What is it?
Gout is a form of inflammatory arthritis that causes sudden, severe pain, swelling and tenderness – most often in the large joint of the big toe. However, gout isn't limited to the big toe; it can affect other joints including the feet, ankles, knees, hands, wrists, elbows and sometimes soft tissue and tendons. It usually affects only one joint at a time, but it can become chronic and, over time, affect several joints.
A gout attack can last anywhere from a few days to two weeks, if untreated. An estimated 6.1 million Americans have experienced at least one gout attack. The disease most commonly affects men and can manifest anywhere from age 30 onward. Women get gout too, although they are at a slightly lower risk, and it usually appears after menopause.
What are the effects?
For many people, the first symptom of gout is excruciating pain and swelling in the big toe – often following a trauma, such as an illness or injury. Subsequent attacks may occur off and on in other joints, primarily those of the foot and knee, before becoming chronic. In its chronic stage, gout can affect many joints, including those of the hands. Other problems related to gout can include the formation of tophi, or lumps of crystals under the skin, in the joints and in bone; kidney stones; and impaired kidney function.
How Is it diagnosed?
A doctor who has experience with gout attacks may be able to recognize this type of inflammatory arthritis simply by evaluating signs and symptoms, such as:
The only way for your doctor to make a definite diagnosis of gout is to examine synovial fluid – a lubricating liquid found inside your joints – under a microscope. The presence of uric acid crystals signifies gout. Blood tests can determine if your uric acid levels are elevated, but not everyone with a high level of uric acid develops gout.
What are the treatment options?
Although gout is chronic, it can be controlled – and you can get on with living your life. Once your doctor has confirmed a gout diagnosis, you'll work together to come up with a treatment plan likely involving both medication and lifestyle changes.
The first objective will be to relieve the pain and inflammation of the current gout attack. Once the gout attack is under control, which can take a few hours or a couple of days, you and your doctor will focus on managing the disease long-term. Your efforts will center on preventing future attacks, avoiding the long-term damage to your joints and chronic pain associated with uncontrolled gout and preventing the formation of tophi, lumps of crystallized uric acid that can form in the affected joints or surrounding tissues.