Signs and Symptoms of Gout

Medically reviewed by Kashif J. Piracha, MD

Gout is a type of arthritis characterized by inflammation, pain, redness, and stiffness in one or more joints. Gout often strikes the big toe joint first, but it can happen in any joint, and even in more than one joint at a time. Gout is caused by sharp uric acid crystals building up in a joint. Gout symptoms flare up and then disappear, often for weeks or months before returning again.

Uric acid is a natural compound your body makes when it breaks down purines from food. Purines are natural substances found in food and your body uses them to build DNA. Your kidneys usually filter out excess uric acid, but sometimes eating foods high in purines, like organ meat (such as liver or kidney), dried beans, and anchovies, can cause uric acid levels to build up and cause problems.

Gout is common, especially in people who have a family history of gout. It is also more common in men, individuals over age forty, people who drink alcohol, and those who eat a diet high in purines. There is no cure for gout and it can sometimes be difficult to diagnose. Knowing the most common signs and symptoms can help you know when to see a healthcare provider.

Common Symptoms

Some people can have a build-up of uric acid in their blood but do not have any of the classic symptoms of gout. But for the majority of people, gout symptoms come on suddenly and can include joint pain, redness and inflammation, lingering pain, and limited range of motion.

Joint Pain

Your joints are the areas of your body where two bones meet, such as a knee joint or elbow joint. Joint pain during a gout flare-up can feel intense. The pain in your joint usually happens suddenly and without any warning. It is common for gout attacks to happen during the night while you are sleeping. The pain in your joint may be severe enough to wake you up during the night. The intense joint pain often stays for a few hours before subsiding.

Redness and Inflammation

During a gout attack, the skin over your joint may look visibly red and feel hot inside. Your joint may feel warm to the touch. Uric acid crystals can form in the synovial fluid (the liquid in your joints that cushions the bone) and this irritates and inflames the area. Your immune system sends white blood cells to the area to help with the problem, but it causes pain, redness, and inflammation.

Lingering Pain

The intense pain will subside after a gout attack, but you may feel lingering discomfort or mild pain in one or more joints. This is much less painful than the intense pain you experience during a gout attack, but it can be uncomfortable. Often, joint discomfort can linger for a few days or weeks after an episode of gout.

Limited Range of Motion

If gout progresses and you experience more and more episodes, you may feel a limit in the range of motion of your joint. Gout can cause damage to joints over time if not treated, resulting in these limitations.

Many people who experience gout in small joints, like fingers and toes, also experience a decreased range of motion. Because of the pressure on the knees while walking, it is common to feel a limited range of motion in the knee as well.

Rare Symptoms

More serious symptoms can develop over time, especially if you have gout that’s been untreated for years. These can include tophi gout and kidney complications.

Tophi Gout

People who experience repeated flare-ups of gout without seeking treatment may develop tophaceous gout, or tophi, after a period of years. This is a rare, late stage of gout that affects between 12-35% of people with gout.

With tophi, excess uric acid crystals accumulate in your joints, kidneys, bones, cartilage, or under your skin in small, stone-like deposits. Depending on the location of tophi, it can result in restricted movement, disability, and damage to your joints or organs. Tophi may eventually cause erosion (loss) of the bone and cosmetic changes to the joint area that may be distressing. In most cases, tophi can be prevented with proper treatment.

Kidney Complications

Your kidneys are responsible for filtering excess uric acid from your body through your urine. In more severe cases of gout, uric acid crystals may accumulate in your kidneys and lead to kidney stones. Sometimes, a stone can become large enough that it blocks a ureter, the tube that moves urine from your kidneys to your bladder. Approximately 15% of people who have gout go on to develop uric acid kidney stones.

Gout Symptoms in Children

Pediatric cases of gout are extremely uncommon and thus have not been widely studied. The studies that have been conducted suggest that gout in children is often associated with other medical conditions, with obesity being the main cause.

Other medical conditions that are associated with gout in children are Down syndrome, congenital heart disease, metabolic syndrome, asthma, gastroenteritis, and medication side effects.

When to See a Healthcare Provider

Speak with your healthcare provider if you suspect you have gout because it can be difficult to diagnose on your own. Call your healthcare provider if you experience any intense joint pain that seems to come on suddenly, particularly if the skin in the area is red, warm, and swollen. Gout may mimic other conditions, like skin infections, so it’s best to talk to a healthcare professional right away.

If your gout attacks seem to be happening more frequently or your symptoms seem to be worsening, talk with your healthcare provider. Gout can be treated with medication or lifestyle modifications that may help prevent further gout episodes.

A Quick Review

Gout is a type of very painful arthritis that flares up and then subsides. It is caused by the accumulation of sharp uric acid crystals in your joints. Common symptoms include short- and long-term joint pain, inflammation, and limited range of motion. Gout can progress to a disabling form called tophi gout if left untreated. While there is no cure for gout, it can be managed well and many people reduce or even eliminate painful gout episodes with proper medical therapy.

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