Gout - Symptoms

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What are gout symptoms and signs?

The small joint at the base of the big toe is the most common site of an acute gout attack of arthritis. An acute attack of gouty arthritis at the base of the big toe is medically referred to as podagra. Other joints that are commonly affected include the ankles, knees, wrists, fingers, and elbows. Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness. Tenderness can be intense so that even a blanket touching the skin over the affected joint can be unbearable. Patients can develop fever with the acute gout attacks. These painful attacks usually subside in hours to days, with or without medication. In rare instances, an attack can last for weeks. Most patients with gout will experience repeated attacks of arthritis over the years.

Uric acid crystals can deposit in tiny fluid-filled sacs (bursae) around the joints. These urate crystals can incite inflammation in the bursae, leading to pain and swelling around the joints (a condition called bursitis). In rare instances, gout leads to a more chronic type of joint inflammation that mimics rheumatoid arthritis.

In chronic (tophaceous) gout, nodular masses of uric acid crystals (tophi) deposit in different soft-tissue areas of the body. Even though they are most commonly found as hard nodules around the fingers, at the tips of the elbows, in the ears, and around the big toe, tophi nodules can appear anywhere in the body. They have been reported in unexpected areas such as in the vocal cords or (rarely) even around the spinal cord. When tophi appear in the tissues, the gout condition is felt to represent a substantial overload of uric acid within the body.

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Comment from: robert, 75 or over Male (Patient) Published: December 05

I am 78 years old. I have had gout since I was around 65. I have been taking 300 mg of allopurinol for several years. I tried going without it once. Boy, did I suffer! My big toes hurt so bad until I got in the routine once again with allopurinol. This is a life time drug now. But the last 6 years I've also got stinging gout! It can be anywhere in your feet, starts out tickling, and you scratch it and it gets to stinging so bad it really is painful. This will show up once a month sometimes twice a month. It lasts around an hour every hour and then lets up. It can last 4 days. Lately I've been getting the same sensation in the cheek of my buttocks. I looked up uric instead of allopurinol but my uric acid is within limits. My VA (Veterans Affairs) nurse says that's the way it goes.

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Comment from: John S, 45-54 Male (Patient) Published: December 06

I've had gout for about five years now and it is getting worse with each attack. The last one was the worst. It has lasted about a month so far and still hasn't gone away. I could barely walk for the first couple of days with the aid of a cane. I took Colcrys but didn't get it in time. Now I'm walking, but just barely. I'm close to 100lbs overweight and need to lose weight for this and other reasons, and also change my diet. The pain is in my big toe joint and ankle. It was going away but had another flare up last weekend, possibly due to alcohol and dietary factors. I know there are products out there like Urcinol. It would be well worth it if they work but I'd like to hear some unbiased testimony.

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