If you've already been diagnosed with gout and you have an attack, see your GP if any medication you've been prescribed see below doesn't start working within a couple of days.
Read more about diagnosing gout. If you produce too much uric acid or your kidneys don't filter enough out, it can build up and cause tiny sharp crystals to form in and around joints. These crystals can cause the joint to become inflamed red and swollen and painful. Read more about the causes of gout. With treatment, many people are able to reduce their uric acid levels sufficiently to dissolve the crystals that cause gout — and as a result have no further attacks.
However, lifelong treatment is usually required. Read more about treating gout. Read more about the complications of gout. Pseudogout is a similar condition to gout, but usually affects the knee joint first. It's a form of arthritis that causes pain, stiffness, tenderness, redness, warmth and swelling in one or more of your joints - commonly the knee or wrist.
The main symptom of gout is a sudden attack of severe pain in one or more joints, typically your big toe. The intense pain can make getting around difficult. Even the light pressure of a bed cover or blanket can be unbearable. Contact your GP immediately or call the service if you have both:. If you've already been diagnosed with gout and you have an attack, see your GP if any medication you've been prescribed doesn't start working within a couple of days.
Read more about diagnosing gout and treating gout. Gout is caused by small crystals forming in the joints, resulting in severe pain, tenderness and swelling. These crystals can grow when a waste product called uric acid starts to build up to high levels in the body.
If your kidneys don't filter out enough uric acid, or your body is producing unusually high levels of it, it can build up in the body and turn into microscopic crystals. These crystals usually form in and around the joints, possibly because the temperature in these areas is slightly lower than the rest of the body.
If they get into the space between joints, the crystals can cause painful inflammation redness and swelling. A high level of uric acid in the blood is the main factor that increases your risk of developing gout. However, it's still uncertain why some people with a high level of uric acid in the blood develop gout, while others with an equally high level don't. Certain medications can increase your uric acid levels and your risk of developing gout.
These include:. Uric acid is created when the body breaks down purines. Eating foods that contain a high level of purines can increase your risk of gout. Beer, fortified wines like port, and spirits do this more than wine. Moderate consumption of wine — one or two glasses a day — shouldn't significantly increase your risk of gout. Some research has found that drinking sugar-sweetened soft drinks and drinks with high levels of fructose a naturally occurring sugar found in many fruits had an increased risk of gout.
Studies have shown that gout often runs in families. Around one in five people with gout have a close family member with the condition. Your GP may suspect gout based on your symptoms. Sometimes further tests will be needed to confirm the diagnosis and rule out other possible causes.
See your GP if you experience symptoms of gout for the first time. Your GP will ask about your symptoms and medical history, and examine the affected area, to help make a diagnosis. They may also ask you about your diet, particularly your intake of beer, spirits and foods high in purines, such as red meat and seafood. Your GP may be unable to make a firm diagnosis straight away and you may be referred for further tests. These will either confirm the diagnosis of gout or rule out other conditions.
A sample of fluid may be taken from the affected joint. The fluid can be checked for the small crystals that cause gout, and it can be tested for infection to rule out septic arthritis. A blood test known as a serum uric acid test may be used to measure the amount of uric acid in your blood. A high level or uric acid is often associated with gout.
This is because the level of uric acid in your blood can drop when uric acid crystals form in the joints. An X-ray is rarely used to diagnose gout because the condition isn't usually detectable using this method. However, an X-ray is sometimes used to help rule out similar conditions that affect the joints, such as chondrocalcinosis a build-up of calcium crystals in the joints or to assess whether there has been any joint damage due to repeated or persistent attacks of gout.
An ultrasound scan of an affected joint is a simple and safe investigation that's increasingly used to detect crystals in the joints. It can also detect crystals deep in the skin that aren't obvious during a physical examination.
Treatment for gout includes pain relief to help you cope with a gout attack, as well as medication and lifestyle changes to prevent further attacks. Apply the ice pack to your joint for around 20 minutes. Don't apply ice directly to your skin and don't apply it for more than 20 minutes at a time because this could damage the skin.
If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first. Non-steroidal anti-inflammatory drugs NSAIDs are usually recommended as the first treatment for gout. They work by reducing pain and inflammation during an attack. If you've been prescribed NSAIDs, it's a good idea to have them with you at all times so you can use them at the first sign of a gout attack.
Continue to take your medication throughout the attack and for 48 hours afterwards. This reduces the risk of the NSAID causing indigestion , stomach ulcers and bleeding from the stomach. It's best to have it with you at all times so you can use it at the first sign of a gout attack.
Your GP will tell you how long to take it for and how often. When taken in high doses, side effects of colchicine include feeling sick, abdominal tummy pain and diarrhoea. Corticosteroids are sometimes used to treat severe cases of gout if other treatments don't work or you're unable to take an NSAID or colchicine. A short course of steroid tablets often provides relief, but they can't be used long-term in high doses as they cause side effects, including:.
Corticosteroids can also be given by injection to provide rapid pain relief. This can be either into a muscle, a vein or directly into the affected joint. You can reduce your chances of having further gout attacks by taking medication and making lifestyle changes to reduce the level of uric acid in your body. The condition usually affects the joint at the base of the big toe. A gout attack can occur at any random time, such as the middle of the night while you are asleep. Prior to visiting your podiatrist to receive treatment for gout, there are a few things you should do beforehand.
If you have gout you should write down your symptoms--including when they started and how often you experience them, important medical information you may have, and any questions you may have. Writing down these three things will help your podiatrist in assessing your specific situation so that he or she may provide the best route of treatment for you. If you have any questions, please feel free to contact our office located in Frankfort, IL.
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Switch to Accessible Site. Show references Gout. Centers for Disease Control and Prevention. Accessed Dec. Goldman L, et al. Crystal deposition diseases. In: Goldman-Cecil Medicine. Elsevier; Ferri FF. In: Ferri's Clinical Advisor American College of Rheumatology.
Caffo AL. Clinical manifestations and diagnosis of gout. Gout or pseudogout adult. Mayo Clinic. Gloperba prescribing information. Food and Drug Administration. Accessed Jan.
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