What Is Gout?

Medically reviewed by Anita C. Chandrasekaran, MD

Gout is a form of arthritis that causes pain, inflammation, redness, and stiffness in one or more joints. In most cases, gout affects the joints in the big toe first and then spreads to other joints over time.

You can develop gout if you have an excess amount of uric acid—a waste product that is found in your blood. If you have too much uric acid in your body, the acid can accumulate and cause crystals in your joints, eventually leading to gout symptoms.

About nine million people in the United States have a history of gout. The good news: while the condition is painful, you can better manage your symptoms with lifestyle changes and medications.

Symptoms

Most people with excess uric acid in their blood supply can develop gout. Normally, symptoms tend to come on suddenly and may include:

• Sudden joint pain

• Swelling or redness in the joint that is affected

• The skin near the affected joint feels warm to the touch

• Sensitivity near the affected joint

• Lingering pain that may feel more intense at night

While gout can develop in any of your joints, it may be more common to experience symptoms in your big toe, feet, ankle, knees, and fingers.

Causes

A build-up of uric acid (a waste product from cell turnover that is found in your blood) can cause gout symptoms to occur. Uric acid is a natural compound your body produces when you digest and break down the food you eat.

Normally, your kidneys filter out any extra or unneeded uric acid from your body. However, some underlying health conditions, drinking too much alcohol, genetic factors or eating certain foods can affect the functioning of your kidneys. This can make it difficult for excess uric acid to leave your body and eventually create uric acid crystals in your joints—triggering gout symptoms to develop.

Risk Factors

Anyone can develop gout but some people may be at a higher risk of experiencing symptoms. Risk factors for gout include:

• Being assigned male at birth and being over the age of 40

• Having a family history of gout

• Living with underlying medical conditions such as obesity, high blood pressure, and diabetes

• Eating a diet high in purines, such as fish or red meats

• Drinking excess amounts of sugary drinks or alcohol

Diagnosis

Gout can sometimes be difficult to diagnose because its symptoms are similar to other inflammatory and arthritis-related conditions. Additionally, symptoms of gout are only active during a gout flare-up, so seeing your healthcare provider when you’re not in a flare-up can make getting a diagnosis harder.

If you are experiencing symptoms of gout, it’s best to see your healthcare provider for proper testing. Your provider will likely ask about your personal and family medical history and perform a physical exam to assess your symptoms. In some cases, your provider can also recommend you to a rheumatologist (or, a doctor who specializes in the joints, muscles, and bones) for further testing.

Your primary care provider or rheumatologist may also order one or more of the following diagnostic tests to reach an accurate diagnosis:

• Blood test: Assesses the level of uric acid in your blood

• Joint fluid test: Uses a needle to remove a sample of your synovial fluid (or, fluid located in between your joints) to check for the presence of uric acid crystals

• X-ray: Identifies the extent of joint damage (if any), checks for inflammation, and can rule out other causes of joint pain

• Ultrasound: Detects the presence of uric acid crystals in your joints and can also diagnose tophi gout—a rare, late-stage complication of gout

• Urinalysis: Tests your urine to check for issues in your blood and kidneys

Treatment

If you receive a diagnosis for gout, starting treatment early can prevent long-term complications from occurring and help improve current symptoms. Since there is no cure for gout, the goal of treatment is to reduce uric acid levels in your blood, improve current symptoms, and prevent future flare-ups from occurring.

You can manage gout with a combination of lifestyle changes and medications, including:

• Taking pain relievers, such as non-steroidal anti-inflammatory drugs such as Advil (ibuprofen)

• Reducing alcohol intake

• Eating a diet that is low in purines and sugar

• Drinking more water

• Applying ice to the affected joints

• Avoiding activities that place pressure on the affected joints

• Trying medications to lower uric acid levels such as Zyloprim (allopurinol), Krystexxa (pegloticase), or Uloric (febuxostat)

How to Prevent Gout Flare-Ups

Prevention measures for future gout flare-ups tend to look similar to your treatment options. That’s because one of the goals of gout treatment is to also reduce the risk of experiencing flare-ups in the future. That said, there are some things you can do to minimize the likelihood of experiencing active gout pain, including:

• Lowering your intake of purine-rich foods

• Stay hydrated with water

• Exercise regularly to manage underlying conditions such as obesity or high blood pressure

• Limiting or avoiding alcohol

• Following your treatment plan and taking medications as directed by your healthcare provider

Complications

Sometimes, gout can lead to serious complications—especially if your condition is left untreated. That’s why getting an early diagnosis and receiving treatment is critical. If your condition progresses, you can develop the following complications:

• Tophaceous gout (tophi): Tophi is a rare, late-stage type of gout that develops in people who do not receive treatment for gout. This complication can occur when there is an extreme excess of uric acid crystals that have developed in your joints, kidneys, bones, or under your skin. As a result of the uric acid, you may experience permanent damage to your joints and organs.

• Kidney complications: In severe cases of gout, uric acid crystals may accumulate in your kidneys and cause kidney stones to develop. Approximately 15% of people with gout can develop kidney stones, especially if they don’t receive treatment for their condition.

Living With Gout

While gout can be painful, it’s most important to talk to your healthcare provider to find a treatment plan that works for you and then follow it closely. With a few lifestyle modifications, many people with gout can manage their condition and reduce the risk of future flare-ups or complications.

Following your treatment plan and implementing preventative lifestyle strategies, such as getting light exercise, making any necessary dietary changes, and limiting alcohol can help you improve your symptoms. If you developed gout because of underlying health conditions such as high blood pressure, diabetes, or heart or kidney disease, talk to your healthcare provider about what you can do to better manage your underlying condition and gout simultaneously.

It’s important to note that many people with gout are able to live normal and fulfilling lives, while limiting their flare-ups, when following a treatment plan that works for them. So don’t wait—talk to your provider today to see what you can do to minimize the pain and maximize your quality of life. 

Frequently Asked Questions

What age is gout most common?

Gout can develop at any age, but most people are likely to develop symptoms between the ages of 30 and 50.

Can stress and anxiety trigger gout?

Stress plays a big role in several health conditions, and gout is no different. In some people, stress can trigger gout flare-ups. Some studies show that high levels of stress may lead to an increased level of uric acid in your body, which can cause inflammation and produce gout pain.

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