Symptoms of Gout

Gout often starts suddenly, usually at night, with severe joint pain that peaks within hours.

Typical flare

• Intense pain in one joint, most often the base of the big toe
• The joint is red, hot, swollen and extremely tender, even to the touch of a bedsheet
• Other common joints: ankle, foot, knee, wrist, fingers and elbow
• Mild fever and feeling unwell in some people
• The flare usually peaks in 12 to 24 hours and may last 3 to 10 days without treatment, then settles fully

Between flares

Many people have no symptoms between attacks. Without treatment, flares can become more frequent and last longer.

Long-standing gout

• Several joints involved at once
• Tophi: hard, chalky lumps under the skin, often on the ears, fingers, elbows or toes
• Constant stiffness, pain and damage to joints
• Kidney stones

Warning signs that need urgent care

• A hot, swollen joint with fever or chills. This can be a joint infection (septic arthritis), which needs same-day care.
• Severe pain and swelling that does not improve with treatment
• First attack in a young person or in a woman before menopause
• Flank pain, blood in the urine or vomiting, which may mean a kidney stone

Key point

Many joint problems look like gout. A doctor can confirm the diagnosis, and proper treatment prevents joint damage.

Before your appointment

Carry earlier uric acid and kidney reports, a list of all medicines and supplements, and notes on which joints hurt, when flares started and what you ate or drank beforehand. Tell your doctor about any kidney stones, diabetes, blood pressure or family history of gout.