Gout

What is gout?

Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). There are times when symptoms get worse, known as flares, and times when there are no symptoms, known as remission. Repeated bouts of gout can lead to gouty arthritis, a worsening form of arthritis.

There is no cure for gout, but you can effectively treat and manage the condition with medication and self-management strategies.

 

What are the signs and symptoms of gout?

Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remission—weeks, months, or years—without symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.

Symptoms in the affected joint(s) may include:

  • Pain, usually intense.
  • Swelling.
  • Redness.
  • Heat.

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What causes gout?

Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat. When there is too much uric acid in the body, uric acid crystals (monosodium urate) can build up in joints, fluids, and tissues within the body. Hyperuricemia does not always cause gout, and hyperuricemia without gout symptoms does not need to be treated.

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What increases your chances for gout?

The following make it more likely that you will develop hyperuricemia, which causes gout:

  • Being male.
  • Being obese.
  • Having certain health conditions, including:
    • Congestive heart failure.
    • Hypertension (high blood pressure).
    • Insulin resistance.
    • Metabolic syndrome.
    • Diabetes.
    • Poor kidney function.
  • Using certain medications, such as diuretics (water pills).
  • Drinking alcohol. The risk of gout is greater as alcohol intake goes up.
  • Eating or drinking food and drinks high in fructose (a type of sugar).
  • Having a diet high in purines, which the body breaks down into uric acid. Purine-rich foods include red meat, organ meat, and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout, and tuna.

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How is gout diagnosed?

A medical doctor diagnoses gout by assessing your symptoms and the results of your physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint.

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Who should diagnose and treat gout?

The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases. Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a provider near you, visit the database of rheumatologistsExternal on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout.

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How is gout treated?

Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to

  • Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
  • Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food (like red meat or organ meat), may help prevent future attacks. Changing or stopping medications associated with hyperuricemia (like diuretics) may also help.
  • Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.

In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.

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How can I manage my gout and improve my quality of life?

Gout affects many aspects of daily living, including work and leisure activities.  Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.

For gout in particular:

  • Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines (like a diet rich in red meat, organ meat, and seafood), and limit alcohol intake (particularly beer and hard liquor).

CDC’s Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.

  • Learn self-management skills. Join a self-management education class, which helps people with arthritis and other chronic conditions—including gout—understand how arthritis affects their lives and increase their confidence in controlling their symptoms and living well. Learn more about the CDC-recommended self-management education programs.
  • Get physically active. Experts recommend that adults engage in 150 minutes per week of at least moderate physical activity. Every minute of activity counts, and any activity is better than none. Moderate, low impact activities recommended include walking, swimming, or biking. Regular physical activity can also reduce the risk of developing other chronic diseases such as heart disease, stroke, and diabetes. Learn more about physical activity for arthritis.
    • Go to effective physical activity programs. For people who worry that physical activity may make arthritis worse or are unsure how to exercise safely, participation in physical activity programs can help reduce pain and disability related to arthritis and improve mood and the ability to move. Classes take place at local Ys, parks, and community centers. These classes can help people with arthritis feel better. Learn more about CDC-recommended physical activity programs.
  • Talk to your doctor. You can play an active role in controlling your arthritis by attending regular appointments with your health care provider and following your recommended treatment plan. This is especially important if you also have other chronic conditions, like diabetes or heart disease.
  • Lose weight. For people who are overweight or obese, losing weight reduces pressure on joints, particularly weight bearing joints like the hips and knees. Reaching or maintaining a healthy weight can relieve pain, improve function, and slow the progression of arthritis.
  • Protect your joints. Joint injuries can cause or worsen arthritis. Choose activities that are easy on the joints like walking, bicycling, and swimming. These low-impact activities have a low risk of injury and do not twist or put too much stress on the joints. Learn more about how to exercise safely with arthritis.

Learn more about gout

Learn more about arthritis