Signs Your Gout Is Getting Worse

Medically Reviewed by Jennifer Robinson, MD on August 29, 2022
2 min read

When you have gout, your blood has too much uric acid, a substance your body makes when it breaks down food. Over time, the uric acid forms into crystals, which collect around joints. You may not have symptoms at first. But if the area gets inflamed, a gout attack happens, with swelling, redness, and intense pain.

When uric acid levels in your blood stay too high, more and more crystals form around your joints. It can turn into a long-term condition, leading to painful and damaged joints.

Gout will happen differently for everyone. But signs that it may be getting worse include:

  • Flares happen more often and last longer. Over time, the inflammation causes lasting damage to bone and cartilage.
  • Flare-ups in other parts of your body. About half of people with gout have their first attack in the joint at the base of the big toe. When gout gets worse, it can affect other joints, including the ankle and knee.
  • Bumps form under the skin. Uric acid crystals may start to collect in soft tissue, forming lumps called tophi. They often appear on the hands, fingers, elbows, and ears, but they can show up almost anywhere on the body.
  • Kidney problems. Your kidneys normally get rid of uric acid in your body. But too much of it can also damage the organs. Kidney problems linked with gout -- and signs that gout is getting worse -- include gouty kidney, kidney stones, and kidney failure.

If you think your condition is getting worse, talk to your doctor. They will give you medicine to keep your uric acid levels low and to try to prevent future attacks and complications.

Allopurinol (AloprimZyloprim) treats chronic gout by lowering the uric acid produced in your body.

Febuxostat (Uloric) also lowers uric acid production but would be used with caution if you are at risk for heart or blood vessel disease.

Once you start taking these medicines, you’ll need to take them for life so that your uric acid stays at the right levels.

Probenecid and lesinurad (Zurampic) help the body get rid of more uric acid in your urine. Pegloticase (Krystexxa) and rasburicase (Elitek) can break down uric acid into a substance that your body can get rid of. They are only for very severe gout that doesn’t get better with usual treatments.

Scientists are also testing new treatments for chronic gout. At the same time, researchers are getting a better understanding of how the body makes and breaks down uric acid. Insights from this research could lead to new treatments in the future.