What is Gout and How to Control Gout Symptoms

What is Gout and How to Control Gout Symptoms

Gout is a type of arthritis. Gout symptoms can appear as a sudden attack of pain and burning, stiffness and swelling in the joint (usually in the big toe). These attacks can occur again and again unless the gout is treated. Over time, these attacks can damage joints, tendons, and other tissues. Gout is more common in men.

Being overweight, drinking too much alcohol, or overeating meat and fish that contain high amounts of chemicals called purines will increase your chances of developing gout. Also, some medications, such as diuretics, can cause gout.

Table of Contents

Types of gout

Gout symptoms have three stages, with many people never experiencing the third stage.

  1. In the first stage, there is a high uric acid level in the patient’s blood but no symptoms. Uric acid levels may remain constant, and the patient may not have any symptoms. However, some people may develop kidney stones before the first gout attack.
  2. In the second stage, uric acid crystals gradually form (usually in the big toe). At this stage, gout attacks begin. After an attack, the affected joint looks normal. The time between these attacks may gradually shorten. However, subsequent gout attacks may be more severe, last longer, and involve other joints.
  3. In the third stage, the symptoms may not disappear. Gout attacks may affect more than one joint. Also, tiny nodules called Tophi may form under the skin.
Types of gout

Causes and Factors and Gout Symptoms

Large amounts of uric acid cause gout in the blood (hyperuricemia). The exact cause of hyperuricemia is unknown, although hereditary factors (genes) play a role in the occurrence of this disease.

Uric acid may crystallize and accumulate in the joints.

This causes pain and other symptoms.

Gout can appear suddenly without a specific cause, or the following factors can cause it:

  • Certain conditions related to body weight and diet include being overweight, a diet rich in meat and seafood (purine-rich foods), and drinking too much alcohol.
  • Medicines that may increase the concentration of uric acids, such as regular use of aspirin or niacin, or medicines that reduce the amount of salt and water in the body. (diuretics).
  • Significant illnesses or unusual medical complications include rapid weight loss or high blood pressure.
  • Having a rare congenital condition that causes high levels of uric acid in the blood. People with “Clay-Siegmiller” syndrome or “Lash-Nyhan” syndrome have a partial or complete lack of an enzyme that helps control uric acid levels.
uric acid and Gout

Signs and symptoms of gout

Gout symptoms include:

Warmth, pain, swelling and sensitivity to intense touch in the joint (usually the joint of one of the big toes). This symptom is called podagra, which is one of the gout symptoms. The pain often begins at night, may worsen rapidly, last several hours, and be so severe that even the slightest pressure is unbearable.

Among other gout symptoms, the skin around the affected joint is red or purple. The joint may appear to be infected.

If the affected joint becomes limited in movement, it is a gout symptom.

Scaling and itching of the skin around the joint, at the same time as the gout attack subsides

Occurrence of different symptoms of gout

What is Gout and How to Control Gout Symptoms 06

Gout symptoms may vary:

Some people do not experience gout as a painful attack. Instead, they have Gout almost all the time (chronic gout). Chronic gout in older people may be less painful and may be confused with other types of arthritis.

Gout Symptoms may lead to soft tissue inflammation of fluid sacs (bursae), especially in the elbow (elbow bursa) and knee (prepatellar bursitis).

Gout symptoms can also affect the joints of the feet, ankles, knees, wrists, fingers, and elbows.

Its symptoms may appear after an illness or surgery.

Gout Symptoms may initially appear as a nodule on the hand, elbow, or ear. The patient may not have any of the classic gout attack symptoms.

Many other conditions have symptoms similar to gout.

Gout symptoms may vary

gout pain

When you have gout, uric acid crystals can go years without causing any symptoms; They form on your joints. If the blood level of the ovary is very high, These crystals are formed between the space of two joints. Depending on the hardness of the crystal formed, swelling, inflammation and pain will vary from person to person. The skin on the joint where the crystal is formed; In some cases, it is shiny and may be flaky. This type of sudden gout pain usually occurs quickly and often at night.

 This sudden pain usually disappears after five to seven days but can last longer. If gout is not treated, sudden pains become more common and may spread to other joints.

Sudden gout pain usually starts in the big toe joint, often in the early morning. Any light contact with the affected joint is excruciating; Even the weight of socks can be unbearable. Although gout symptoms most often affect the big toe, other joints may also be affected, including:

Other leg joints

  • ankle
  • the knee
  • Elbows
  • wrist
  • fingers

Sometimes gout symptoms are observed in many of these joints simultaneously, But usually, the symptoms of this disease are not common in the spine, shoulders or pelvis. The sudden pain of Gout Symptoms is widespread in the end joints of the legs and arms, such as the fingers and toes. One of the reasons for this is the low temperature of this part of the body, a condition that causes crystals to form in the body.

The degree of sudden pain of Gout Symptoms may vary from person to person. Some people only experience flare-ups every few years, while others may experience flare-ups every few months. Without medication, the frequency of sudden pain or gout symptoms will increase, affecting other joints as well. Among the complications and effects of gout on other parts of the body are:

Narrowing of the arteries can lead to an increased risk of stroke, heart attack, or other heart problems.

