Gout is a common form of inflammatory arthritis. It happens due to high levels of uric acid in the body.
When you think of arthritis, achy, warm, swollen joints probably come to mind. These are indeed some of the most common symptoms of arthritis. But did you know there are actually over 100 different types of arthritis? Gout is one of them.
Gout is a common form of inflammatory arthritis. It happens due to high levels of uric acid in the body.
Researchers estimate that gout impacts one to four percent of people around the world. In fact, it’s three to four times more common than rheumatoid arthritis (RA), another type of inflammatory arthritis.
Looking to know more about gout? This condition guide will explore the ins and outs of gout, including its symptoms, what causes it, how it’s diagnosed, and treatment options.
Gout is an inflammatory form of arthritis that can occur when there’s too much uric acid in the body. Uric acid is a normal waste product made by the body, but in some people, it can accumulate at higher levels and lead to gout.
Gout can be divided into four stages:
Hyperuricemia. In this stage, high levels of uric acid can be detected in your blood, but you won’t have any gout symptoms yet.
Gout flare. During a gout flare-up, you have acute gout symptoms, such as intense pain and swelling in an affected joint.
Intercritical gout. This is the time between gout flares when you have no symptoms, although uric acid levels are still high.
Chronic gout. In this advanced stage of gout, hardened deposits of uric acid crystals form around the joints and sometimes areas of the body like the kidneys.
What does gout look like, and what does gout feel like?
Gout causes painful swelling, typically only impacting one joint. Its symptoms can come and go. Periods when gout symptoms are more severe are called gout flares or gout attacks.
A gout flare comes on suddenly, and symptoms are often intense. This will most commonly happen at night.
Gout in foot joints is most common, with gout often affecting the big toe joint. However, other joints can be affected as well, particularly those in the lower body. For example, gout in ankles or gout in knee joints may also occur.
Gout in hands is less common but can happen. In this situation, it usually affects small joints in the fingers.
The symptoms of gout are:
Joint pain
Joint swelling
Skin around the affected joint that’s red and warm to the touch
Early-stage gout symptoms might be less intense. But when gout flares up, symptoms peak after 12 to 24 hours.
During a gout flare-up, you may experience symptoms that last a week or two, after which they typically go away. Many people with gout don’t have any symptoms between flares.
If you have untreated gout for a long time, something called tophi can develop. Tophi is when uric acid crystals around the joints form larger, hard deposits. It can lead to pain, soft tissue damage, and joint deformities.
Folks with gout are more prone to certain other health conditions, called comorbidities. These may include:
High blood pressure (hypertension)
Heart disease like heart failure and coronary artery disease
Stroke
Metabolic syndrome
Chronic kidney disease
Kidney stones
Osteoarthritis
If you think you have gout or any of these other medical conditions, see a healthcare provider.
What causes gout in feet? Having high levels of uric acid in the body can cause gout in the feet or other lower-body joints.
However, not everyone with a high amount of uric acid develops gout. Roughly two-thirds of people with elevated uric acid never experience a gout flare.
It’s generally accepted that a variety of genetic, environmental, and lifestyle factors all contribute to the development of gout.
What causes gout in females? Uric acid is a waste product naturally made by the body when it breaks down compounds called purines.
When there’s too much uric acid in the body, it can form sharp, needle-like crystals in and around your joints. The presence of uric acid crystals in joint tissue is what leads to the inflammation and pain associated with gout.
Levels of uric acid can rise for different things. For instance, due to genetic factors, your body could naturally make more uric acid than the average person.
Also, since uric acid is typically released in urine, it could start to build up if your kidneys aren’t filtering it out properly.
Lastly, while purines are found in every cell of the body, they’re also in protein-rich foods, such as red meats, organ meats, and certain types of seafood. Eating too much of these foods can contribute to gout.
Sometimes, a gout flare may be triggered by things like an illness, injury, or certain medications.
Some things are known to increase the risk for gout. These are called risk factors.
Not everyone with risk factors for gout will develop it, but those with risk factors are more likely to have gout than people without them.
Unfortunately, some risk factors for gout are totally out of your control. These include:
Age. The prevalence of gout increases steadily with age.
Sex. The prevalence of gout is two to six times higher in people assigned male at birth.
Family history of gout. Genetics can contribute to high uric acid levels, so if a close relative like a parent or sibling has gout, you’re more likely to have it as well.
Race and ethnicity. Studies using data from the United States have found that, compared to white individuals, Black and Asian individuals have a higher prevalence of gout.
