Gout

Signs and symptoms of gout

Gout can be extremely painful and debilitating. Treatments (see section below) are available to help relieve the symptoms and prevent further attacks.

Any joint can be affected by gout. But it usually affects joints towards the ends of the limbs, such as:

• the toes
• ankles
• knees and fingers

Signs and symptoms of gout include:

• severe pain in one or more joints
• the joint feeling hot and very tender
• swelling in and around the affected joint
• red, shiny skin over the affected joint  

Pattern of symptoms

Attacks of gout tend to:

• occur at night, although they can happen at any time
• develop quickly over a few hours
• last between three and 10 days – after this time, the affected joint should start to return to normal, but the problem can persist if treatment isn't started early
• come back – you may experience attacks every few months or years
• become more frequent over time if not treated

It's difficult to predict how often attacks will occur and when exactly they will happen.

Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.

Almost everyone with gout will experience further attacks at some point, usually within a year.

When to see your GP

See your GP if you think you have gout and it hasn't been previously diagnosed. This is important particularly if the pain keeps getting worse and you also have a high temperature (fever).

It's important a diagnosis is confirmed. This is because other conditions that require urgent treatment, such as an infected joint, can sometimes cause similar symptoms.

If you've already been diagnosed with gout and you have an attack, see your GP if any medication you've been prescribed doesn't start working within a couple of days.

Causes of gout

Gout is caused by a build-up of a substance called uric acid in the blood.

If you produce too much uric acid or your kidneys don't filter enough out, it can build up. This can cause tiny sharp crystals to form in and around joints.

These crystals can cause the joint to become inflamed (red and swollen) and painful.

Things that may increase your chances of getting gout include:

• obesity, high blood pressure and/or diabetes
• having a close relative with gout
• kidney problems
• eating foods that cause a build-up of uric acid, such as red meat, offal and seafood
• drinking too much beer or spirits

Treatments for gout

If you have gout, treatment is available from your GP to:

• relieve symptoms during an attack – this can be done using ice packs and by taking medications such as non-steroidal anti-inflammatory drugs (NSAIDs), or other medication that your GP may prescribe

You can prevent further attacks – through a combination of lifestyle changes, such as losing weight or changing your diet, and by taking medication that lowers uric acid levels.

With lifestyle changes and treatment, many people are able to reduce their uric acid levels sufficiently to dissolve the crystals that cause gout.  If uric acid levels stay low, further attacks are less likely. Lifelong treatment is usually required.

Further problems

Sometimes gout can lead to further problems, particularly if it's left untreated.

These can include:

• kidney stones
• small firm lumps of uric acid crystals under the skin called tophi
• permanent joint damage

Pseudogout

Pseudogout is a similar condition to gout. It usually affects the knee joint first.

It's a form of arthritis that causes pain, stiffness, tenderness, redness, warmth and swelling in one or more of your joints - commonly the knee or wrist. 

• Find out more about gout on the NHS website

More useful links

• How to use your health services