Yes, gout is a form of arthritis. Specifically, it’s a type of inflammatory arthritis caused by a buildup of uric acid in the body. When uric acid levels get too high, sharp crystals form inside your joints, triggering intense pain and swelling. About 55.8 million people worldwide had gout as of 2020, making it one of the most common forms of inflammatory arthritis.
How Gout Differs From Other Arthritis Types
Arthritis is a broad term covering more than 100 conditions that cause joint pain and inflammation. Osteoarthritis, the most common type, results from wear and tear on cartilage over time. Rheumatoid arthritis is an autoimmune condition where the immune system attacks joint tissue. Gout has a completely different cause: it’s a crystal deposition disease driven by excess uric acid in the blood.
Your body produces uric acid when it breaks down substances called purines, which are found naturally in your body and in certain foods. Normally, uric acid dissolves in your blood, passes through your kidneys, and leaves your body in urine. But when your body makes too much or your kidneys don’t filter enough out, uric acid accumulates. Once levels get high enough, needle-shaped crystals form in and around your joints, setting off the severe inflammation that defines a gout attack.
What a Gout Attack Feels Like
Gout flares are distinctive. They often strike suddenly in the middle of the night, and the pain can be intense enough to wake you from sleep. The affected joint becomes swollen, red, and warm to the touch. Many people experience their first flare in the big toe, though gout can affect the ankles, knees, wrists, fingers, and elbows as well.
Unlike the gradual, persistent ache of osteoarthritis, gout attacks come and go. A flare typically affects one joint at a time and can be triggered by specific foods, alcohol, physical trauma, certain medications, or illness. Early in the disease, you might go weeks or months between attacks. Without treatment, flares tend to become more frequent and last longer over time.
Foods and Factors That Raise Uric Acid
Diet plays a significant role in gout because many foods are rich in purines, the compounds your body converts into uric acid. The biggest dietary culprits include organ meats (liver, kidneys, sweetbreads), red meat, certain seafood like herring, scallops, mussels, and tuna, and game meats such as venison and veal. Even turkey, often considered a lean alternative, is relatively high in purines.
Alcohol is a double problem. It not only contains purines but also interferes with your kidneys’ ability to remove uric acid, pulling it back into circulation. Beer is particularly problematic because it’s high in both alcohol and purines. Sugar matters too. Table sugar is half fructose, which breaks down into uric acid during digestion. Sugary drinks and foods with high-fructose corn syrup can push levels up even in people who avoid high-purine meats.
Beyond diet, several health conditions increase your risk. Excess body weight and metabolic conditions like obesity, diabetes, and cardiovascular disease are strongly associated with gout. Impaired kidney function is another major contributor, since your kidneys are responsible for clearing most of the uric acid from your blood.
What Happens When Gout Goes Untreated
If gout isn’t managed over time, uric acid crystals can accumulate into visible lumps called tophi that form under the skin, often near joints, on the ears, or along tendons. Tophi aren’t just cosmetic. They can erode bone, destroy cartilage, and physically obstruct joints, preventing them from moving properly. This damage is often permanent.
In some cases, tophi break open and release a chalky white discharge, leaving painful open sores that resist healing. Rarely, they can compress nerves, become infected, or interfere with organ function. Chronic gout with tophi represents the most advanced stage of the disease, but it’s largely preventable with consistent treatment.
How Gout Is Managed
Gout treatment works on two fronts: stopping acute attacks and lowering uric acid levels long term to prevent future flares. During an active flare, anti-inflammatory medications help reduce pain and swelling. The goal is to calm the inflammation as quickly as possible.
For long-term management, the standard approach is uric acid-lowering medication. These drugs work by reducing how much uric acid your body produces. Treatment guidelines recommend bringing blood uric acid levels below 6 mg/dL, and in clinical trials, a nurse-led treatment program achieved that target in 95% of patients. One important thing to know: when you first start uric acid-lowering therapy, you may actually experience more gout flares temporarily. This is normal and expected as crystals dissolve and shift in your joints. Your doctor will typically provide additional medication to manage flares during this transition period.
Diet changes can support medication but rarely control gout on their own. Reducing high-purine foods, limiting alcohol (especially beer), cutting back on sugary drinks, and maintaining a healthy weight all help lower uric acid levels. For most people with recurrent gout, though, medication combined with dietary adjustments offers the most reliable control.
Gout vs. Pseudogout
Gout is sometimes confused with a related condition called pseudogout, which also involves crystal deposits in joints. The key difference is the type of crystal. Gout is caused by uric acid crystals, while pseudogout involves calcium pyrophosphate crystals. Pseudogout more commonly affects the knees and wrists rather than the big toe, and it tends to occur in older adults. The two conditions require different treatment approaches, so accurate diagnosis matters.