You’re lying peacefully in bed, then suddenly you’re wide awake and something’s not right – your big toe is throbbing with a burning pain. If this has ever happened to you, you were likely experiencing gout. Gout is a painful form of inflammatory arthritis that can occur at any age and often appears suddenly at night.
While a gout flare-up is unpleasant, there are things you can do at home to ease symptoms and prevent gout before it starts. Below, we’ll cover the symptoms, causes and treatment options for gout, and how you can prevent gout flare-ups in the future.
Symptoms of gout can be sudden and intense
Symptoms of gout often come on suddenly and include severe pain, inflammation, redness, limited range of motion, swelling, tenderness and warmth at the affected area. A gout attack, or gout flare-up, can last a week or two and then subside. Some people experience frequent flare-ups while others may go years in between gout attacks.
Gout feels like a burning pain in your joint
Gout patients sometimes describe a gout attack as feeling like their joint is “on fire” due to the tenderness and warmth at the affected area. Gout pain can be intense, and symptoms often flare up and then go away, although lingering soreness may occur.
Gout looks like a painful, red and swollen joint
Gout is characterized by redness and swelling at the affected joint. It may be difficult to put on shoes or have anything touching the affected area due to gout swelling and tenderness.
Most people experience their first gout flare-up in the big toe joint (also called podagra, or gout of the foot), although gout can affect the ankle, knee, elbow, wrist and finger joints as well.
What causes gout? Uric acid buildup.
Gout is caused by a buildup of uric acid in the body, which then forms sharp crystals in and around the affected joint (also called hyperuricemia). Your body naturally creates uric acid when it breaks down chemicals called purines that are found in certain foods and drinks. Your kidneys usually filter this uric acid out of your system, but if you consume excess purines or your body does not filter them out properly, high uric acid levels can occur.
People with certain conditions are at higher risk for developing gout. These conditions include obesity, diabetes, high blood pressure, kidney disease, blood cancer and congestive heart failure.
Food doesn’t cause gout, but your diet can play a part
While specific gout-causing foods don’t exist, your diet can play a big part in the likelihood of developing gout. Purines are found in specific foods and drinks, including:
- Red meats such as beef, lamb, pork and bacon
- Gravy and meat sauces
- High-fructose corn syrup that breaks down into uric acid
- Sugary drinks and sweets that often have high levels of high fructose corn syrup or table sugar, which also breaks down into uric acid
- Alcohol, which limits your kidneys’ ability to properly filter uric acid out of your body
- Organ meats such as liver, tripe, sweetbreads, brains and kidneys
- Game meats like venison, veal and goose contain high levels of purines
- Seafood, including codfish, mussels, tuna, trout, haddock, herring and scallops
- Turkey, especially deli turkey due to its processed nature
Genetics and family history can affect whether you develop gout
Gout can be hereditary, which means you are more likely to develop gout if you have a parent or grandparent who has experienced it. It’s important to note any family history of gout when talking to your care team.
Gout is more prominent in men at an earlier age due to naturally higher uric acid levels in the body. While men can develop gout between 30-50 years old, women usually don’t start to develop it until after menopause when their uric acid levels increase.
Gout testing and diagnosis
If you think you have gout, it’s time to see a primary care doctor or clinician. Gout is painful, but highly treatable. If left untreated, it can develop into a condition known as tophi, where uric acid crystals build up in the skin and can permanently damage your joints and internal organs.
Gout can be diagnosed through a variety of imaging tests, such as X-rays, ultrasounds, MRIs and CT scans. Your care team may also order a blood test or joint aspiration test, where a sample of fluid is taken from inside a joint. After testing, your care team will go over your results with you and note any possible causes for the gout attack. They’ll work with you to develop a plan for preventing gout flare-ups in the future.
Treatment options for gout
Treatment for gout often includes a combination of home remedies, medications and preventive measures such as watching your diet. During a gout attack it is helpful to:
- Avoid alcohol and sweet drinks (which create more uric acid in the body)
- Drink plenty of water
- Limit stress on the affected joint
- Elevate the joint above the level of your heart
- Ice the affected joint with an ice pack wrapped in a thin towel, or a cold compress for 15-20 minutes at a time a few times a day
Medications for gout
There are a few over-the-counter medicines, such as Naproxen (Aleve) and ibuprofen (Advil), that help manage gout symptoms and reduce swelling during a gout attack. However, these medicines are nonsteroidal anti-inflammatory drugs (NSAIDS) and some people shouldn’t take NSAIDs due to underlying health conditions. It’s best to talk to your primary care doctor or clinician before taking these medicines.
Some prescription medications can help reduce the severity and duration of a gout attack when it strikes. Colchicine and corticosteroids are prescription medications that reduce inflammation, thereby helping to relieve gout attack symptoms. Corticosteroids can be taken orally, or injected directly into the affected joint or a nearby muscle to provide relief.
Once the gout flare-up is under control, it’s a good idea to prevent future attacks. Your doctor may also prescribe medication like allopurinol to help lower the uric acid levels in your body, which can help prevent future gout attacks. Your doctor can help determine which medication may be right for you.
See a primary care doctor if you suspect gout
Gout shares many symptoms with general infections – intense pain, swelling, and red or discolored skin – so it’s recommended to see your primary care doctor if your symptoms are not getting better.
Gout is a painful condition, but it’s very treatable. Untreated gout can lead to permanent joint and organ damage, so make an appointment if you suspect something isn’t right. If you need more advanced care, your doctor can also refer you to a rheumatologist, a doctor who specializes in treating conditions like gout.
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