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

Gout happens when uric acid builds up in your blood and forms needle-shaped crystals in your joints, most often in the big toe. Your immune system reacts to these crystals as a threat, triggering sudden inflammation, pain, redness, and swelling. The attack usually lasts days to weeks, then stops completely—until the next one.

Unlike osteoarthritis, which develops slowly over years, gout attacks come on fast. You might wake up with severe pain in one joint, or feel it start during the day. Between attacks, you may have no symptoms at all, which is why people sometimes ignore gout until it happens repeatedly or damages the joint.

Key Takeaways

  • Gout develops when uric acid crystals form in a joint, triggering sudden pain and swelling that typically lasts days to weeks.
  • Your body produces uric acid when it breaks down purines, which come from certain foods, drinks, and your own cells.
  • Some people's kidneys do not filter uric acid efficiently, making them more likely to develop gout even if they eat normally.
  • Repeated gout attacks can damage joints permanently, so treating the condition early prevents long-term harm.
  • Gout is different from other types of arthritis and responds to specific medications that lower uric acid or reduce inflammation during attacks.

How uric acid builds up in your body

Your body makes uric acid when it breaks down purines—compounds found in certain foods and drinks, and also produced naturally when your cells die and are recycled. Normally, your kidneys filter uric acid out through urine. But if your kidneys do not work efficiently, or if you produce too much uric acid, it accumulates in your blood instead of leaving your body.

When uric acid levels get high enough, crystals start to form. These crystals settle in joints and surrounding tissue, where they sit until something triggers an attack. That trigger might be a meal heavy in purines, dehydration, an injury, surgery, or even stress. Not everyone with high uric acid develops gout—some people never form crystals, or their body tolerates them without an immune reaction.

Why some people get gout and others do not

Genetics play a large role. If your parents or close relatives had gout, your risk is higher. Your kidneys' ability to filter uric acid is partly inherited, and some people are simply born with kidneys that do not clear it as well as others.

Other factors increase your risk: being male, drinking alcohol regularly (especially beer), eating a diet high in red meat and organ meats, being overweight, and having high blood pressure or kidney disease. Certain medications—including diuretics used for heart conditions and low-dose aspirin—can also raise uric acid levels. Women's risk rises after menopause, when estrogen levels drop.

What happens during a gout attack

A gout attack starts when uric acid crystals trigger your immune system. White blood cells rush to the joint, causing inflammation. This is why the joint becomes hot, red, swollen, and extremely painful—sometimes so painful that even a bedsheet touching it feels unbearable. The pain is usually worst in the first 24 to 48 hours, then gradually improves over days or weeks.

Attacks most commonly hit the big toe, but gout can affect any joint: ankles, knees, wrists, elbows, or fingers. Some people have only one attack in their lifetime. Others have several attacks a year, especially if uric acid levels stay high. The longer you have gout without treatment, the more likely attacks become and the more joints they may involve.

Long-term damage from repeated gout attacks

If gout is not treated, repeated attacks can permanently damage joints and surrounding bone. Over time, uric acid crystals can form deposits called tophi—lumps of crystallized uric acid that appear under the skin, often on the ears, fingers, or elbows. These deposits are a sign that uric acid has been high for a long time.

Chronic gout can also lead to kidney stones and kidney damage, since the same uric acid crystals that form in joints can form in the urinary tract. This is why doctors recommend treating gout early, even if attacks are infrequent. Lowering your uric acid level prevents future attacks and protects your joints and kidneys from harm.

How gout differs from other types of arthritis

Osteoarthritis develops when cartilage wears down over years, causing gradual stiffness and pain. Rheumatoid arthritis is an autoimmune disease where your immune system attacks joint tissue. Gout is different: it is caused by a specific chemical—uric acid—and responds to treatments that target that chemical.

Gout attacks are also more sudden and severe than other arthritis pain, and they often affect only one joint at a time. Between attacks, you typically feel fine, whereas osteoarthritis and rheumatoid arthritis cause ongoing discomfort. This pattern—sudden severe pain followed by complete relief—is one of the clearest signs that you have gout rather than another joint condition.

When to see a doctor about joint pain

If you have sudden severe pain, redness, and swelling in a joint, especially your big toe, see a doctor. They can test your uric acid level and, if needed, take fluid from the joint to check for uric acid crystals under a microscope. This test is the only way to confirm gout for certain.

You should also see a doctor if you have had multiple attacks, if attacks are getting more frequent, or if pain is affecting more than one joint. Early diagnosis and treatment prevent permanent joint damage and reduce how often attacks happen. If you already know you have gout, regular follow-up helps your doctor adjust your treatment to keep uric acid at a safe level.

Frequently Asked Questions

Can you have high uric acid without having gout?

Yes. Many people have high uric acid levels but never develop gout because their body does not form crystals, or the crystals do not trigger an immune reaction. However, high uric acid still raises your risk of kidney stones and kidney damage, so doctors may recommend lowering it even without gout symptoms.

Is gout caused by eating too much red meat?

Diet contributes to gout, but it is not the only cause. Red meat, organ meats, and certain seafood are high in purines and can raise uric acid. However, genetics and kidney function matter more—some people develop gout despite eating well, while others eat purine-rich foods without problems.

Can gout go away on its own?

A single gout attack will go away on its own within days to weeks. But the underlying high uric acid remains, so attacks typically return unless you lower your uric acid level with medication or significant lifestyle changes. Treating the root cause prevents future attacks.

Does gout only affect older men?

Gout is more common in men and increases with age, but it can develop in women and younger people too. Women's risk rises after menopause. Younger people with a family history of gout, obesity, or kidney disease can develop it at any age.

What is the difference between gout and pseudogout?

Pseudogout is caused by calcium pyrophosphate crystals instead of uric acid crystals. The symptoms look similar—sudden joint pain and swelling—but the crystals are different, so the treatment is different. A joint fluid test tells your doctor which one you have.