Gout is a form of arthritis that affects the joints. It usually affects the small bones in the lower part of the body. Externally manifested by inflammation of the joint accompanied by severe pain, a gout attack may last for several days. After the preliminary attack, ninety percent of the people have reported second or subsequent episodes.
Gout is usually a sign of your joints’ degeneration, and ignoring the symptoms can lead to more severe conditions that may be difficult to treat. In order to distinguish gout from other forms of arthritis, you should be able to spot the symptoms:
Pain in the Joints
Certain medical conditions or lifestyle triggers increase the level of uric acid in the bloodstream. Over a span of days, these deposits of uric acid in the synovial fluid around the joints lead to the creation of sharp needle-like crystals of monosodium urate. These crystals begin to scratch against the cartilage, tendons, and nerves in the joint which leads to pain. The most commonly affected joint is that of the big toe. Nevertheless, gout can affect more than one joint, and any part of the body, although it is most common among the extremities. Similar pain can be felt in the wrists, elbows, and knees and can sometimes attack two opposite joints.
The excruciating pain can be controlled only by painkillers. While the attacks frequently occur at night, they may continue throughout the day.
Swelling of the Joints
The scratching of the tendons by the uric acid crystals cause them to be irritated and damaged leading to swelling. Inflammation is the body’s natural reaction to irritation, a sort of alarm signal that there is a foreign body.
The bulge will always be found around the affected joint and is usually red and tender to the touch. The area can also be over-sensitive, making even the brushing of a blanket over the affected area painful and unbearable. It makes using the joint difficult and can hinder activities involving the affected joint such as walking if the big toe is swollen. In addition, the area is usually hot, indicating a possible infection.
Peeling of Skin
The skin around the affected area develops a reddish rubbery texture. A mild irritation or itch accompanies the pain. Within a few days, the skin around the joints may start peeling off in patches.
During episodes of severe attack, the patient may have a high fever accompanied by pain. The fever is just a manifestation of the infection and subsides within a few days.
In chronic cases of gout, where the affliction has continued for several years, painless lumps called ‘tophi’ develop in the area around the joints. These lumps are clusters of uric acid crystals that have accumulated over the years outside the affected joints. Tophi are easily discernible under the skin and may be found in other parts of the body like fingertips, earlobes, or elbows. A creamy discharge is also plausible in some instances.
Pattern of Symptoms
Many joint problems may appear similar because the body responds in the same way regardless of the cause. Some of the problems that may cause similar symptoms may be trauma to the joint, arthritis, and pseudogout. In order to eliminate other conditions, it’s also important to understand the way gout presents itself. The symptoms of gout follow a distinguished pattern:
Attacks Often Occur at Night
Uric acid crystals are deposited into the joints where temperatures are cooler than the rest of the body. At night, temperatures are favorable for this deposit to take place, and the symptoms are exacerbated as more crystals are formed. While symptoms can take place at any time, gout is marked by frequent attacks at night and eliminates the question of direct trauma.
Symptoms Develop Quickly
Symptoms of gout are not constant, but the attacks usually develop quite rapidly. Sudden pain that rises from mild to excruciating in a few hours is usually the first indication of the attack. The pain peaks within 8 to 12 hours and then may start subsiding after that. The skin around the affected area becomes inflamed and tender to touch. The initial episode may completely disappear in ten to twelve days even if it is left untreated. It is impossible to predict when the symptoms will present, but when they do, there usually isn’t enough time to prevent them.
After a few days, the symptoms may go away on their own and the affected joint will recover and reduce the inflammation. The swollen area will leave behind rough flaky skin that will also eventually peel away and return to normal. The symptoms may not be apparent in a fortnight but the infection prevails.
If a proper medication was not sought, the symptoms may return in a few months or weeks. Recurrent attacks will also have more severe symptoms if the condition is not treated. In chronic cases, where the level of uric acid remains high for several years, the episodes of pain become more frequent and intense. The pain becomes a more or less permanent feature refusing to subside. It may have a serious effect on the mobility of the individual. In chronic cases, the pattern of symptoms may alter. Gout is commonly monoarticular in nature. This means that it affects one joint at a time. Polyarticular gout has been reported in less than 10% of the affected population. In chronic cases, it may affect several joints in the same limb and the upper extremities may also be affected. The episodes of pain become more frequent and last longer.
Thorough medical and physical examination to identify the nature of joint pain is imperative to control the condition. If you suspect any of the above symptoms, it is best to consult a doctor to establish the cause. Besides causing gout, deposition of high levels of uric acid in the body can be harmful to other organs. It can also lead to formation of kidney stones. Early diagnosis and treatment of gout are essential to prevent complications.