Acute Gout Attack
Gout is a type of arthritis and is therefore also known as gouty arthritis. It causes moderate to severe joint pain and discomfort. A typical acute gouty attack is characterised by the sudden advent of excruciating joint pain, redness, warmth, and swelling.
The big toe (the first metatarsophalangeal joint) is the joint most commonly affected by acute gout and is known as podagra. Less frequently, other joints may be affected by a gout attack, with the ankles, feet, knees, fingertips, wrists, and elbows being the most common.
An acute gouty attack typically reaches its climax within 12 to 24 hours of its onset, and then gradually begins to subside without treatment. It takes approximately 7 to 14 days without treatment and 3 to 4 days with treatment to recover completely from the attack.
Dr. Thomas Sydenham, who himself suffered from gout, elegantly described an acute gouty attack in 1683:
The patient retires to bed and rests soundly. Around 2 a.m., he is awoken by excruciating pain in the great toe; less frequently in the ankle, heel, or instep. The agony is comparable to that of a dislocated joint, but the affected area feels as if cold water has been poured over it. It is accompanied by fever, shivers, and shivering. The pain, which was initially moderate, will intensify. The intensity of the goosebumps and shivers increases in tandem with its intensity. After some time, these symptoms reach their peak, adapting to the ligaments and bones of the tarsus and metatarsus. Now it is a gnawing pain, now a violent shredding of the ligaments, and now a sensation of tightening and pressure.
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