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Introduction

Knee Pain

Gout

Gout is a common and complex form of arthritis that can affect anyone. It's characterized by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe.

An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the bedsheet on it may seem intolerable.

Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares.


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Causes

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 and 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

Symptoms

The signs and symptoms of gout almost always occur suddenly, and often at night. They include:

  • Intense joint pain. Gout usually affects the big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins.

  • Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.

  • Inflammation and redness. The affected joint or joints become swollen, tender, warm and red.

  • Limited range of motion. As gout progresses, you may not be able to move your joints normally.

Diagnosis

A healthcare provider will diagnose gout with a physical exam. They’ll ask you about your symptoms and examine your affected joints. Tell your provider when you first noticed symptoms like pain and swelling in your joint and how often the symptoms come and go.

Non-surgical treatments

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), colchicine or corticosteroids

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

With treatment, many people are able to reduce their uric acid levels sufficiently to dissolve the crystals that cause gout – and as a result have no further attacks. However, lifelong treatment is usually required.

Surgery