How does gout feel like

So exquisite and lively meanwhile is the feeling of the part affected, that it cannot bear the weight of bedclothes nor the jar of a person walking in the room. Some patients only experience acute gout attacks which may be limited to times per year or even times in lifetime. However, for some patients, gout can be a chronic, relapsing problem with multiple severe attacks that occur at short intervals and without complete resolution of inflammation between attacks.

This form of gout, called chronic gout, can cause significant joint destruction and deformity and may be confused with other forms of chronic inflammatory arthritis such as rheumatoid arthritis. Frequently, uric acid tophi hard, uric acid deposits under the skin are present and contribute to bone and cartilage destruction.

Tophi are diagnostic for chronic tophaceous gout. Tophi can be found around joints, in the olecranon bursa, or at the pinna of the ear. With treatment, tophi can be dissolved and will completely disappear over time. It is important to recognize that although almost uniformly all patients with gout have hyperuricemia high levels of uric acid in the blood …all patients with hyperuricemia do not have gout. Although most patients will have elevated levels of uric acid in the blood for many years before having their first gout attack, there is no current recommendation for treatment during this period in the absence of clinical signs or symptoms of gout.

Hard deposits, called tophi, can build up on your joints and in other places, like your ear. These lumps may be painful and swollen, and they can permanently damage your joints.

Which one of these surgeries your doctor recommends depends on the extent of the damage, where the tophi are located, and your personal preferences. Certain conditions, such as blood and metabolism disorders or dehydration, make your body produce too much uric acid.

A kidney or thyroid problem, or an inherited disorder, can make it harder for your body to remove excess uric acid. For some people, gout is caused by consuming foods that are high in gout-producing purines. Most people can tolerate high-purine foods. But if your body has trouble releasing excess uric acid, you may want to avoid certain foods and drinks, such as:.

Some foods help reduce uric acid levels in the body and are good choices if you have gout. Alcohol , like red meat and seafood, is high in purines. When your body breaks down purines, the process releases uric acid. More uric acid increases your risk of having gout. Alcohol can also reduce the rate at which your body removes uric acid.

Not everyone who drinks will develop gout. But a high consumption of alcohol more than 12 drinks per week can increase the risk — especially in men. Beer is more likely than liquor to influence the risk. Your doctor can diagnose gout based on a review of your medical history, a physical exam, and your symptoms. Your doctor will likely base your diagnosis on:. Your doctor may also order a test to check for a buildup of uric acid in your joint. A sample of fluid taken from your joint can show whether it contains uric acid.

They may also want to take an X-ray of your joint. If you have symptoms of gout, you can start with a visit to your primary care doctor. If your gout is severe, you may need to see a specialist in joint diseases. Certain foods, medications, and conditions can set off gout symptoms. You may need to avoid or limit foods and drinks like these, which are high in purines:. Some medications you take to manage other conditions increase the level of uric acid in your blood.

Talk with your doctor if you take any of these drugs:. Sometimes it can be hard to pinpoint which of these factors is behind your gout attacks. Keeping a diary is one way to track your diet, medications, and health to help identify the cause of your symptoms. If you have medical conditions or take medications that raise your risk of gout, ask your doctor how you can lower your risk of gout attacks. Symptoms of gout 3. Causes of gout 4. Diagnosing gout 5.

Treating gout 6. Complications of gout. About gout Gout is a type of arthritis in which small crystals form inside and around the joints. It's estimated that between one and two in every people in the UK are affected by gout. Signs and symptoms of gout Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers. Signs and symptoms of gout include: severe pain in one or more joints the joint feeling hot and very tender swelling in and around the affected joint red, shiny skin over the affected joint Symptoms develop rapidly over a few hours and typically last three to 10 days.

Almost everyone with gout will experience further attacks at some point, usually within a year. When to see your GP See your GP if you suspect you have gout and it hasn't been previously diagnosed, particularly if the pain keeps getting worse and you also have a high temperature fever. What causes gout? Gout is caused by a build-up of a substance called uric acid in the blood. Treatments for gout If you have gout, treatment is available from your GP to: relieve symptoms during an attack — this can be done using ice packs and by taking medications such as non-steroidal anti-inflammatory drugs NSAIDs , colchicine or corticosteroids prevent further attacks — through a combination of lifestyle changes, such as losing weight or changing your diet, and taking medication that lowers uric acid levels, such as allopurinol 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.

Can gout cause further problems? Sometimes gout can lead to further problems, particularly if it's left untreated. These can include: kidney stones small firm lumps of uric acid crystals under the skin called tophi permanent joint damage Read more about the complications of gout.

