For many people, the first symptom of gout is excruciating pain and swelling in the big toe – often following a trauma, such as an illness or injury. Gout may also appear in another lower-body joint, such as the ankle or knee. Subsequent attacks may occur off and on in other joints, primarily those of the foot and knee, before becoming chronic.
Gout usually affects one joint at a time, but if left untreated it can affect many joints. Joint pain that used to resolve in a week to 10 days could become a milder, but constant pain. Eventually, untreated gout can cause other problems. Tophi – painless but disfiguring lumps of crystals formed from uric acid may develop under the skin around joints. The crystals can also form kidney stones.
Gout is associated with other serious health risks such as high blood pressure, diabetes, chronic kidney disease and cardiovascular disease.