Gout is a common form of arthritis characterised by repeated attacks of extreme joint pain, swelling and redness.
The most commonly affected joint is the big toe, but gout can affect your feet, ankles and knees, elbows, wrists and fingers.
Gout occurs when uric acid, a normal waste product, builds up in your bloodstream and forms urate crystals in a joint.
Your body makes uric acid when it breaks down purines, a substance found in your body and in some foods.
Uric acid normally dissolves in your blood, is processed by your kidneys and leaves your body in urine.
If your body makes too much uric acid, or your kidneys can’t clear enough of it out, it builds up in your blood. This is called hyperuricaemia.
Having hyperuricaemia doesn’t mean you’ll develop gout – in fact most people with hyperuricaemia don’t go on to develop gout. Because of this it’s thought that other factors such as your genes may be involved.
Similar attacks to gout can be caused by a condition called pseudogout (or acute calcium pyrophosphate arthritis). In this case, crystals of calcium (rather than urate) are deposited in joint cartilage and then shed into the joint space. This is likely to affect your knees and other joints more than the big toe and is most common in people with osteoarthritis.
You’re more likely to have a gout attack if you:
An attack of gout usually happens suddenly, often overnight. Symptoms include:
Gout is diagnosed using a number of tests including:
Early diagnosis and treatment is very important. The main goal for everyday management of gout is to reduce the level of uric acid in your blood so it can’t form crystals in the tissues or joints and cause joint damage.
The first step in treating your gout is getting the pain and inflammation under control. This may involve medication (e.g. anti-inflammatories, analgesics), cold packs on the swollen joint, and rest.
Once the painful attack is under control, your doctor may prescribe medications that lower the levels of uric acid in your blood. This will depend on things such as:
During a gout attack, you can reduce pain and swelling by applying an ice pack to the painful joint for short periods of time, and protecting and resting the joint.
Other things you can do to prevent future attacks:
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This information has been produced in consultation with and approved by: Musculoskeletal Australia.