Symptoms of gout are unlike those of general arthritic conditions. There is striking difference in how the symptoms and the intensity of pain appear with gout than with most forms of arthritis.
Many types of arthritis can be debilitating but the progress and worsening of those conditions is usually gradual.
However, symptoms of gout aren’t gradual. Gout attacks usually appear very quickly, with severe pain and no warning.
Gout symptoms can differ from person to person but the most common are:
Pain. The most common symptom of gout is extreme pain, often described as being like a repeated stabbing of hot knives with sharp points. The pain may so severe that the person cannot bear weight on the affect food or knee. Many sufferers of goat in the big toe cannot bear even the weight of a single sheet on the affected joint.
Sudden Appearance. Often, gout attacks occur without warning and can progress rapidly from no discomfort to severe, debilitating pain.
Nocturnal Attacks and Interrupted Sleep. Flare-ups in the middle of the night when the sufferer was previously soundly asleep are common.
There is a combination of reasons why symptoms of gout appear more commonly at night.
- The high frequency of night attacks is due to drops in body temperature during sleep. The lowering of the temperature triggers the formation of uric acid crystal in the joint.
- The fact that the extremities tend to have a lower temperature than the rest of the body also lead to a higher tendency for night time attacks if the gout is in the toe or fingers, compared to when the sufferer has gout in other parts of the body, such as the knee.
- Another factor is that when the body is sleeping, with the joints inactive, fluid that is normally around the joints is drawn away by the body. The uric acid is stays in the joint, thus increasing in concentration triggering the formation of uric acid crystals.
Keeping the temperature slightly elevated – keeping the big toe warm with bed socks, using water bottles, etc – tends to provide some relief and may reduce the number of night time attacks.
Only one joint is affected. Gout symptoms are highly localised. The vast majority of gout sufferers (around 90%) experience gout only in one joint. About half of these experience it in the big toe. Other common areas are the ankle, foot, heel, knee, elbow, wrist and fingertips.
Short duration. Gout symptoms are literally an ‘attack’. The pain hits, intensifies and then stops and goes away – until the next attack. Without medication a gout attack can typically last for 3 to 8 days but can extend to a couple of weeks. During the affected period the intensity of pain will be at its maximum level during the initial part of the attack and then progressively lose intensity.
Swollen Joints. The most common visible symptom of gout is swelling. Joints affected by gout tend to be visibly swollen. The inflammation is the body’s response to the irritation in the joints caused by the uric acid crystals.
Warm, Red Skin. Another visible but not as common symptom of gout is redness. The joint will appear red and warm to the touch.
Stiffness. Inflammation and pain can leave the joint stiff and limit its range of movement.
Fever and Flu-like Symptoms. The reaction of the immune scan system can result in fever and muscle aches and pains. This is one of the secondary symptoms of gout, that is, a symptom of the body reacting to the initial symptoms of gout.
Tophi. Some sufferers of gout that have had the condition for years may experience the appearance of small white or yellow lumps seen through the skin. These are known as Tophi, nodules created by the collection of uric acid crystals. The condition, although usually painless, is known as chronic tophaceous gout and is the most disabling form of gout.
Kidney Stones. Kidney stones are a possible secondary symptom of gout. If gout cause an accumulation of uric acid crystals kidneys, the end result could be kidney stones. Gout sufferers can develop kidney stones with or without more common gout symptoms, like joint inflammation. If left untreated kidney stones can result in kidney damage or kidney failure.
Joint Damage. If left untreated long enough gout can become chronic, get to the stage of tophi developing and then result in permanent joint damage.
The ways in which gout manifest in an individual can depend on which of the particular causes of gout led to his or her condition. Therefore, not all gout sufferers will experience all of the primary and secondary symptoms of gout.