This condition often comes on suddenly and unexpectedly. Upon examination, a sufferer will find the joint at the base of the big toe to be hot, inflamed and so sensitive that even the slightest pressure will cause excruciating pain.
What Causes Gout?
Gout is caused by a buildup of too much uric acid in the body. This acid comes from the breakdown of substances called purines, which are found in all of the body’s tissues, as well as in many foods, such as liver, dried beans and peas. In a healthy body, uric acid will dissolve in the blood and then pass through the kidneys. It leaves the body in our urine. Uric acid might build up in the blood for many reasons, including:
● The body starts making more uric acid
● The kidneys do not sufficiently get rid of uric acid
● A person eats foods high in purines
High uric acid levels can cause hyperuricemia. Most cases do not result in gout, but some do.
What Are The Warning Signs?
Gout symptoms almost always come on suddenly -- often at night -- and rarely with warning. Among these symptoms, Mayo Clinic outlines that patients suffering from gout will experience:
Joint Pain
Gout most commonly affects the large joint of the big toe on either foot. It also might affect feet, ankles, knees, hands and wrists. The pain from an attack of gout is typically most severe within the first 12 hours after the attack starts and may be so excruciating that even the slightest pressure is unbearable. Many times, gout sufferers are woken from sleep because of this pain. A gout attack may peak as long as 24 to 48 hours after the symptoms first appear, and then goes away after five to seven days. While some attacks last only hours, others may go on for several weeks.
Discomfort
After the initial 12-hour period in the first attack of gout, the pain typically subsides but leaves lingering joint discomfort that can last from days to weeks. Subsequent attacks are more likely to be longer and affect multiple joints.
Inflammation
People suffering from an attack of gout have joints that become hot, swollen, tender and red. Often, the first symptom of gout is swelling of the big toe, accompanied by excruciating pain. In subsequent attacks, the swelling may affect other joints, primarily in the foot and knee.
Limited Range of Motion
As the disease progresses and becomes chronic, sufferers may experience decreased joint mobility. During its chronic stage, gout may affect many joints simultaneously, including the feet, knees and hands.
General Signs of Illness
People suffering from attacks of gout may develop chills and a mild fever (below 100.4), loss of appetite or general malaise (a general feeling of being unwell).
Get Treated
Because the pain of a gout attack typically subsides within a day, it may be tempting to assume that there was an injury. If you experience the onset of sudden, intense joint pain, call your doctor to determine if you are suffering from gout. It’s important to note that even though the attack has subsided, the urate crystals are still present, and a future attack is more likely to occur without medical attention. Left untreated, this disease can lead to worsened pain and joint damage. And without proper treatment, gout can lead to complications and chronic conditions, including:
● Recurrent gout: For some, an attack of gout is a one-time occurrence, and the condition never returns. For others, the attacks may return several times a year and get progressively worse. If ignored, gout can erode and cause destruction to the affected joint or joints.
● Advanced gout: Left untreated, deposits of urate crystals begin to form under the skin in nodules. These nodules will often develop in the extremities, like hands, feet or elbows. The nodules themselves aren’t typically painful but can become swollen and cause discomfort during gout attacks.
● Kidney stones: These same crystals that collect under the skin can begin to form and collect in the urinary tract, leading to the formation of kidney stones. Patients who develop chronic forms of gout can talk to their doctors about taking medications to reduce the risk of kidney stones, which are incredibly painful to pass once formed.
For those who are unlucky enough to have recurring gout attacks, the disease is a chronic illness. The good news is that it can be controlled. Once a diagnosis of gout has been made, you can work with your doctor to develop a treatment plan that likely will include medication and diet/lifestyle changes. Medications will be aimed at both treating acute attacks -- by reducing pain and inflammation in the joints and tissues -- and in preventing future attacks by lowering uric acid in the body. Among the lifestyle changes your doctor likely will recommend will be weight loss, diet changes to limit your intake of foods and beverages that contain purine, and limiting your alcohol consumption.
If you experience sudden, severe joint pain accompanied by a fever and a sensation that the joint is hot and inflamed, you should seek immediate medical care because this can be the sign of an infection.