Gout Attack Explained - Causes, Symptoms, and Frequency

What You Should Expect During and After a Gout Attack

Elbow joint with gout
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If not yourself, you likely know someone who has experienced an intensely painful gout attack. The word attack suggests this is no laughing matter. What exactly goes on during a gout attack?

For more details on gout attacks, read this excerpt from UpToDate -- a trusted electronic reference used by many physicians and patients looking for in-depth and well-explained medical information.

Then read on so you will have the full understanding of a gout attack.

Gout Attack: Details from UpToDate

"Gout attacks cause sudden severe joint pain, sometimes with redness, swelling, and tenderness of the joint. Although an attack typically affects a single joint, some people develop a few inflamed joints at the same time. The pain and inflammation are worst within several hours, and generally improve completely over a few days to several weeks, even if untreated. It is not clear how the body 'turns off' a gout attack."


The first gout attack you will experience typically follows years of asymptomatic hyperuricemia (high blood uric acid level). Meaning, a gout attack occurs when excess uric acid accumulates in the body and deposits as crystals in and around joints. The big toe is often the first joint affected. But, what exactly triggers a gout attack in this setting is still unknown.

Risk Factors

Men and women can both experience gout attacks. As for men, their first gout attack usually occurs between age 40 to 69. Women typically are older when the first gout attack occurs – but other factors play a role, such as the age of menopause and use of thiazide diuretics. Other important risk factors include genetics, prescription medications, and diet.

What the Pain Feels Like

Pain increases in intensity from a twinge to severe pain over an 8 to 12 hour period in a typical gout attack. As described in the excerpt above, usually a single joint is involved in a gout attack but it is possible that more joints are involved. In 50% of patients, the big toe is affected initially but the midfoot, ankles, heels, and knees can also be involved early on. Less commonly, wrists, fingers, and elbows are involved in a gout attack.

Other Symptoms 

Besides joint pain, a gout attack can cause inflammation of tissues next to the joint, such as tendons and skin, and even cause body-wide symptoms such as fever, chills, and malaise.

Duration and Frequency

Untreated gout attacks can range from mild (lasting only a few hours) to severe (lasting between 1 to 2 weeks). Early on, there may be years between gout attacks, but over time, gout attacks typically become more frequent, last longer, and involve more joints. You may progress from acute intermittent gout to the chronic inflammation of tophaceous gout.


Becker, Michael A. "Patient information: Gout" UpToDate