ZocdocAnswersWhich joints does gouty arthritis attack first?

Question

Which joints does gouty arthritis attack first?

I am 52 and I have gout. How will this progress? How can I get better?

Answer

Gout most often presents in the joint connecting the big toe to the foot; this is characterized by an inflamed joint that is red, hot, swollen, and very tender to touch or manipulation. However, gout often affects other joints as well. Gout is caused by the deposition of uric acid crystals in the joint space, and the inflammatory process that results. While some people will have only rare episodes of gout, other people may be more prone to frequent attacks; repetitive episodes and uncontrolled uric acid levels over many years can lead to joint erosion and even chronic disability. It is important to follow-up with either your primary care doctor and/or a rheumatologist for optimal treatment of your gout. This will include a short-term treatment to help you get over the acute gout attack (which can involve either non-steroidal anti-inflammatory drugs, steroids, or colchicine). If attacks become more frequent, then prophylactic medication such as allopurinol to suppress the levels of uric acid will be an important part of treatment. Reducing the consumption of uric acid in the diet can also help, which may involve cutting back on beef and alcohol.

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