Gout is characterized by sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe. The signs and symptoms of gout are almost always acute, occurring suddenly — often at night — and without warning.
- Intense joint pain. Gout usually affects the large joint of the big toe, but it can occur in the feet, ankles, knees, hands and wrists. The pain is likely to be most severe within the first 12 to 24 hours.
- Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
- Inflammation and redness. The affected joint or joints become swollen, tender and red.
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Gout occurs when urate crystals accumulate in the joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when a person has high levels of uric acid in the blood. The body produces uric acid when it breaks down purines — substances that are found naturally in the body, as well as in certain foods, such as meat, anchovies, herring, spinach, asparagus and mushrooms.
Normally, uric acid dissolves in the blood and passes through the kidneys into the urine. But sometimes the body either produces too much uric acid or the kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needle-like urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.