Just saw my husband’s foot and I’m panicking. It’s huge and red and he says it feels like it’s on fire. Emergency care is hours away. What is this?

A gout attack typically presents itself through a sudden onset of intense pain, swelling, and redness in the affected joint, most commonly the big toe. The affected area may appear visibly swollen and feel warm to the touch, sometimes even hot. In severe cases, the affected skin might have a shiny or taut appearance due to the swelling.

These symptoms occur because of the rapid accumulation of uric acid crystals in the joint space, leading to intense inflammation. The pain can be so severe that even the weight of a bedsheet can be unbearable, and the discomfort often peaks within the first 24 hours. The abruptness and severity of the symptoms can be frightening, but understanding that these are hallmark signs of gout can help in managing the initial shock.

While infections and injuries can also cause swelling and redness, gout has distinct characteristics. Unlike infections, gout rarely causes fever or chills unless there’s an accompanying infection (which is a medical emergency). Injuries often have a clear precipitating event, like a fall or twist, whereas gout attacks can occur spontaneously, often overnight.