Table of ContentsView AllTable of ContentsCausesUric AcidSymptomsDiagnosisTreatmentPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Causes
Uric Acid
Symptoms
Diagnosis
Treatment
Prevention
Frequently Asked Questions
Gout attacks occur suddenly. They can wake you up in the middle of the night, feeling like your big toe is on fire. The toe is so inflamed that even the weight of a light bedsheet can lead to severe pain.
People with gout often experience symptoms that come and go—periods of flare-ups (severe symptoms) and periods of remission (few or no symptoms). Gout treatment typically focuses on managing symptoms and preventing gout attacks.
This article covers gout causes, symptoms, diagnosis, treatment, and more.
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Gout Causes
Hyperuricemia can occur because the body produces too much or the kidneys cannot properly eliminate it.If the uric acid levels get too high,urate crystalsbuild up in the joints. The crystals are the cause of gout.
It is possible to have high uric acid levels and never get gout. According to a 2021Biomoleculesreport, only up to 36% of people with hyperuricemia will develop gout.
Gout Risk FactorsSome risk factors increase your risk for gout. These include:Being male: According to a 2019Advances in Rheumatologyreview of studies, only 5.1% of people with gout are women.Gout is more prevalent in women aftermenopause.Body mass index (BMI)of 30 or moreMetabolic syndrome: This is a cluster of conditions that increase the risk for heart disease, stroke, and type 2 diabetes. Metabolic syndrome includes high blood pressure, high blood sugar, excess body fat at the waist, and abnormal cholesterol or triglyceride levels.Decreased kidney functionCongestive heart failureGenetics or family historyHeavy alcohol consumptionEating a diet high in purine-rich foodsExcessive use of water pills
Gout Risk Factors
Some risk factors increase your risk for gout. These include:Being male: According to a 2019Advances in Rheumatologyreview of studies, only 5.1% of people with gout are women.Gout is more prevalent in women aftermenopause.Body mass index (BMI)of 30 or moreMetabolic syndrome: This is a cluster of conditions that increase the risk for heart disease, stroke, and type 2 diabetes. Metabolic syndrome includes high blood pressure, high blood sugar, excess body fat at the waist, and abnormal cholesterol or triglyceride levels.Decreased kidney functionCongestive heart failureGenetics or family historyHeavy alcohol consumptionEating a diet high in purine-rich foodsExcessive use of water pills
Some risk factors increase your risk for gout. These include:
What Causes Gout?
What Is Uric Acid?
Uric acid is a waste product created when the body breaks down chemicals calledpurines. These are released from the body’s cells when they are broken down, and they are found in the diet. Most of the time, uric acid will dissolve in the blood, pass through the kidneys, and leave the body through urine.
A diet rich in purine foods and drinks can increase uric acid levels. Purine-rich foods and beverages include:
What Foods Should You Avoid With Gout?
Too much uric acid in the body leads to hyperuricemia. Hyperuricemia will cause urate crystals to develop and settle into the joints leading to gout. Urate crystals can also find their way into the kidneys and lead tokidney stones.
What Are Kidney Stones?Kidney stones can occur as a result of high levels of uric acid. Kidney stones can block the passage of urine and cause severe pain. Most kidney stones will pass on their own without medical intervention, while others will need medicine or surgery to treat.
What Are Kidney Stones?
Kidney stones can occur as a result of high levels of uric acid. Kidney stones can block the passage of urine and cause severe pain. Most kidney stones will pass on their own without medical intervention, while others will need medicine or surgery to treat.
Gout Symptoms
Periods of increased symptoms of gout are called gout attacks or gout flare-ups. Gout attacks are very painful and can come on quickly.
Gout
Symptoms of a gout attack might include:
A gout attack generally affects one joint at a time. Gout usually affects the big toe but can affect other joints, including the knees, ankles, feet, hands, wrists, and elbows.
Gout attacks are the worst in the first 12–24 hours.The earliest signs of a gout attack are itching, burning, stiffness, or minor soreness of the affected joint. Symptoms will worsen and then slowly resolve.
Most people will recover from a gout flare within a week or two. Once the flare has resolved, you might go a long time (several months to a year or more) without symptoms.
Can You Have Gout in Your Heel?
A diagnosis of gout is usually made based on symptoms, medical history, physical examination, lab work, and imaging.
Your healthcare provider will ask questions about the onset of symptoms and any symptom patterns. They will also ask about any family history of gout or other inflammatory conditions you might have.
The physical examination looks at the affected joint for swelling, redness, or tenderness. Your healthcare provider will also examine the affected joint’srange of motion(joint movement) and look for signs of tophi.
Blood work might be done to measure uric acid levels in the body. While high uric acid levels are a sign of gout, it is possible to have high levels and never develop gout.
What to Know About a Uric Acid Test
Ajoint aspiration testis the most accurate test for diagnosing gout.This test requires collectingsynovial fluid(the fluid that lubricates joints). To collect the fluid, the healthcare provider will insert a needle in the skin near the affected joint and withdraw the fluid into a tube. The fluid is then examined under a microscope to look for urate crystals.
