Gout Symptoms, Causes, Treatment and Prevention

Gout is a common form of inflammatory arthritis that causes joint pain, swelling, and redness ³. It often appears as sudden episodes called gout attacks or flares ⁵.

Gout develops when urate crystals collect in joints and nearby tissues ^1,4. Urate is another name for uric acid ⁹.

This guide explains gout symptoms, causes, treatment and prevention in plain language. It covers warning signs, diagnosis, medicines, diet, and long-term care.

Early diagnosis, treatment, and lifestyle changes can make gout easier to manage ^3,4. Ongoing care may also limit repeated attacks and joint damage ^1,6.

The body makes uric acid when it breaks down substances called purines ^3,4. Purines occur in body tissues and many foods ^3,4.

Most uric acid dissolves in the blood and travels to the kidneys ³. The kidneys filter it from the blood, and it leaves through urine ³.

Sometimes the body produces too much uric acid ^3,4. In other cases, the kidneys remove too little ^3,4. Both problems can allow uric acid to build up over time ^3,4.

Sustained high urate can allow monosodium urate crystals to form ¹. These crystals can collect inside joints and the tissues around them ¹. Crystal deposits then cause inflammation, pain, swelling, and changes in joint movement ⁴.

Hyperuricemia means the blood contains an elevated amount of urate ⁴. Gout involves urate crystal deposits that cause inflammation and symptoms ^1,4.

Hyperuricemia often appears before gout develops ¹. However, many people with elevated urate never develop gout symptoms ^3,4,6.

A serum urate level above 6.8 mg/dL exceeds the usual blood solubility threshold ¹. However, a high result alone does not mean someone has gout ^3,6.

Longer exposure to excess uric acid may increase the chance of gout ⁵. Risk also involves genes, health conditions, medicines, diet, and environmental factors ¹.

Gout can progress through several stages over time ⁴. The stages can follow this general pattern:

Tophi can damage nearby bone and soft tissue over time ^3,4. They can also change the shape of an affected joint ^3,4.

Urate crystals may collect in the urinary tract and cause kidney stones ^3,6. Untreated or undertreated gout can eventually cause progressive joint destruction ¹.

Gout attack symptoms often appear suddenly during the night ^3,5,6. Severe pain may wake someone from sleep ^3,4.

Symptoms commonly affect one joint during an early flare ^3,4. Possible gout attack symptoms include:

Redness can be harder to see on Black or brown skin ⁶. Warmth, swelling, tenderness, and movement changes may be more noticeable ^4,5.

Some attacks can also cause fever, tiredness, or a general feeling of illness ^1,7. Fever during gout can make it hard to distinguish gout from septic arthritis ¹.

Gout most often affects the lower limbs ¹. The big toe joint is the most common location ^1,3. Gout in this joint is often called podagra ¹.

Other affected areas can include these joints:

An early attack often involves one joint ^3,4. Long-standing gout can eventually affect several joints at the same time ¹.

An acute flare often reaches its highest intensity within 12 to 24 hours ¹. An initial attack may resolve within 3 to 14 days without treatment ¹.

Many flares improve within one or two weeks ^3,4,5. Symptom-free periods may occur between attacks ^3,4. Some people have no further flare for years ^3,4.

Without adequate treatment, attacks may occur more often and last longer ^3,4. Later attacks may also involve several joints ¹.

Chronic gout can cause ongoing joint pain, stiffness, and reduced movement ⁸. Tophi may appear after urate crystals collect under the skin ^4,8.

Tophi can form near the fingers, feet, elbows, or Achilles tendons ⁶. The Achilles tendon runs along the back of the ankle.

Tophi may begin as painless lumps ^3,4. They can later cause pain, tissue damage, and changes in joint shape ^3,4. Some tophi may drain a chalk-like material ^1,8.

Uric acid levels rise when production exceeds the amount removed from the body ^3,4. Reduced kidney removal can allow uric acid to build up in the blood ³.

Kidney disease can interfere with uric acid removal ^8,10. Fast cell breakdown may also increase uric acid production ^3,4.

A risk factor raises the chance of gout but does not make gout certain. People with high uric acid levels may never experience a gout attack ^3,6.

Gout becomes more common with increasing age ^4,8. It affects men more often than women ^4,7.

Women tend to develop gout later, often after menopause ^4,5. A family history of gout also raises a person’s risk ^4,6.

Genes can affect urate buildup and gout risk ^1,4. Some rare genetic conditions can increase urate levels ^3,4.

Several health conditions are linked with a higher risk of gout ^3,4,6. They include:

These risk factors cannot confirm that joint pain comes from gout. Diagnosis requires a review of symptoms, examination findings, and selected tests ^3,5.

Some medicines may increase uric acid levels or gout risk ^1,3,4. Possible contributors include:

A clinician may consider changing medicine that contributes to high uric acid ³. Ask the prescriber before changing or stopping any prescribed medicine.

Changes in urate concentration can trigger inflammation in people prone to gout ¹. Possible triggers include dehydration, fasting, trauma, surgery, and acute illness ¹.

