Gout Symptoms: Four Stages of Gout

As one of the arthritic diseases, gout must be the most painful. It would certainly seem so to anyone who suffers from gout. When there is too much uric acid in the body, a condition medically known as hyperuricemia, needle-like crystals of uric acid start forming and get deposited in your connective tissues and the joints. The big toe is a particularly vulnerable spot. Uric acid crystals also build up as lumps called tophi, located just beneath the skin near your joints, or accumulate in the kidneys to form kidney stones. They build up quietly, but one day you suddenly feel that explosion of pain associated with gout.

Severe attacks of gout often occur at nighttime. You may suddenly wake up to extremely painful sensations pulsating in your big toe or other small joints. When you are roused from sleep like that, no pain can possibly exceed what you feel. That only means you have not paid enough attention to your body. Gout does not just happen, it develops slowly in four main stages.

Stage 1: Asymptomatic Hyperuricemia - Asymptomatic means without symptoms. At this stage your uric acid level in the blood remains at a high level. You do not feel anything (yet) but the excess uric acid forms its crystalline needles that gradually get deposited in your joint spaces.

Stage 2: Gouty Arthritis, or acute gout - At this stage, the accumulation of crystals in your joints has reached near saturation. Yet, the uric acid in your blood remains at high levels which caused more crystals to form and deposit in your joints. The excess at one part of your body led to an excess in another.

This causes that sudden attack of intense pain; your joints become swollen and very tender; the tissues around the joint become inflamed and heat up. Stress, alcohol, or drugs may trigger the attack. It usually comes at night, lasts maybe three to ten days, and then subsides. The subsequent attacks may not happen until several months later or years, but they will become progressively more painful, more frequent, and last longer.

Stage 3: Inter-critical gout, or interval - This is a peaceful interval between acute attacks. Everything appears and feels normal, the crystal deposits in your joint are still high but some stable equilibrium has been reached. It is easy to get complacent and forget about gout at this stage. You should not. You should find a way to get treated and be rid of it.

Stage 4: Chronic or Tophaceous gout - This is the most destructive, most disabling stage. It takes a long while to progress to this stage, perhaps 10 years. By the time you get here, there is already permanent damage inflicted on your joints, advanced deterioration has set in, and extreme pain becomes rather regular. The worst scenario that can happen here is damage to the kidneys, which can lead to renal failure in extreme cases. This is terrible, but with proper treatment, most gout sufferers never get to this advanced stage.

Gout Treatment

Like most arthritic diseases, gout is something that can be avoided, or at least minimized. Treatment is more likely to be more effective if intervention is done at the early stages. It is never too early to start working on it.

If you have a gout attack, many doctors recommend oral doses of ibuprofen or naproxen, available in both prescription and nonprescription versions, or other anti-inflammatory drugs. If you are taking aspirin, your doctor may recommend that you stop it temporarily. Aspirin can slow the elimination of uric acid and make gout worse. But if you take a low dose of aspirin to prevent other problems such as a heart attack, check with your doctor before stopping it.

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