Gout is a form of arthritis caused by uric acid crystals in your joints

Yes, gout is arthritis. Specifically, it is a type called crystal arthritis because it happens when needle-shaped uric acid crystals build up inside a joint and trigger sudden, severe inflammation. Unlike osteoarthritis (wear and tear) or rheumatoid arthritis (immune system attack), gout flares come on fast — often overnight — and usually hit one joint at a time, most commonly the big toe.

The reason gout develops is different from other arthritis types. Your body makes uric acid when it breaks down purines, which come from certain foods and drinks and are also made naturally in your cells. Normally your kidneys filter uric acid out through urine. But if you make too much uric acid or your kidneys do not clear it well enough, it can crystallize in joints and surrounding tissue. When those crystals irritate the joint lining, you get a gout attack.

Gout is one of the most painful forms of arthritis, but it is also one of the most treatable. Attacks can be stopped quickly with the right medication, and you can prevent future attacks by lowering your uric acid level over time.

Key Takeaways

  • Gout is arthritis caused by uric acid crystals forming inside joints, usually the big toe, and causes sudden severe pain and swelling.
  • Attacks happen when uric acid levels get too high, either because your body makes too much or your kidneys do not filter it out well enough.
  • A single gout attack can last days to weeks, but medication can stop the pain and swelling within hours to days if started early.
  • Long-term uric acid-lowering medication can prevent future attacks, but you need to know your uric acid level and take the medication consistently.
  • Certain foods, drinks, and medications can trigger attacks, and avoiding or limiting them reduces how often flares happen.

How a gout attack feels and where it happens

A gout attack usually starts suddenly, often at night or early morning. You may wake up with intense pain, redness, warmth, and swelling in one joint. The big toe is the most common site, but gout can also hit the ankle, knee, wrist, elbow, or fingers. The pain is often described as throbbing or burning and can be severe enough to make even a bedsheet touching the joint unbearable.

The attack typically peaks within 24 to 48 hours and then gradually improves over several days to a week, even without treatment. However, waiting it out is not necessary — medication can cut the pain and swelling much shorter. Between attacks, you may have no symptoms at all, which is why some people do not realize they have gout until the second or third flare.

What causes uric acid to build up

Gout develops when uric acid levels stay too high for too long. This happens for two main reasons: your body produces more uric acid than normal, or your kidneys do not filter it out efficiently. Often it is a combination of both, and genetics play a role — gout runs in families.

Certain foods and drinks raise uric acid quickly. Red meat, organ meats, seafood (especially shellfish and anchovies), and alcohol — particularly beer — are the biggest dietary triggers. Sugary drinks and foods with high-fructose corn syrup also increase uric acid. Dehydration makes it worse because your kidneys need water to filter uric acid out. Some medications, including diuretics (water pills) used for high blood pressure and heart disease, can raise uric acid levels too.

Conditions like kidney disease, high blood pressure, obesity, and metabolic syndrome all increase your risk of gout. Men are more likely to develop gout than women, and risk rises with age. Women's risk increases after menopause when estrogen levels drop.

Medications that stop attacks and prevent future ones

Two types of medication treat gout. Acute attack medications stop pain and swelling once a flare starts. Nonsteroidal anti-inflammatory drugs (NSAIDs) like indomethacin or naproxen work well if you start them early. Colchicine, an older medication, is very effective for gout specifically and works best within the first 24 hours of an attack. Corticosteroids are an option if NSAIDs or colchicine do not work or you cannot take them.

Uric acid-lowering medications prevent future attacks by keeping uric acid levels low enough that crystals do not form. Allopurinol and febuxostat are the most common. You take these daily, even when you feel fine, and they work over weeks to months. Your doctor will check your uric acid level with a blood test to see if the dose is working. The goal is usually to get uric acid below 6 mg/dL.

Starting uric acid-lowering medication can actually trigger an attack in the first few weeks because crystals start to break down. Your doctor may prescribe a low dose of colchicine or an NSAID to take alongside it during this period to prevent flares. Do not stop the uric acid medication if an attack happens — keep taking it as prescribed.

