Understanding Gout: A Guide to its 12 Symptoms

The first sign of gout is usually sudden, sharp pain—often in the big toe. It can also hit the ankles, knees, elbows, wrists, or fingers. The pain comes from tiny uric acid crystals building up in the joint. It tends to be worst during the first day or two but may take a week or more to fade.

Swelling is common and usually shows up alongside the pain. The joint often looks puffy and feels tight or stiff. It happens quickly and can make movement harder. Tight clothing or pressure from socks can make it feel worse.

The skin over a gout-affected joint often turns red or deep pink. This change is part of the body’s natural inflammation response. The area may look irritated or feel tender even with light contact.

Inflamed joints can feel noticeably warm—or even hot—to the touch. That warmth often radiates outward, making the area feel like it’s burning from the inside. Heat, along with pain, redness, and swelling, helps doctors confirm a gout diagnosis.

Someone experiencing a gout attack has difficulty moving the associated joint. There are a few reasons for this. Not only might the person be in too much pain, but the associated swelling may also prevent the joint from moving as it should. Plus, the uric acid crystals in the joint itself can lead to stiffness.

While the worst of the pain associated with a gout attack usually resolves in a day or two, discomfort can linger in the joint for a few days or weeks, though it should eventually go away. Subsequent attacks may last longer and affect more joints. Depending on severity and frequency, gout can cause chronic pain issues.

With a gout attack, tenderness has characteristics that are separate from pain. As mentioned, intense joint pain is a hallmark of a gout attack. Tenderness has more of an effect on the outside of the joint. For example, someone experiencing a gout flare may not be able to rest a blanket against their knee without experiencing increased pain.

Chronic aches and pains can be a sign that gout is getting worse. Someone who continues to have achy joints weeks or months after a gout attack may be experiencing long-term damage. While not as painful as a flare, the longevity of these dull aches can significantly impact an individual's quality of life.

Dry, peeling skin over the affected joint is a common symptom of gout and usually a result of the inflammation and swelling stretching the tissue and causing damage to the surface layers of the skin. This peeling and dry skin can persist for days after the gout attack resolves.

Tophi are the large deposits of uric acid that accumulate in the joints after subsequent gout attacks. They cause the joint to be permanently disfigured and can greatly affect the quality of life. Tophi do not go away after a gout attack resolves.

The distinctive qualities of a gout attack are that it usually comes on suddenly, quickly, and at night. A flare can reach its worst point within 12 hours. The person may not have shown any signs of an impending flare during the day and then wake up at night in severe pain.

Gout can cause a range of systemic symptoms, including nausea and loss of appetite. These symptoms may occur right before a flare, during its peak, or as the gout attack is resolving. This is not common but does occur in some people with gout.