Gout

Gout is one of the most common types of inflammatory arthritis. It's caused by a buildup of uric acid, a waste product, in the blood. This buildup causes uric acid crystals to form inside the joints and sudden flare-ups of severe pain, swelling, warmth, and redness in the affected joints.

Experts at UPMC provide comprehensive care for people with gout, including expert diagnosis and treatment designed to manage symptoms when they occur and reduce the risk of future flare-ups.

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On this page

• What Is Gout?
• What Are the Signs and Symptoms of Gout?
• How Do You Diagnose Gout?
• How Do You Treat Gout?

What is Gout?

Gout is one of the most common types of inflammatory arthritis. It's caused by a buildup of uric acid, a waste product, in the blood. This buildup causes uric acid crystals to form inside your joints — most commonly your big toe, knee, or ankle. These crystals can cause sudden flare-ups of severe pain, swelling, warmth, and redness in the affected joints.

Gout symptoms typically flare up for a week or two before getting better. Although it affects 4% to 5% of adults in the United States, gout often goes undiagnosed or undertreated.

What are the types of gout? 

There are two main types of gout, including:

• Primary gout — Happens when your body either produces too much uric acid or doesn’t get rid of enough uric acid, causing high levels of uric acid in your blood.
• Secondary gout — Caused by medications, such as chemotherapy drugs or diuretics, or health conditions, such as kidney disease.

Your doctor may use other terms to describe different stages of gout, including:

• Acute gouty arthritis or gout flares — Happens when gout symptoms come on suddenly and severely.
• Asymptomatic hyperuricemia — Occurs when levels of uric acid in your blood are high, but you don’t have any gout symptoms.
• Intercritical or interval gout — The time between gout flare-ups when no symptoms are present.
• Pseudogout or CPPD arthropathy — A condition that produces similar symptoms to gout but is caused by calcium pyrophosphate crystals instead of uric acid crystals.
• Tophaceous gout — A late-stage complication of gout that causes joint damage and hard deposits to form over the hands and other parts of the body.

What causes gout?

Gout occurs when uric acid builds up in your blood and the fluid around your joints. This buildup can happen when your body makes too much uric acid, or when your kidneys don’t remove enough uric acid from your body.

When uric acid levels are too high, needle-like uric acid crystals can form in your joints. These crystals cause gout symptoms, including pain, swelling, redness, and warmth, which usually flare up for a few weeks before getting better.

What are gout risk factors and complications?

Gout risk factors

Gout usually develops in middle age. It's more common in men.

Other risk factors for gout include:

• Chronic health conditions, such as heart failure, high blood pressure, metabolic syndrome, chronic kidney disease, and genetic disorders that increase uric acid levels.
• Consuming large amounts of fructose, a type of sugar.
• Drinking alcohol.
• Eating red meat, organ meats, and shellfish that increase uric acid levels.
• Family history of gout.
• Obesity.
• Taking medications such as B-3 vitamin (niacin) supplements, chemotherapy drugs, diuretics, some drugs used by patients with organ transplants, or antibiotics that treat tuberculosis.

Complications of gout

If left undiagnosed or untreated, gout can cause painful flare-ups that affect your quality of life. Over time, gout can become chronic tophaceous gout, a more severe form of the disease that causes hard uric acid deposits called tophi to develop under your skin. If left untreated, it can lead to permanent joint and bone damage and loss of motion.

Chronic gout can also cause kidney stones.

How can I prevent gout? 

Although you can’t control all your risk factors for gout, you may be able to reduce your risk by eating a healthy diet, managing your weight, and limiting alcohol consumption.

If you have already been diagnosed with high uric acid levels or gout, you can follow your doctor’s recommendations to reduce your risk of future flare-ups and prevent your condition from getting worse.

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What Are the Signs and Symptoms of Gout?

Gout can affect one or more joints, often impacting the big toe, knee, or ankle.

Symptoms of gout may include:

• Extreme tenderness to the touch.
• Fever.
• Severe joint pain that starts suddenly, often at night, and may wake you up. The big toe is often the first joint affected.
• Swelling, warmth, redness, or throbbing in the affected joint.

When should I see a doctor about my gout symptoms?

If you have gout symptoms, you should see your doctor, who can offer treatment to ease symptoms during an attack, reduce your risk of future flare-ups, and prevent permanent joint damage.

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How Do You Diagnose Gout?

Our experts will perform a complete physical exam, order tests, and review your symptoms and medical history before diagnosing gout. Sometimes special imaging studies are used to help diagnose gout.

What to expect during your visit

When you arrive for your first appointment, you'll meet with a provider. He or she will ask about your medical history, perform an exam, and order tests.

Tests to diagnose gout

Your doctor may order tests to diagnose gout, including:

• Blood or urine tests — Check the levels of uric acid in your body. A blood uric acid level of over 6 mg/dL is considered high. However, not everyone with high uric acid levels develops gout symptoms.
• Synovial fluid analysis — Looks for uric acid crystals in the fluid that surrounds your joints.
• Ultrasound or dual-energy CT scan — Looks for signs of uric acid crystals in your joints.

Gout prognosis

With early diagnosis, proper treatment, and lifestyle changes, most people with gout can manage symptoms when an attack occurs and lower their risk of a future attack. Medication can help reduce uric acid to normal levels. Over time, with treatment, uric acid crystals disappear.

Symptoms of acute gout usually get better in a week or two without treatment, and you may feel better for several weeks or months. With treatment, flares can resolve in hours to days. However, without long-term management of gout, you may have recurrent attacks that can lead to other complications, including an increased risk of heart attacks.

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How Do You Treat Gout?

The goals of gout treatment are to:

• Ease symptoms from gout flare-ups.
• Prevent future flare-ups.
• Reduce your risk of complications, such as tophi and kidney stones.

Your doctor may recommend treatments, including:

Lifestyle changes

Although you may not be able to completely prevent gout, your doctor may recommend lifestyle changes to reduce your risk of flare-ups, including:

• Eating a healthy diet.
• Getting regular exercise.
• Limiting alcohol consumption.
• Managing your weight.
• Stopping or changing medications that increase uric acid levels.

Medicine to treat gout

Your doctor may prescribe medications to treat gout flare-ups, including:

• Colchicine — an anti-inflammatory drug.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen.
• Oral or injected steroids.
• Medications that lower your levels of uric acid — such as allopurinol or febuxostat.

When taken regularly, these medications can reduce your risk of flare-ups and complications.

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Why Choose UPMC for Gout Care?

When you choose UPMC for gout care, you will receive:

• Specialized gout treatment — You'll receive advanced care from experienced providers with expertise in gout management.
• Advanced treatment — Our team specializes in caring for patients with gout and is up to date on the latest treatments.
• Access to advanced clinical trials — Our team participates in leading-edge clinical trials and research to learn more about gout and find new, effective treatments.

By UPMC Editorial Staff. Last reviewed on 2025-04-04.