Gout symptoms

Find out about the symptoms and complications of gout


Earle Logan
BSc in Health Studies, Dip.Nut
@EarleLogan2
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An introduction to gout symptoms

The symptoms of gout are often easy to identify. In the majority of cases, symptoms begin in one of the big toes, although they can occur in any joint. If the condition progresses, more than one joint can be affected, although the smaller joints of the body such as those in the hands and feet are more prone to the condition.

Symptoms of gout are caused by a build-up of uric acid in or around a joint which then  crystallises, penetrating into the soft tissue surrounding the joint.

Symptoms of gout

  • Pain - Gout is notoriously painful, to the point where it can even be debilitating. Typically, the pain can come on rapidly, last a few days and then go again. During an attack of gout, the pain is often worst at night, and even covering the affected joint with a bed sheet can be excruciatingly painful. Bumping the affected joint is also sore
  • Inflammation –this occurs when inflammatory chemicals and fluid build up in or around the joint. In the case of gout, this fluid is likely to contain high levels of uric acid, and possibly also crystals. This can cause the joint to feel stiff, and any movements will be extremely painful. Inflammation of the joint also causes it to feel warm and throbbing
  • Changes to the skin – when suffering from an attack of gout, the skin often turns red and shiny, because the inflammation is stretching and putting pressure on the skin. However, as the inflammation subsides, in some cases when the skin has been stretched too much, it may also turn itchy, flaky or peel.

Pattern of symptoms

Gout attacks can be difficult to predict as often there is not a specific trigger. However, when they do occur symptoms develop rapidly, usually over a matter of hours.

Attacks of gout can last anything from about three to ten days. During the first few attacks, usually only one joint is affected. As you experience more and more attacks, it is likely that several joints will begin to be affected.

Although some people only experience one or two attacks of gout during their lifetime, most people with gout experience recurring attacks, often with increasing frequency and intensity. Over half of people who experience gout, have another attack within a year.

If uric acid levels in the bloodstream are continually high, more and more crystals will form, and other joints may suffer. Adhering to a gout diet can prevent this from happening, so that attacks of gout become less frequent and result in fewer complications.

Complications of gout

Gout can be associated with a number of other conditions or complications:

  • Tophi – these are deposits of uric acid crystals, visible as small white or yellow bumps around a joint or on the ear. Tophi are usually painless, but are an indication that the level of uric acid in your blood is too high. Your doctor is likely to recommend ways of reducing this. If tophi become large or inflamed, it is worth speaking to your doctor, as they may have to be surgically removed
  • Joint damage – repeated episodes of gout over a long period of time can lead to damage in your joints. The features are similar to osteoarthritis (wear and tear arthritis) or rheumatism and are usually irreversible
  • Kidney stones – the body excretes excess uric acid via the kidneys. Just as uric acid crystals can gather in joints, they can also form in the kidneys. This is why up to 25% of people who are prone to gout are likely to have kidney stones.

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