Menopause. Postmenopausal women have a higher risk of gout. Reproductive factors like starting your period later, entering menopause earlier, and using oral contraceptives or hormone replacement therapy have also been found to increase gout risk.
Certain underlying health conditions can increase the risk of gout as well:
Kidney disease
Diabetes
High blood pressure
Heart disease
Taking certain types of medications can contribute to gout. A couple examples include cyclosporine, an immunosuppressant drug, and diuretics.
Lastly, dietary factors also increase gout risk. Specifically, eating lots of purine-rich foods can raise your risk of gout.
High- and moderate-purine foods include:
Red meats like beef, pork, veal, and venison
Liver and other organ meats
Poultry, such as chicken, turkey, and duck
Fish, including anchovies, herring, trout, and haddock
Shellfish like mussels, scallops, oysters, and shrimp
Alcohol
If you’re worried you have gout, seek medical advice to see whether your diet may need adjusting.
If you suddenly have signs of gout — like severe pain and swelling in one of your joints, particularly at the base of your big toe — see a healthcare provider ASAP so they can check it out.
Numerous medical conditions that can cause similar symptoms to gout. This includes other types of inflammatory arthritis like RA, psoriatic arthritis, and septic arthritis.
Gout can also appear similar to another condition called calcium pyrophosphate deposition (CPPD) — or pseudogout. However, CPPD happens due to the formation of calcium phosphate crystals, not uric acid crystals.
Your healthcare provider can do a variety of tests to help diagnose the cause of your symptoms. They may also refer you to a rheumatologist, a doctor specializing in inflammatory conditions that affect the joints, bones, and muscles.
When you see your medical professional for gout symptoms, they’ll start by doing a physical exam and evaluating the affected joint.
Your provider will also get your medical history, asking you about things like:
When your symptoms started, how severe they are, and if anything makes them better or worse
Any underlying health conditions you have
The types of medication, both prescription and over-the-counter (OTC), you take
Whether any health conditions run in your family
If your healthcare provider suspects gout, they’ll order the following tests:
A blood test to check the levels of uric acid in your blood
An analysis of a sample of joint fluid from the affected joint to check for uric acid crystals
Imaging tests like an X-rays, ultrasound, or CT scan to visualize uric acid crystals in the affected joint
Beyond the tests listed above, your healthcare provider will likely order other evaluations to help rule out other conditions that could be causing your symptoms. For instance, they might want to do a blood test for rheumatoid factor, which is associated with RA.
Gout isn’t curable, but effective gout treatments are available. Because of this, it’s crucial to get diagnosed by a healthcare provider so you can get started on a treatment plan that alleviates your symptoms and prevents flares.
The treatment you get for gout can depend on the frequency and severity of your flares.
If you’re seeing a healthcare provider during a gout flare, they may recommend using medications to reduce your symptoms.
These can include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), which are available OTC and include ibuprofen (Advil, Motrin) and naproxen (Aleve)
Colchicine, a prescription medication that can ease gout pain
Corticosteroids, prescription medications that can quickly reduce inflammation in the body
Home remedies can also help during a gout flare-up. Your healthcare provider might recommend:
Resting the affected joint and elevating it above your heart
Using a cold compress to ease swelling
Avoiding anything that puts pressure on or compresses the affected joint
If you have frequent gout flares, gout associated with tophi, or joint damage, your provider may prescribe medication to lower uric acid levels. These can help prevent gout flares and further complications.
According to the American College of Rheumatology guidelines, allopurinol is the first-line medication for lowering uric acid levels. Febuxostat is another uric acid-lowering medication that may be used.
It’s not always possible to prevent gout, but there are lifestyle changes you can make to reduce your risk.
You can also adopt these lifestyle changes if you’ve been diagnosed with gout to help prevent further attacks of gout.
To prevent gout or a gout flare-up, try the following:
Focus on eating a healthy, balanced diet, such as the Mediterranean way of eating or DASH (dietary approaches to stop hypertension)
Reduce your intake of purine-rich foods, which include things like red meat, organ meat, and some seafood and shellfish.
Limit alcohol or avoid it altogether.
Avoid foods that cause gout, including those with high-fructose corn syrup, like sodas, juice drinks, and sweets, which can increase uric acid production.
Drink plenty of water to help flush uric acid out of your body.
Get regular exercise.
Ask your healthcare provider about healthy weight loss strategies if you have overweight or obesity.
If you have other health conditions that increase the risk for gout, such as heart disease or diabetes, it’s vital to work with your healthcare provider to ensure these conditions are managed. Doing so can help lower your risk of developing gout.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.