 acid crystals which cause you pain free article  gout is a condition in which uric acid a waste product that occurs naturally within the body rises above normal levels rather than being flushed by the kidneys and through the urine it forms crystals which are then deposited in the joints these deposits give rise to inflammation of the joints causing pain swelling redness and tenderness of the area typically the joint affected is the big toe but gout can also affect the ankle knee foot hand wrist and elbow uric acid crystals may also form deposits in other areas such as under the skin or in other soft tissues and in the kidney or urinary tract gout predominantly affects adult males it is the most common cause of inflammatory arthritis in men over the age 40 men are at least four times more likely to develop gout than women women who do develop gout rarely develop it before reaching menopause the onset of gout is usually quick and unexpected often people who develop gout will do so during the night while sleeping after having gone to bed in good health they are awakened by acute pain in the big toe or more rarely in the heel ankle or instep this pain has been described as feeling as though a bucket of cold water poured over the affected area with the pain increasing to a violent stretching tearing sensation there is also a pressure and tightness around the area the pain becomes so acute that not even the weight of a bed sheet can be tolerated the soft tissues such as the muscles and tendons around the joint can become hot red and swollen and to wear a shoe may become impossible gout typically affects the joint at the base of the big toe in over half of all initial attacks this is the first joint affected the majority of initial gout attacks involve only one joint over 50 of people who have had an acute attack of gout will have a recurrence within the year over time the attacks may become more frequent lasting longer and often involve more joints for some individuals the attacks linger and the disease becomes chronic the crystals of uric acid deposited inside the joint and in the surrounding soft tissues lead to destructive changes in the joint and cause persistent inflammation a number of factors seem to contribute to the cause of gout acute gout may be triggered by events such as surgery heart attacks or trauma use of alcohol or some medications such as certain diuretics also known as water pills particularly those used to treat high blood pressure can set off a gout attack certain foods such as seafood and liver and beverages such as coffee and tea may contribute to the incidence of gout a family history of gout is common for those who develop it and this may be a result of genetic predisposition or environmental factors the goal in treating gout is to safely provide relief of acute attacks prevent further attacks and damage to the joints and prevent the formation of tophi or kidney stones establishing the correct diagnosis is important because most therapies work best when started early in the disease there are a variety of treatments used for gout some of the treatments used are the following nonsteroidal antiinflammatory drugs nsaids nsaids reduce pain when taken at a low dose and relieve inflammation when taken at a higher dose the most commonly used nsaid to treat gout is indocid other nsaids used to treat gout are naprosyn orudis voltaren and tolectin those who do not respond well to a nsaid usually are prescribed cortisone cortisone is a steroid that reduces inflammation and swelling it is typically administrated by an injection into the joint for severe pain and inflammation doctors can inject a powerful antiinflammatory drug called corticosteroid corticosteroids are drugs that closely resemble cortisone an injection can provide almost immediate relief for a tender swollen and inflamed joint however this treatment can only be used rarely since corticosteroids can weaken cartilage and remove the minerals from the bone resulting in further joint weakness colchicine is another medication that has been used since the 1800s to treat gout it is very effective however it is not used as frequently as nsaids are because it tends to cause side effects such as nausea vomiting and diarrhea there are a number of other medications used for treatment of other conditions that alter how uric acid is excreted through the kidneys dietary habits may cause your body to produce too much uric acid to keep levels of uric acid low reduce your amount of certain foods and drinks such as coffee cocoa tea seafood liver gravy peas and spinach alcohol beer wine etc also stops uric acid from leaving your body and can trigger gout sudden changes in your diet or dramatic weight gain loss may also cause gout attacks medications have made the management of gout very effective those people who have occasional attacks can usually manage them well with treatment which includes making changes to the way one lives types of foods eaten control of weight etc those with chronic gout can control the level of uric acid through the ongoing use of medication it is possible after years of treatment that the total body of uric acid stored can remain low enough to where one may not need medication  getting comfort  