Symptoms & Stages

Gout is an extremely painful disease. Each gout attack can last for several days, and the pain is so severe that the majority of gout patients rank their pain level as a nine or 10 on a standard pain scale.

Symptoms of gout in a joint include:

  • Sudden and severe episodes of pain
  • Stiffness and swelling
  • Redness
  • Tenderness
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For more than half of all people, gout begins in the big toe – and 90 percent of gout patients will suffer gout of the big toe at some point during the course of the disease. Untreated high uric acids and gout will, in time, affect more joints, including:

  • Instep
  • Ankle
  • Heel
  • Knee
  • Achilles Tendon
  • Wrist
  • Finger
  • Elbow

Stages of Gout

There are four stages that medical professionals use to classify the severity of gout. With proper management of lifestyle and the right medication, it’s possible to manage gout symptoms, avoid future attacks and prevent joint damage.

Stage 1 – Asymptomatic Hyperuricemia

During this stage, a person has no symptoms of gout, but uric acid levels are above 6.0 mg/dL. Treatment is not usually necessary. Many people will have elevated uric acid levels for years before their first attack, so regular monitoring of uric acid levels and making healthy diet and lifestyle adjustments can help to reduce future attacks. Not everyone with high uric acid gets gout, but the higher the uric acid, the more likely it is.

Stage 2 – Acute Gout Attack

During this stage, crystals that have been depositing in the joints activate and cause episodes of intense pain and swelling in the joint. The pain will subside, even without treatment, within three to 10 days. Because the first attack is followed by others in many instances, this is the time to seek medical care for appropriate diagnosis and therapy. Another gout attack may not occur for months or years, but chances are good that more will come, so regular monitoring of uric acid levels and ongoing treatment is important.

Stage 3 – Intercritical Gout

During this stage, a person is in between gout flares. It is a symptom-free time, when their joints are functioning normally. However, even when symptoms are absent, ongoing deposits of uric acid crystals continue to accumulate, silently. Additional and more painful attacks of gout are likely to continue unless the uric acid is lowered to below 6.0 mg/dL.

Stage 4 – Chronic Tophaceous Gout

This is a late stage of gout. It now becomes a chronic arthritis which often results in deformity and destruction to the bone and cartilage. An ongoing, destructive inflammatory process is active, and kidney damage is also possible. With proper medical attention and treatment, most gout patients will not progress to this advanced, disabling stage.