What's pseudogout? Symptoms of gout The main symptom of gout is a sudden attack of severe pain in one or more joints, typically your big toe. Other symptoms can include: the joint feeling hot and very tender, to the point of being unable to bear anything touching it swelling in and around the affected joint red, shiny skin over the affected joint peeling, itchy and flaky skin as the swelling goes down The intense pain can make getting around difficult.

Which joints can be affected? Gout can affect almost any joint and can occur in more than one joint at the same time. The joints towards the ends of the limbs tend to be affected more often, including the: toes — particularly the big toe joint midfoot where your shoelaces sit ankles knees fingers wrists elbows If gout is left untreated, it's likely to affect more joints over time.

Pattern of symptoms Attacks of gout tend to: occur at night, although they can happen at any time develop quickly over a few hours last between three and 10 days — after this time, the affected joint should start to return to normal, but the problem can persist if treatment isn't started early come back — you may experience attacks every few months or years become more frequent over time if not treated It's difficult to predict how often attacks will occur and when exactly they will happen.

When to seek medical advice See your GP if you suspect you have gout and it hasn't been previously diagnosed. Contact your GP immediately or call the service if you have both: severe, worsening joint pain and swelling a high temperature fever of 38C Causes of gout Gout is caused by small crystals forming in the joints, resulting in severe pain, tenderness and swelling. Uric acid Uric acid is created when the body breaks down chemicals known as purines.

What can increase your risk? Other factors that may increase your risk of developing gout are outlined below. Medical conditions Some underlying medical conditions can increase your risk of developing gout, including: high blood pressure diabetes kidney disease high levels of fat and cholesterol in your blood obesity metabolic syndrome a combination of diabetes, high blood pressure and obesity psoriasis a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales osteoarthritis Medication Certain medications can increase your uric acid levels and your risk of developing gout.

These include: diuretics water tablets — used to treat high blood pressure or an abnormal build-up of fluid in your body certain medicines used to treat high blood pressure — including beta-blockers and ACE inhibitors low-dose aspirin — used to reduce the risk of blood clots niacin — used to treat high cholesterol ciclosporin — used to treat conditions such as psoriasis some chemotherapy medicines Diet Uric acid is created when the body breaks down purines.

Foods naturally high in purines include: red meat — such as beef, lamb and pork seafood — especially shellfish and oily fish offal — such as liver, kidneys and heart Alcohol Alcoholic drinks can raise the level of uric acid in the blood. Sugary drinks Certain sugary drinks may also increase your risk of gout. Family history Studies have shown that gout often runs in families.

Diagnosing gout Your GP may suspect gout based on your symptoms. Further tests Many conditions can cause gout-like symptoms. Joint fluid test A sample of fluid may be taken from the affected joint. Blood test A blood test known as a serum uric acid test may be used to measure the amount of uric acid in your blood. X-ray An X-ray is rarely used to diagnose gout because the condition isn't usually detectable using this method. Ultrasound scan An ultrasound scan of an affected joint is a simple and safe investigation that's increasingly used to detect crystals in the joints.

Treating gout 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. Pain relief for a gout attack What to do during an attack You should: take any medication you've been prescribed as early as possible after you notice an attack see below — this should start to have an effect within two or three days rest and raise the limb avoid knocking or damaging the affected joint keep the joint cool — remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel ensure you're well hydrated Apply the ice pack to your joint for around 20 minutes.

NSAIDs used to treat gout include naproxen, diclofenac and etoricoxib. Colchicine reduces some of the swelling and pain associated with a gout attack. Corticosteroids 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: weight gain thinning of the bones osteoporosis easy bruising muscle weakness Corticosteroids can also be given by injection to provide rapid pain relief.

Medication and lifestyle changes to prevent further attacks 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. Medication Medication to reduce uric acid levels — known as urate-lowering therapy ULT — is usually recommended if you have recurrent attacks of gout or you have complications of gout.

An attack of gout usually lasts 5 to 7 days, then gets better. It may not cause lasting damage to joints if you get treatment immediately.

These symptoms could mean you have an infection inside your joint and need urgent medical help. They may refer you to see a specialist rheumatologist and arrange a blood test and scan. Sometimes a thin needle is used to take a sample of fluid from inside the affected joint, to test it. The blood test will find out how much of a chemical called uric acid there is in your blood. Having too much uric acid in your blood can lead to crystals forming around your joints, which causes pain.