritis that usually affects the big toe, but can develop in any joint, including one or both of the knees. It forms when your body has high levels of uric acid. This acid forms sharp crystals that cause sudden bouts of pain, swelling, and tenderness.
When gout affects the knee, it can make everyday movements, such as walking or standing, painful or uncomfortable. While there’s no cure for gout, there are several treatments that can help to prevent flare-ups and control painful symptoms.
Read on to learn more about gout and how it can affect your knee.
The main symptom of gout in the knee is pain and discomfort in the surrounding area. Keep in mind that gout is often unpredictable, regardless of the joint it’s affecting. You might go weeks or even months without any symptoms, only to wake up with a burning pain in your knee.
In some cases, gout starts out in one of your big toes before moving on to other areas, such as your knee. Over time, these flare-ups may last longer than previous episodes.
Other symptoms you might feel from gout in your knee include:
- warmth (to the touch)
- stiffness and limited range of motion
The buildup of uric acid in the body is known as hyperuricemia. Your body produces uric acid when it breaks down purines. These are compounds found in all your cells. You can also find purines in several types of food, especially red meat and some seafood, as well as alcohol and some sugar-sweetened drinks.
Usually, uric acid passes through your kidneys, which help to eliminate extra uric acid in your urine. But sometimes, there’s too much uric acid for your kidneys to handle. In other cases, the kidneys can’t process typical amounts of uric acid due to an underlying condition.
As a result, more uric acid circulates throughout your body, ending up in your knee as uric acid crystals.
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Experts aren’t sure why some people produce more uric acid or have trouble processing it. But there’s evidence that the condition is often genetic.
Other things that may increase your risk of developing gout include:
- consuming a lot of high-purine foods
- consuming foods and drinks, especially alcohol, that increase uric acid production
- being overweight
Having high blood pressure or heart failure can also put you at a higher risk of developing gout. Diuretics, which are sometimes used to treat these conditions, can also increase your risk.
If you think you might have gout but haven’t been diagnosed, try to see a doctor while you’re having symptoms. Gout is easier to diagnose when you’re in the middle of a flare-up, especially one that’s causing swelling, redness, and other visible symptoms.
During your appointment, your doctor will likely ask you several questions about your diet, any medications you take, and whether you have a family history of gout. This can help to rule out other potential causes of your symptoms, including an infection or rheumatoid arthritis.
Your doctor may also order a blood test to check your uric acid levels. Some people have high levels of uric acid and don’t develop gout. Others have typical uric acid levels but still develop gout. As a result, your doctor will want to do some other tests as well.
An X-ray, MRI, or CT scan of your knee can help to eliminate other possible causes of joint inflammation. Depending on your exam, your doctor may also order an ultrasound to check for the presence of crystals in your knee.
Finally, they might do a joint fluid test. This involves taking a small sample of joint fluid from your knee with a small needle and looking at it under a microscope for any uric acid crystals.
Based on the results of your exam and tests, they may refer you to an inflammatory arthritis specialist called a rheumatologist for treatment.
There’s no cure for gout, but a combination of medications and home treatments can help to manage knee pain and reduce the number of flare-ups you have.
Medications that can help reduce pain from a gout flare-up in your knee include:
- over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Advil)
- prescription-strength NSAIDS, such as celecoxib (Celebrex) or indomethacin (Indocin)
- corticosteroids, which may be taken orally or injected into your knee joint to help ease pain and inflammation
- colchicine (Colcrys), a pain reliever that targets gout pain but can sometimes cause nausea and other side effects
Your doctor might also prescribe a low daily dose of colchicine to reduce your risk of future flare-ups.
Other drugs that may help to reduce your number of future flare-ups include:
- alloprinol (Zyloprim) and febuxostat (Uloric), which limit the body’s uric acid production and may help to reduce the chances of gout forming in other joints
- uricosurics, such as lesinurad (Zurampic) and probenecid (Probalan), which help your body eliminate excess uric acid, though they may increase your risk of kidney stones
One of the most effective ways to manage gout is to limit your intake of purine-rich foods and drinks. Remember, your body produces uric acid when it breaks down purine.
That means consuming less:
- red meat
- organ meats, such as liver
- seafood, particularly tuna, scallops, sardines, and trout
- sugary drinks
Cutting out some of these foods may also contribute to weight loss. This can be an added bonus since carrying extra weight is a risk factor for gout.
Try swapping out purine-rich foods with fruits, vegetables, whole grains, and lean proteins. Learn more about what to eat and what to avoid when you have gout.
There are some other home treatments you can try, but these haven’t been adequately studied to know whether or not they’re effective. Still, they may offer some relief. Here’s how to try them out for yourself.
Gout flare-ups can last for several hours at a time, but you may feel pain in your knee for days or weeks. Some people only have one flare-up in their life, while others have them several times a year.
Keep in mind that gout is a chronic condition, meaning it lasts for a long time and requires ongoing management. Dietary changes and medications can make a big difference, but you’ll also be at risk of having a flare-up.
Keep in mind that it can also take some time to find the right combination of diet changes and medication that works for you. Don’t be discouraged if things don’t seem to be improving right away.
If left unmanaged, gout-related inflammation can cause permanent damage to your knee joint, especially if you have frequent flare-ups.
Over time, lumps of uric acid crystals, called tophi, can also form around your knee. These lumps aren’t painful, but they can cause additional swelling and tenderness during a flare-up.
Gout is a chronic condition with no cure, so you’ll likely need to keep an eye on it for some time. While it can take some time to find the right management approach, many people with gout find a combination of mediation and lifestyle changes to be effective.
If you’re newly diagnosed, consider seeing a rheumatologist if you haven’t already. They may be able to offer more tips about how to manage gout symptoms.