The Sudden Onset of Severe Pain
The first sign of gout is often extreme pain — either in one of your big toes or another joint.
This first attack frequently occurs at night, and the pain may be extreme enough to awaken you. It’s often so severe that even having the painful joint covered by a blanket is unbearable.
The pain can last anywhere from a week to several months, sometimes ebbing and flowing in severity.
Generally, the pain is most severe in the first 12 to 24 hours of the attack, but this will vary.
Many people with gout will find it affects their joints, typically in the:
- Big toe
- Wrist; or
The joint may become noticeably discolored, turning deep red or purple at the onset, and changing color as the attack progresses.
Swollen joints become stiff and hot to the touch. The individual may spike a fever of up to 102.2℉ and may experience chills.
They may also suffer from decreased mobility in the affected joint.
Another occasional symptom of gout is tophi. These large, hard, visible bumps are made of uric acid crystals.
Tophi can form in:
- Cartilage; or
Rarely an early sign of gout, tophi tend to occur in those who had gout for a while. Not every person suffering from gout gets tophi.
Occasionally, tophi may become infected or begin pressing on a nerve and cause pain, but otherwise, they rarely cause physical discomfort.
The biggest problem with tophi, aside from their unsightly appearance, is that they can cause damage to joints and cartilage that eventually leads to bone erosion. Over time, this can result in significant deformity and even disability.