What is gout?
Gout is a form of inflammatory arthritis caused by high levels of uric acid in the bloodstream. When uric acid builds up, it can form sharp crystals in and around joints. These crystals trigger sudden, intense pain and inflammation.
Gout most commonly affects the big toe joint, but it can also occur in other areas, including:
- Knees
- Ankles
- Feet
- Hands and wrists
- Elbows
Gout flares often come on suddenly and can last anywhere from a few days to 1–2 weeks. In some cases, symptoms can be severe and significantly impact mobility and daily activities.
Symptoms of a gout flare include:
- Sudden and intense joint pain
- Swelling, redness, and warmth around the joint
- Extreme tenderness or sensitivity (even light touch can be painful)
- Reduced movement due to pain and stiffness
- Formation of hard lumps under the skin in long-term cases (known as tophi), which are deposits of uric acid crystals
What causes uric acid build up?
Uric acid is a natural waste product created when the body breaks down substances called purines. Purines are found in the body’s cells and are also present in certain foods and drinks.
When cells naturally break down, purines are released. The liver then processes these purines and converts them into uric acid.
Purine-rich foods include:
- Red meat
- Organ meats (such as liver)
- Certain seafood (such as sardines and mussels)
- Alcohol
- Foods and drinks high in added sugars (including high-fructose corn syrup)
In a healthy system, uric acid dissolves in the blood and is filtered out by the kidneys through urine. However, gout can develop when:
- The body produces too much uric acid, or
- The kidneys are unable to filter it out efficiently
When uric acid levels become too high, crystals can form in joints. The immune system then responds to these crystals, triggering inflammation and the sudden pain of a gout flare.
How does gout impact a person?
Gout can significantly impact mobility and function, especially during flare-ups. It may cause:
- Difficulty walking or weight-bearing
- Changes in gait to avoid pain in the big toe
- Muscle tightness and joint stiffness
- Reduced range of motion
Gout affects approximately 1 in 15 Australians and is more common in men, with peak onset between 60–64 years
How can I manage gout?
Gout can be effectively managed with a combination of medical care and lifestyle strategies, including:
- Medication to reduce uric acid levels
- Low-impact exercise such as walking or swimming
- Ice, elevation, and rest during flare-ups
- Hydration and dietary modifications
- Mobility aids if needed
- Soft tissue treatment and exercise to reduce muscle tightness, improve joint mobility, support gait mechanics, and restore functional movement
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