Gout is essentially a type of arthritis, and unfortunately it is very painful even compared to other types of arthritis. When there is too much uric acid in the body this is essentially what leads to the condition. When uric acid accumulates in the body it can lead to sharp uric acid crystal deposits which tend to form in joints. The big toe is one of the most prevalent places for gout to form and this is typically where people first experience it. Excessive uric acid also leads to lumps under the skin called tophi which are essentially deposits of the acid. Aside from the big toe, gout may form in the elbows, fingers, wrists, knees, heels, ankles, and insteps. Usually uric acid leaves the body through the kidneys, but it can build up if a person eats too many foods high in purines such as peas, liver, anchovies, and dried beans. It may also build up if the kidneys are unable to get rid of enough uric acid, or if the body starts to increase the amount of uric acid it produces.
The first symptom of gout--called podagra--that most people experience is a joint which suddenly becomes painful, stiff, swollen, red, and hot. Sometimes the area is so tender and the pain is so acute that even the slightest pressure, like a bed sheet, can cause an extreme amount of pain. Unfortunately the pain often starts during the night, waking up the person experiencing it. The pain is generally not expected and happens very fast and abruptly. Shocks of pain are often random.
The tenderness may also last a long time and extend beyond the joint. If the big toe is affected then the tenderness may even extend up into the leg. It could also endure for hours and become worse quite quickly. Pain is generally worse between the first 1-12 hours after it begins. Thankfully your doctor will probably be able to prescribe you some kind of painkillers.
At first glance the joint may look infected due to the heat and coloration, but this is just another symptom of gout. The surface of the skin may appear red or even somewhat purple. The swelling involved can also be quite extensive. If the gout begins in the big toe the entire foot can end up experiencing inflammation and in some cases it can even extend beyond the knee.
You may also experience skin peeling. As the tissue around the joint is damaged the skin often starts to peel. The type of peeling and flakiness will likely resemble eczema and a bad sunburn. You may also experience some itching around the area. If the skin starts to crack as a result of swelling there may even be bleeding. If you are experiencing swelling it is important to keep your doctor up to date. You may also experience a low-grade fever with polyarticular gout, a limited range of joint mobility, and kidney stones. It is important to see a doctor if you are experiencing the symptoms of gout, as the condition can cause joint damage and worse pain if it is not addressed.