Gout is one of over 100 different types of arthritic conditions that can attack the human body. It is a type of arthritis that causes sudden burning pain, stiffness and swelling in a joint, often attacking the big toe.
This condition affects more men than women. The risk is higher if the individual is overweight, drinks alcohol, or if a high amount of fish or meats high in purines are eaten consistently.
Purines are a colorless crystalline organic based nitrogen that is the component in certain foods. These purines are then metabolized into uric acid. The cause of gout is too much uric acid in the blood stream which then forms hard crystals inside the joints.(1)
The most common symptom of an attack is night time swelling, tenderness and redness in the joint. This is accompanied by sharp pain.
Gout Flare Ups
The attack can last a few days or many weeks before it resolves. Some individuals may not get another flare up for many months or years while others remain pain-free for the rest of their lives.
The most common joint in which gout appears is in the big toe, although it can occur in the foot, ankle, knee or wrist as well. The signs and symptoms are almost always acute.
This means that it develops suddenly and without any warning. When the pain is left untreated it typically lasts for five to 10 days as the crystals dissolve from the joint area.
The pain and discomfort will gradually subside over two weeks and leave the joint apparently pain-free and normal.
During the flareup the joint will be red, swollen and very tender.
Touching or moving the toe in any way will be intensely painful. In fact, individuals who are suffering from a flareup report that pressure as little as the bed-sheet over the toe will increase the pain.(2)
Symptoms and Gout Stages
Symptoms will generally develop in only one joint at a time. On rare occasions they will develop in two or three joints simultaneously, but if there are widespread symptoms then the condition is probably not related to gout.
The symptoms of this condition can be split into four different stages. In the asymptomatic stage the uric acid levels are rising in the blood but the individual experiences no symptoms.
It is during the acute stage of the attack that individuals experience the pain, swelling and tenderness common with gout.
The inter-critical stage is the time between episodes which are symptom-free. The majority of individuals will have a second attack from six months to two years after the primary attack. Some will live symptom-free for up to 10 years but most will have a second attack.
During the chronic stage individuals will suffer with persistently painful joints that have large deposits of urate crystals in the cartilage, membranes and tendons and soft tissue around the joints.
The skin over these deposits will develop sores and often release a white pus. The joint will become stiff and the individual will only have limited motion on this affected joint.
With early diagnosis and treatment and long-term dietary changes in lifestyle choices, many individuals will never reach the chronic stage. See this page: What Foods to Avoid if you have Gout
The changes which are required to ensure that the chronic stage is never reached are minor compared to the poor pain control and limited motion an individual will suffer if they reach the chronic stage of gout symptoms.
(1) National Institute of Arthritis and Musculoskeletal and Skin Diseases: Questions and Answers about Gout
(2) University of Maryland Medical Center: Gout – Symptoms
Top Photo of monosodium urate crystals in joint fluid by Ed Uthman