According to the Arthritis Foundation, about 8 million Americans have had at least one gout attack. Gout is a type of arthritis caused by a buildup of uric acid in your blood. This buildup can happen when your body makes too much uric acid or doesn’t excrete enough of it in your urine. Uric acid is a waste product that your body produces when it breaks down substances called purines, which are found naturally in your body and in your food.
Acute gouty arthritis
Over time, enough uric acid can build up in your blood that it gets deposited as crystals in your joints. These crystals cause intense pain, swelling, warmth, and tenderness in your joints. This is called a gout attack.
Gout attacks can be very uncomfortable, though the pain of a gout attack should subside within three to 10 days, even if it goes untreated. Gout attacks can happen several months, or even years, apart.
Gout and joints
Gout usually starts in a single joint, often the large joint of your big toe. It can also affect other joints, including those in your feet, ankles, knees, hands, and wrists. You may have occasional gout attacks in a single joint in your foot, knee, or other area.
As time goes on, your gout may become chronic and start to affect several joints at once.
Chronic gouty arthritis
Chronic gout can develop when you’ve had high levels of uric acid in your blood for years. Over time, the constant buildup of uric acid can wear away at your joints. This damage occurs very slowly. It may take up to 10 years for your joints to become seriously affected. Because your kidneys remove uric acid from your body, they can also become damaged.
You can take steps to stop your gout from becoming chronic. Start by making an appointment with your doctor. A doctor can treat your gout to prevent it from getting worse and permanently damaging your joints.
Treatment can relieve your gout pain and swelling. It can also stop your gout from permanently damaging your joints. Your doctor may advise you to take steroids, colchicine, or nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin (Indocin), during an acute attack to reduce the amount of swelling and pain in your joints. They may prescribe medications, such as allopurinol (Zyloprim) or febuxostat (Uloric), to help stop uric acid from building up in your blood. These medications can reduce the frequency of acute attacks. Eating fewer foods that contain purines can also reduce the amount of uric acid in your body and decrease the frequency of attacks.
Diet and flares
Avoiding foods that are high in purines, such as gravy, liver, kidneys, mackerel, anchovies, scallops, dried beans, dried peas, asparagus, and mushrooms, can help you treat gout. Drinking a lot of water and other fluids can also help. Try to avoid drinking alcohol, especially beer, as alcohol can raise uric acid levels in your blood.
Weight loss and exercise
Being overweight can make your gout worse. Losing weight slowly over time is an effective way to lower the amount of uric acid in your blood and help relieve gout. A good weight-loss strategy is to eat a sensible diet that is high in fruits and vegetables and low in saturated and trans fats. Regular exercise can also help you lose weight and keep your joints mobile.
See your doctor
Your doctor can help you create a treatment plan to prevent painful gout attacks and stop the disease from becoming chronic. This can help protect your joints from permanent damage.
You may need to see a rheumatologist, which is a doctor who specializes in treating arthritis. Your healthcare team may also include other specialists, such as a podiatrist to help care for your feet during gout attacks. Talk to your doctor to learn more about your condition and treatment options.