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Gout-Causes, Symptoms, Diagnoses, Causes, Prevention

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Gout-Causes, Symptoms, Diagnoses, Causes, Prevention

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Burning pain in the big toe at night is a sign of gout. Read the article to know ways to get rid of this pain

Medically reviewed by

Dr. Srivastava Durgesh

Published At August 6, 2019
Reviewed AtDecember 13, 2023

What Is Gout?

Gout is a complex form of arthritis, which results from the buildup of uric acid in the body. It causes sudden pain, swelling, and redness in the joints, most commonly the big toe. The person might feel like the big toe is on fire, suddenly in the middle of the night. Gout causes bouts of severe pain and tenderness in the joints. It commonly affects men, and it affects women usually after menopause.

Quick Facts

  • Gout is a type of arthritis.

  • Pain and inflammation of the joint result due to uric acid crystal formation in them.

  • Burning pain in the big toe is characteristic of gout.

  • Medications can treat most cases of gout.

Where Does Gout Usually Occur?

Gout usually affects the large joint but in some cases, it can also affect other smaller joints, such as

  • Ankle.

  • Knee.

  • Feet.

  • Hands and wrist.

  • Elbows.

What Causes Gout?

Hyperuricemia (excess uric acid in the blood) causes gout. Uric acid is produced when purines, which are naturally found in the body and food like seafood and organ meats, break down. Usually, the uric acid that is produced, gets excreted through the urine.

But if the body produces too much uric acid or the kidneys are not able to efficiently excrete it, then excess uric acid builds up in the body. The excess uric acid forms urate crystals, which accumulate in the joints. These urate crystals result in inflammation and intense joint pain.

Eating too much of foods like shellfish, red meat, sweet juices, and salt can also result in gout. Kidney problems, thyroid diseases, and medications (diuretics and Cyclosporine) can affect the body’s ability to eliminate uric acid.

What Are the Symptoms of Gout?

Patients usually experience sudden and intense pain, mostly in the night. The symptoms are:

  • Severe joint pain, most commonly the big toe. The other joints that can get affected are the knee, ankles, elbows, and fingers.

  • The pain is severe for the first 4 to 12 hours. After which, the pain subsides and can last for days to weeks.

  • The joints appear red and become inflamed.

  • The joint range of motion decreases.

What Are the Stages of Gout?

The four stages of gout are:

  1. Asymptomatic Hyperuricemia- This stage is when the uric acid in the blood is high, but no other symptoms are seen.

  2. Acute Gout- In this stage, the high uric acid results in the formation of uric acid crystals in one joint. This causes pain, swelling, and tenderness in the affected joint. The pain will develop suddenly and last for 3 to 10 days. A person may have multiple such attacks over months or years.

  3. Interval Gout- Otherwise called intercritical gout, is the time between two attacks of acute gout.

  4. Chronic Tophaceous Gout- If gout is left untreated for many years, hard nodules (tophi) form in the joints and surrounding tissue. This permanently damages the joints.

What Are the Risk Factors for Gout?

Some of the factors that increase the risk of gout are:

  • Postmenopausal women.

  • Men between 40 and 50 years of age.

  • Family history of gout.

  • Consuming more of purine-rich food like red meat, shellfish, etc.

  • Consuming more alcohol.

  • Taking medicines like Cyclosporine or diuretics.

  • Hypertension.

  • Kidney disease.

  • Thyroid disease.

  • Diabetes.

  • Sleep apnea.

How Is Gout Diagnosed?

Depending on the clinical presentation, medical history, and physical examination, the doctor will come to a diagnosis. If necessary, the person might need to do the following tests:

  • Blood Test- To check the level of uric acid and creatinine. Diagnosis cannot be made only based on the levels of uric acid, as some people with high uric acid do not develop any symptoms.

  • Joint Fluid Test - A needle is used to draw fluid from the joint, and urate crystal can be seen under a microscope.

  • X-Ray- To rule out other causes of joint pain.

  • Ultrasound and CT scan (Computed Tomography)- To detect urate crystals in the joint.

What Are the Treatment Options for Gout?


  • Drugs used to treat acute attacks of gout are as follows:

    • Nonsteroidal Anti-inflammatory Drugs (NSAIDs) - Ibuprofen, Naproxen, Indomethacin.