Imaging of affected joints can rule out other causes of your joint symptoms. An ultrasound scan (uses sound waves to produce images) can detect urate crystals in the joints and soft tissues.
Some hospitals now use dual-energy computed tomography (CT) scanning (uses X-rays and a computer) to evaluate for gout also, if the diagnosis is not clear from other tests.
Understanding the Relationship Between Gout and Autoimmune Diseases
Treating gout focuses on reducing pain and symptoms during a gout attack and preventing future gout attacks.
Medications that improve symptoms during gout attacks include:
Your healthcare provider might also prescribe a medication to help lower uric acid levels in your body and prevent future gout attacks.Medicines for this purpose include:
Gout-Friendly Exercises to Meet Your Physical Goals
While medication can help improve symptoms or prevent attacks, you should also consider your diet as treatment, such as:
Oatmeal and Gout: Pros, Cons, and Recommendations
Summary
Gout is a type of inflammatory arthritis that causes sudden, painful attacks of swelling, tenderness, and redness in one or more joints. Gout can affect any joint but most often affects the big toe.
The cause of gout is too much uric acid in the body. The uric acid will crystalize and make its way in and around the joints leading to severe inflammation of the affected joint. Some people have a higher risk for gout, including males and people with a family history of gout.
A Word From Verywell
Gout is a lifelong condition. Most people can have a good quality of life if gout is diagnosed early and managed appropriately. But untreated gout can lead to joint damage.
Some people with gout might develop tophi, which occur when there is a buildup of uric acid in the joints and soft tissues. Others might develop other health problems, including kidney stones or severe arthritis. Let your healthcare provider know about all the symptoms you experience, whether related to gout or another health condition.
Frequently Asked QuestionsSome foods can help to lower uric acid. For example, low-fat dairy can lower uric acid levels and reduce future attacks. Cherries are also believed to help prevent attacks.Learn MoreHow Food Can Help Treat GoutA gout flare might start with burning, itching, or tingling of the affected joint an hour or two before the flare becomes worse. The joint might also feel stiff or a little sore. Some people do not experience any early signs and wake up in the middle of the night with a severely inflamed joint.Learn MoreSymptoms of GoutThere is no cure for gout, but the condition is treatable. Treatment aims to reduce symptoms during gout attacks and prevent future attacks. Healthcare providers will also prescribe medicines to reduce uric acid levels, which might prevent future flares.Learn MoreTreating Gout
Some foods can help to lower uric acid. For example, low-fat dairy can lower uric acid levels and reduce future attacks. Cherries are also believed to help prevent attacks.Learn MoreHow Food Can Help Treat Gout
Some foods can help to lower uric acid. For example, low-fat dairy can lower uric acid levels and reduce future attacks. Cherries are also believed to help prevent attacks.
Learn MoreHow Food Can Help Treat Gout
A gout flare might start with burning, itching, or tingling of the affected joint an hour or two before the flare becomes worse. The joint might also feel stiff or a little sore. Some people do not experience any early signs and wake up in the middle of the night with a severely inflamed joint.Learn MoreSymptoms of Gout
A gout flare might start with burning, itching, or tingling of the affected joint an hour or two before the flare becomes worse. The joint might also feel stiff or a little sore. Some people do not experience any early signs and wake up in the middle of the night with a severely inflamed joint.
Learn MoreSymptoms of Gout
There is no cure for gout, but the condition is treatable. Treatment aims to reduce symptoms during gout attacks and prevent future attacks. Healthcare providers will also prescribe medicines to reduce uric acid levels, which might prevent future flares.Learn MoreTreating Gout
There is no cure for gout, but the condition is treatable. Treatment aims to reduce symptoms during gout attacks and prevent future attacks. Healthcare providers will also prescribe medicines to reduce uric acid levels, which might prevent future flares.
