Gout explained: symptoms, causes, and care

Gout is inflammatory arthritis caused by urate crystals collecting in and around a joint. An attack can bring sudden severe pain, warmth, redness, and swelling, often in one joint at a time. The big toe is a familiar site, but ankles, knees, feet, fingers, and other joints can also be involved. A symptom such as joint pain does not by itself establish gout; examination and testing may be needed.

When urate levels remain high, crystals can form in joint tissues. The immune system reacts to them, producing intense inflammation. Attacks may settle and recur, while ongoing crystal deposits can gradually affect joints and form firm lumps under the skin. Kidney disease, medicines, body weight, alcohol, dehydration, and inherited factors can influence urate handling, but gout can occur without one obvious cause. Other forms of arthritis and infection can look similar.

Arrange medical advice for a new or unusually severe attack, especially if the joint is hot and red. Treatment may include an anti-inflammatory medicine selected around your kidney function, stomach health, heart health, and other medicines. Long-term urate-lowering treatment may be considered when attacks recur or deposits cause problems. Take medicines as prescribed, drink normally unless a clinician has limited fluids, and discuss alcohol, weight, and diet changes without relying on a single food rule.

Seek urgent care for a painful hot swollen joint with fever, chills, feeling very unwell, a wound, or rapidly spreading redness, because joint infection requires prompt treatment. Get urgent advice for inability to pass urine, severe flank pain, or sudden weakness. A first attack should be assessed rather than labelled from symptoms alone.

Ask whether joint fluid, blood tests, or imaging can clarify the diagnosis; how kidney function affects medicine choices; whether you need urate-lowering treatment; and which symptoms should prompt same-day review.