    • Colchicine.

    • Corticosteroids - Prednisone.

  • Drugs to help reduce uric acid levels:

    • Block the Production of Uric Acid - Xanthine oxidase inhibitors (Allopurinol, Febuxostat).

    • Aid in Uric Acid Removal - Uricosurics (Probenecid, Iesinurad).

Home Remedies:

  • Avoid alcoholic and sweetened beverages.

  • Limit consumption of red meat, organ meat, and shellfish.

  • Exercise regularly.

  • Foods like coffee, vitamin C, and cherries can be used to lower uric acid levels.

How to Prevent Gout?

Steps to prevent gout are:

  • Do not drink.

  • Eat a diet low in purine-rich food.

  • Consume a low-fat diet.

  • Reduce weight.

  • Quit smoking.

  • Drink a lot of water.

What Are the Complications of Gout?

Some of the complications are:

  • Recurrent gout may lead to permanent joint destruction.

  • Tophi can form in different parts of the body.

  • Kidney stone.

  • Chronic gout leads to impaired renal function and may cause secondary hypertension.

How long will gout last?

There is no permanent cure for gout but it is not fatal. Treatments for gout can reduce the frequency of attacks and can lower the level of uric acid. There will be flares of symptoms that occur if a person has gout. But if it is not treated then the occurance of flares will be very frequent.

What Are the Risk Factors Associated With Gout?

Some common risk factors are:

  • Diet:

A diet that is rich in red meat and sweetened beverages can enhance the uric acid level which can result in gout. High consumption of beer is also a risk factor.

  • Medical condition:

Untreated increases blood pressure and chronic conditions such as diabetes, obesity, and heart and kidney conditions also increase the risk of gout.

  • Medications:

Certain medications can also increase the risk of gout.

  • Increased Weight:

If the person is overweight then more amount of uric acid will be produced and the kidney finds it difficult to eliminate the uric acid. So this in turn increases the risk of gout.

  • Family History:

If the family has a history of gout there are increased chance of the person being affected by gout.

  • Surgery or trauma:

Some people can be affected by gout after surgery or trauma. Some can also get affected by gout after getting a vaccination.

  • Age and Sex:

Men are at higher risk of being affected by gout than women as the level of uric acid in women is less.


Gout is a severe painful form of arthritis. Gout usually occurs due to increased uric acid which forms crystals that accumulate in the joints, which results in swelling and pain. Gout does not have a permanent cure but treatment can help to manage the symptoms and can help to reduce the frequency of the attacks.

Frequently Asked Questions


What Can Trigger An Attack Of Gout?

Some of the main triggers are joint injury, surgery, chronic illness, infection, taking Cyclosporine and diuretic medications, and chemotherapy. The other causes are fasting, crash diet, alcoholism, dehydration, and sweet beverages.


What Is The First Sign Of Gout?

The first signs of gout are sudden and severe joint pain, joint tenderness, and joint stiffness. It usually affects the joint of the big toe.


What Foods Get Rid Of Gout?

Foods like fruits, vegetables, soy items, whole grains, and low-fat dairy products might help in lowering uric acid levels and prevent gout.


What Is The Best Thing To Drink If You Have Gout?

Drinking coffee and cherry juice regularly has shown to reduce the risk of gout.


What Is The Best Painkiller For Gout Pain?

Painkillers like Ibuprofen, Naproxen, Colchicine, and Prednisone are effective in relieving gout pain.


How Long Does Gout Last?

The acute attacks of gout can last anywhere between 3 to 10 days.


How To Get Rid Of Gout?

Making lifestyle changes and avoiding foods that trigger gout will prevent acute attacks. During acute attacks, painkillers like Ibuprofen, Naproxen, Colchicine, and Prednisone are used.


What Foods Cause Gout?

Food items that need to be avoided are alcohol, red meat, organ meat (kidney, liver), seafood (shrimp, lobster), and sweetened beverages.


How To Treat Gout Naturally?

Some natural treatment includes cherries, magnesium supplements, ginger, apple cider vinegar, and hibiscus.
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Dr. Srivastava Durgesh
Dr. Srivastava Durgesh



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