Gout is thought of as a disease of the past, but right now there are eight million Americans with the condition. In fact, the incidence of gout has gone up in recent years. However, even though it’s the most common form of inflammatory arthritis in men over 40, most people who have it—perhaps associating gout with high living rather than aging and medications—mistake it for something like a stubbed toe, ankle sprain, or athletic injury.
“When gout attacks for the first time, many sufferers mistake the pain for an impact-induced injury or a sprain,” said Herbert S. B. Baraf, M.D., clinical professor of medicine at The George Washington University. “It is important to be able to recognize the signs and symptoms of gout and to seek proper treatment.”
Gout symptoms generally appear as swelling and pain in the joints. It often affects the big toe but a flare can happen anywhere in the body—look for redness and inflammation accompanying the pain. Your doctor can test for high levels of uric acid, which causes gout.
One well-known gout sufferer is the actor Jim Belushi, who says he initially thought he had injured himself jogging.
“When I first developed gout, I didn’t want to do anything about it,” Belushi said. “I thought I could tough it out, but when the pain became too unbearable for me to perform on stage, I saw a rheumatologist and got my gout under control.”
Ordinarily the body breaks substances in foods, called purines, into uric acid, which is eliminated. However, when the body is overwhelmed by uric acid and can’t eliminate it all, it builds up and crystallizes around joints, causing inflammation. Left untreated, it can even cause visible bumps.
Treatment for gout generally involves nonsteroidal anti-inflammatory drugs, corticosteroid injections, and possibly dietary changes to reduce purines. Alcohol consumption, fatty foods, and rapid weight loss can all increase frequency and severity of gout flares. A rheumatologist can work with you on a strategy to manage your uric acid levels.