Alcohol can raise uric acid and trigger attacks ^1,4,6. Beer, wine, and spirits have all been linked with flares ¹.

Purine-rich animal foods may increase gout risk ^3,4. Examples include organ meats, red meat, and selected seafood ^4,6.

Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout, and tuna ⁶. Fructose-sweetened drinks can also raise uric acid and gout risk ^4,6.

A clinician starts by asking about symptoms and examining the affected joints ^3,5. The visit may cover family history, diet, alcohol use, and current medicines ¹⁰.

Useful details include when the pain began and whether earlier attacks occurred ⁵. The clinician may also look for tophi or changes around the joints ¹⁰.

Calcium pyrophosphate arthritis can cause symptoms similar to gout ^3,9. However, calcium crystals cause that condition instead of urate crystals ^3,9.

A clinician may remove fluid from a painful joint for testing ^3,5. This procedure is called joint aspiration.

A laboratory examines the fluid under a microscope for uric acid crystals ^3,10. Finding these crystals provides direct evidence of crystal deposits within the joint ^3,5.

Blood or urine tests may measure uric acid levels ³. Blood tests may also check kidney function ¹⁰.

A high blood uric acid result does not prove gout by itself ^3,6. Many people with high uric acid never develop symptoms ^3,4,6.

An ultrasound may show uric acid crystal buildup near an affected joint ³. A special computed tomography scan may also detect crystal deposits ³.

Clinicians use imaging with the history, examination, and laboratory findings ³. Imaging may also help assess other possible causes of the symptoms ³.

Gout treatment addresses active flares and the risk of future attacks ^3,5. Clinicians may choose among several medicines for an active flare ^3,5.

Common clinician-directed options include:

Treatment selection depends on symptoms, general health, and gout severity ^3,7. A clinician should explain each medicine’s risks, benefits, and possible side effects ⁷.

Talk with a clinician before using an NSAID for gout ⁵. Medicine choice requires an individual review rather than one plan for everyone ^3,7.

Some people need daily medicine to lower blood uric acid ^3,8. These medicines aim to prevent future problems rather than manage current flare symptoms ^3,5.

Available options can include:

A common serum urate treatment target is below 6 mg/dL ⁸. Serum urate is the amount of uric acid measured in blood.

A clinician may prescribe preventive medicine when urate-lowering treatment begins ⁷. Blood tests may measure uric acid and check kidney function ¹⁰.

Take long-term medicines according to the prescribed plan ⁷. Discuss side effects, missed doses, or other concerns with the prescriber.

Gout treatment and diet can work alongside prescribed medicines ⁵. Some people still need urate-lowering medicine after making diet changes ^3,5.

A balanced plan can include vegetables, whole grains, legumes, nuts, fruit, and dairy ⁸. Ask a clinician whether a DASH-style eating plan fits your needs.

Practical food changes may include:

Extreme food limits are not the only part of gout care. Treatment may combine medicines with changes in food and alcohol intake ^3,5.

Dehydration can trigger a flare in people prone to gout ¹. Harvard Health advises people with past gout attacks to stay hydrated ¹⁰.

Plan fluid intake with a clinician when personal guidance is needed. If weight is a concern, ask a clinician about a safe plan.

Obesity is associated with a higher chance of developing gout ^3,4,6. Weight management may be included among lifestyle changes discussed during care ^3,7.

Taking medicine as prescribed may lower future flare risk and severity ⁷. Requested blood tests can measure uric acid and assess kidney function ¹⁰.

A clinician may review medicines that could raise uric acid ³. Discuss any change with the clinician who prescribed that medicine.

Report new symptoms or worsening attacks to a healthcare professional ⁷. More frequent or severe attacks can lead to another treatment review ⁵.

Early diagnosis, treatment, and lifestyle changes can improve gout control ^3,4. Medicines may help prevent attacks in people with recurrent gout ⁶.

Untreated gout can cause permanent joint damage ⁵. Long-term disease can also cause tophi, changed joint shape, and kidney stones ^3,6.

Keep a simple record of attacks, possible triggers, and medicine use. Bring that record to medical visits for discussion.

Call a healthcare professional if sudden, intense joint pain develops ⁶. This is especially important when gout has not been diagnosed ⁵.

If fever occurs with a hot, inflamed joint, seek medical care right away ⁶. These symptoms may mean that an infection is present ⁶. Do not assume the problem is only another gout flare.

Arrange a medical review when attacks become more frequent or severe ⁵. A clinician should also assess new lumps that might be tophi ⁸.

Report worsening symptoms or new concerns to a healthcare provider ⁷. Medical assessment can help identify gout or another cause of joint symptoms ^3,9.

Understanding gout symptoms, causes, treatment and prevention can support earlier medical care. Gout develops when urate crystals collect in joints and cause inflammation ^1,4.

Treatment may combine flare medicines, long-term uric acid control, and diet changes ^3,5. A common long-term serum urate target is below 6 mg/dL ⁸.

Consistent care may reduce repeated attacks and limit progressive gout ^6,8. Medical review supports medicine use, uric acid testing, and kidney function checks ^7,10.