Foods and drinks that trigger gout attacks

If you have gout, certain foods and drinks make attacks more likely. Limit or avoid red meat, organ meats (liver, kidney), and shellfish like shrimp, crab, and mussels. Anchovies and sardines are particularly high in purines. Alcohol, especially beer, raises uric acid significantly — even moderate drinking can trigger an attack in someone with gout. Sugary soft drinks and fruit juices with high-fructose corn syrup should be limited.

Staying well hydrated helps your kidneys filter uric acid, so drink plenty of water throughout the day. Low-fat dairy products, coffee, and vitamin C may actually help lower uric acid, so these are safer choices. You do not have to eliminate trigger foods completely, but reducing how often you eat them and how much you eat at once lowers your attack risk.

Weight loss also helps if you are overweight, because it reduces uric acid production and improves kidney function. Even a 10-pound loss can make a difference in how often attacks happen.

When to call your doctor about gout

Call your doctor if you have sudden severe pain and swelling in a joint, especially if it is your first time experiencing this. You need a diagnosis to confirm it is gout and not another condition like infection or another type of arthritis. Your doctor will likely order a blood test to check your uric acid level and may take fluid from the joint to look for uric acid crystals under a microscope.

Seek urgent care or go to the emergency room if you have a fever along with joint pain and swelling, because this could signal an infection rather than gout. Also seek when ready care if the pain is so severe you cannot move or bear weight on the joint and over-the-counter pain medication is not helping.

Once you have been diagnosed with gout, call your doctor if attacks are happening more than twice a year, if an attack lasts longer than a week even with medication, or if you develop gout in multiple joints. These are signs you need uric acid-lowering medication or a dose adjustment. Also report any side effects from gout medications — your doctor can switch you to a different option.

How gout differs from other types of arthritis

Gout, osteoarthritis, and rheumatoid arthritis are all arthritis, but they develop and behave very differently. Osteoarthritis is caused by wear and tear on cartilage over years and develops slowly, usually in people over 50. Rheumatoid arthritis is an autoimmune disease where the immune system attacks joint linings, and it typically affects multiple joints on both sides of the body symmetrically.

Gout attacks come on suddenly and usually hit one joint. The pain is often more severe than other arthritis types, but attacks are temporary — you can feel completely fine between flares. Osteoarthritis and rheumatoid arthritis cause ongoing pain and stiffness that does not fully go away. Gout is also the only type where a specific blood test (uric acid level) and crystal identification can confirm the diagnosis.

The good news is that gout is highly treatable. With the right medication and lifestyle changes, many people can prevent attacks almost entirely or reduce them to rare events. Other arthritis types require ongoing management but cannot be cured in the same way.

Frequently Asked Questions

Can you have gout and another type of arthritis at the same time?

Yes. Some people develop osteoarthritis or rheumatoid arthritis and also have gout. If you have multiple joint problems, tell your doctor about all your symptoms so they can diagnose each one correctly. The treatment for gout does not interfere with treatment for other arthritis types, but your doctor needs to know about all your conditions to prescribe safely.

Does gout ever go away on its own?

Individual attacks go away on their own over days to a week, but the condition does not disappear without treatment. If you do not take uric acid-lowering medication, attacks will keep happening, often more frequently over time. With medication and lifestyle changes, you can prevent most or all future attacks and keep uric acid at a safe level long-term.

What is the difference between gout and pseudogout?

Pseudogout is caused by calcium pyrophosphate crystals instead of uric acid crystals, and it usually affects larger joints like the knee. It looks similar to gout but requires different treatment. Your doctor can tell the difference by testing joint fluid under a microscope, so it is important to get a proper diagnosis.

Can I stop taking uric acid medication once attacks stop?

No. Uric acid-lowering medication works only while you take it. If you stop, uric acid levels will rise again and attacks will return. Most people with gout need to take this medication long-term, similar to how someone with high blood pressure takes blood pressure medication indefinitely. Talk to your doctor before making any changes to your medication.

Is gout more serious than other arthritis?

Gout attacks are extremely painful, but they are not usually dangerous. However, if uric acid stays high for years without treatment, it can damage joints permanently and form deposits called tophi in the skin and cartilage. Untreated gout can also affect kidney function. This is why taking uric acid-lowering medication as prescribed matters, even when you feel fine.