Gout

What is it?

Gout is a type of arthritis caused by a build-up of uric acid crystals in the joints.

Uric acid is a natural substance in the blood, but when levels get too high, sharp crystals can form and trigger sudden, painful localised inflammation, usually in a single joint.

What are the symptoms?

The most common symptom is sudden, very severe joint pain, often starting at night. The big toe is a typical site, but gout can affect ankles, knees, wrists, and fingers.

The joint often becomes very red, swollen, and exquisitely tender to touch. Usually, the pain is very severe for 48 hours and then settles over the following 8-10 days.

How is it diagnosed?

Doctors usually diagnose gout based on symptoms, medical history, and examination of the affected joint. Sometimes fluid from the joint is tested under a microscope to confirm uric acid crystals are present.

Blood tests:

A blood test can measure uric acid levels. High levels support the diagnosis but are not always conclusive, as levels may be normal during an attack. It is best to have a blood test taken at least 4 weeks after a gout attack for accurate results.

During an acute attack, the inflammation levels e.g. CRP are usually very high

How is it treated?

Acute attacks are treated with long acting anti-inflammatory medicines e.g. Naproxen, or colchicine. If these approaches are not settling things then a course of steroid tablets or a joint injection can be helpful.

Preventative treatments:

Long-term, medicines like allopurinol or febuxostat can lower uric acid and prevent further attacks (the dose of these needs to be adjusted for the individual – it is worth taking the time to do this as getting the dose right can significantly reduce the risk of every having another attack of gout).

Lifestyle changes—such as reducing alcohol, losing weight, and limiting red meat or sugary drinks—also help.

How do I know if my Gout is severe?

Frequent attacks, involvement of several joints, or joint damage on X-rays suggest more severe gout. Large crystal deposits under the skin (called tophi) also mean the condition is advanced.

Living with Gout

With preventative treatments and healthy habits, most people can manage gout well. Regular check-ups and sticking to prescribed medication greatly reduce the risk of flare-ups and long-term joint damage.

Final thoughts

Gout is painful but treatable. Early recognition, proper medication, and lifestyle choices can make a big difference in keeping you comfortable and active.