Learn MoreTreating Gout
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Gout.National Kidney Foundation.Gout and kidney disease.Zhang WZ.Why does hyperuricemia not necessarily induce gout?.Biomolecules. 2021;11(2):280. doi:10.3390/biom11020280Evans PL, Prior JA, Belcher J, Hay CA, Mallen CD, Roddy E.Gender-specific risk factors for gout: a systematic review of cohort studies.Adv Rheumatol. 2019;59(1):24. doi:10.1186/s42358-019-0067-7Johns Hopkins Medicine.Kidney stones.Johns Hopkins Arthritis Center.Symptoms and diagnosis of gout.Qaseem A, McLean RM, Starkey M, et al.Diagnosis of acute gout: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017;166(1):52-57. doi:10.7326/M16-0569Slobodnick A, Shah B, Krasnokutsky S, Pillinger MH.Update on colchicine, 2017.Rheumatology (Oxford). 2018;57(suppl_1):i4-i11. doi:10.1093/rheumatology/kex453Johns Hopkins Arthritis Center.Treatment of gout.Major TJ, Topless RK, Dalbeth N, Merriman TR.Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts.BMJ2018;363:k3951. doi:10.1136/bmj.k3951Collins MW, Saag KG, Singh JA.Is there a role for cherries in the management of gout?Ther Adv Musculoskelet Dis. 2019;11:1759720X19847018. doi:10.1177/1759720X19847018Nielsen SM, Bartels EM, Henriksen M, et al.Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies.Ann Rheum Dis. 2017;76(11):1870-1882. doi:10.1136/annrheumdis-2017-211472
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Gout.National Kidney Foundation.Gout and kidney disease.Zhang WZ.Why does hyperuricemia not necessarily induce gout?.Biomolecules. 2021;11(2):280. doi:10.3390/biom11020280Evans PL, Prior JA, Belcher J, Hay CA, Mallen CD, Roddy E.Gender-specific risk factors for gout: a systematic review of cohort studies.Adv Rheumatol. 2019;59(1):24. doi:10.1186/s42358-019-0067-7Johns Hopkins Medicine.Kidney stones.Johns Hopkins Arthritis Center.Symptoms and diagnosis of gout.Qaseem A, McLean RM, Starkey M, et al.Diagnosis of acute gout: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017;166(1):52-57. doi:10.7326/M16-0569Slobodnick A, Shah B, Krasnokutsky S, Pillinger MH.Update on colchicine, 2017.Rheumatology (Oxford). 2018;57(suppl_1):i4-i11. doi:10.1093/rheumatology/kex453Johns Hopkins Arthritis Center.Treatment of gout.Major TJ, Topless RK, Dalbeth N, Merriman TR.Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts.BMJ2018;363:k3951. doi:10.1136/bmj.k3951Collins MW, Saag KG, Singh JA.Is there a role for cherries in the management of gout?Ther Adv Musculoskelet Dis. 2019;11:1759720X19847018. doi:10.1177/1759720X19847018Nielsen SM, Bartels EM, Henriksen M, et al.Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies.Ann Rheum Dis. 2017;76(11):1870-1882. doi:10.1136/annrheumdis-2017-211472
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Gout.National Kidney Foundation.Gout and kidney disease.Zhang WZ.Why does hyperuricemia not necessarily induce gout?.Biomolecules. 2021;11(2):280. doi:10.3390/biom11020280Evans PL, Prior JA, Belcher J, Hay CA, Mallen CD, Roddy E.Gender-specific risk factors for gout: a systematic review of cohort studies.Adv Rheumatol. 2019;59(1):24. doi:10.1186/s42358-019-0067-7Johns Hopkins Medicine.Kidney stones.Johns Hopkins Arthritis Center.Symptoms and diagnosis of gout.Qaseem A, McLean RM, Starkey M, et al.Diagnosis of acute gout: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017;166(1):52-57. doi:10.7326/M16-0569Slobodnick A, Shah B, Krasnokutsky S, Pillinger MH.Update on colchicine, 2017.Rheumatology (Oxford). 2018;57(suppl_1):i4-i11. doi:10.1093/rheumatology/kex453Johns Hopkins Arthritis Center.Treatment of gout.Major TJ, Topless RK, Dalbeth N, Merriman TR.Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts.BMJ2018;363:k3951. doi:10.1136/bmj.k3951Collins MW, Saag KG, Singh JA.Is there a role for cherries in the management of gout?Ther Adv Musculoskelet Dis. 2019;11:1759720X19847018. doi:10.1177/1759720X19847018Nielsen SM, Bartels EM, Henriksen M, et al.Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies.Ann Rheum Dis. 2017;76(11):1870-1882. doi:10.1136/annrheumdis-2017-211472
Centers for Disease Control and Prevention.Gout.
National Kidney Foundation.Gout and kidney disease.
Zhang WZ.Why does hyperuricemia not necessarily induce gout?.Biomolecules. 2021;11(2):280. doi:10.3390/biom11020280
Evans PL, Prior JA, Belcher J, Hay CA, Mallen CD, Roddy E.Gender-specific risk factors for gout: a systematic review of cohort studies.Adv Rheumatol. 2019;59(1):24. doi:10.1186/s42358-019-0067-7
Johns Hopkins Medicine.Kidney stones.
Johns Hopkins Arthritis Center.Symptoms and diagnosis of gout.
Qaseem A, McLean RM, Starkey M, et al.Diagnosis of acute gout: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2017;166(1):52-57. doi:10.7326/M16-0569
Slobodnick A, Shah B, Krasnokutsky S, Pillinger MH.Update on colchicine, 2017.Rheumatology (Oxford). 2018;57(suppl_1):i4-i11. doi:10.1093/rheumatology/kex453
Johns Hopkins Arthritis Center.Treatment of gout.
Major TJ, Topless RK, Dalbeth N, Merriman TR.Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts.BMJ2018;363:k3951. doi:10.1136/bmj.k3951
Collins MW, Saag KG, Singh JA.Is there a role for cherries in the management of gout?Ther Adv Musculoskelet Dis. 2019;11:1759720X19847018. doi:10.1177/1759720X19847018
Nielsen SM, Bartels EM, Henriksen M, et al.Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies.Ann Rheum Dis. 2017;76(11):1870-1882. doi:10.1136/annrheumdis-2017-211472
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