Osteoarthritis occurs when urate crystals and hard tophi cause joint damage.

Increased risk of kidney disease or worsening if you already have it.

kidney stone

Increased risk of certain cancers, especially prostate cancer

Mental health problems, including depression


Erectile dysfunction

However, it should be noted that by taking medicine to reduce urate levels and having a healthy diet and lifestyle, most of the damage and complications caused by gout symptoms can be controlled and reduced.

Osteoarthritis and Gout

What factors increase the risk of gout?

  1. family history
  2. Overweight
  3. Gender and age
  4. Taking some medications

What triggers gout?

Several things cause urate crystals to form; These are:

  1. Trauma or injury to the joint
  2. A disease that causes fever
  3. Consuming fatty foods
  4. drinking alcohol
  5. dehydration

Gout Symptoms Diagnosis Methods:

  1. blood test
  2. CTE scan
  3. Synovial fluid test

 What to do during a gout attack?

As soon as you notice the onset of a gout attack, you should take any prescribed medication as soon as possible. These drugs will gradually take effect within two or three days.

Lie down and raise your legs.

Avoid hitting or damaging the affected joint.

Keep your joint cool. Remove the clothing around it and place an ice pack over it, such as a bag of frozen peas wrapped in a towel.

Keep the ice pack on your joint for about 20 minutes. Please do not touch the ice pack directly on the skin for over 20 minutes because it can damage your skin.

Synovial fluid test

Treatment of Gout Symptoms

The treatment of gout symptoms varies depending on how far the disease has progressed. The most common drug treatments to reduce the pain caused by gout symptoms are:

  • NSAID drugs

  Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually recommended as first-line treatment for gout. The action of these drugs reduces pain and inflammation during an attack.

  • Colchicine drug

If you cannot take NSAIDs, or if these drugs are ineffective, you can use colchicine instead.

  • Allopurinol
  • Febuxostat
  • Uricosuric drugs



In addition to drug treatments, experts believe that gout can be treated with regular exercise and efforts to reduce pressure on the affected joints and healthy diets, while in acute and severe cases of gout pain, joint replacement surgery will be the only treatment option.

Nonsteroidal anti-inflammatory drugs

Lifestyle and gout attacks

You can reduce your risk of gout attacks by making lifestyle changes to lower uric acid levels. These changes include:

Avoiding foods with high levels of purines, such as red meat, offal, fatty fish, seafood, and foods containing yeast extract, avoiding sugary drinks and snacks, as they are associated with an increased risk of gout.

  1. Maintain a healthy weight – follow a balanced diet. Do not restrict your diet or follow a high protein and low carbohydrate diet.
  2. Exercise regularly – try to do activities (like swimming) that do not put too much stress on your joints.
  3. Drink plenty of water – keep your body fully hydrated to reduce the risk of crystal formation in your joints.
  4. Reduce alcohol consumption – avoid beer and especially alcoholic beverages and alcohol consumption.
  5. Vitamin C intake: Research has shown that vitamin C may lower uric acid levels in people with gout. For this reason, your diet should contain a lot of fruits and vegetables.
What is Gout and How to Control Gout Symptoms18


Gout is a common form of arthritis that affects the joints and is usually accompanied by pain, swelling and stiffness in the joint area. An excessive increase in blood urate levels is the leading cause of gout. If the kidneys do not naturally excrete the excess urate, urate crystals form on the joints. To treat urate, drugs are usually prescribed to reduce inflammation and urate levels. People can reduce their risk of gout by avoiding foods high in purines, which the body converts to uric acid, staying hydrated, and avoiding alcohol. To diagnose and treat gout symptoms, visit an orthopedic specialist and do not start treatment arbitrarily.

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Author and specialist

Dr. Majid Zahrabi,


  • Board Certified Neurosurgeon
  • DHA certificate holder
  • Plantation certificate holder, France
  • Certified holder of Discogol, France
  • A pioneer in the non-surgical treatment of disc herniation in the Middle East and CIS countries.
  • Under the training and coaching of Professor Jacques Theron (founder of Discogel Therapy) since 2008
  • More than 400 successful cervical and 1300 lumbar discogel injections
  • Trained and certified several neurosurgeons and spine surgeons in the Middle East and CIS countries for the treatment of Discogel
  • Strong belief in patient-centered care planning and participation
  • Neurosurgeon and spine surgeon at Imam Khomeini and Amir Mazandarani Hospital, Sari, Iran, with more than 430 surgeries annually, 2000-2011
  • Neurosurgeon and spine surgeon at Farmaniyeh, Nikan and Yas Sepid Hospital, Tehran, Iran, with more than 400 surgeries annually, 2011-2012
  • Neurosurgeon at Iranian Hospital, Dubai, 2022-2023
  • Since 2015, he has been working as a reference doctor for the treatment of intervertebral disc herniation with Discogel and has trained many doctors of spine-related specialties in various countries of the Middle East and CIS in person/practically and online.



  • Individual training sessions under the direct supervision of Professor Jacques Theron in Discogel treatment, 2008-2020
  • Training sessions under the supervision of Professor Thierry Boye on spinal implants, 2007
  • Participation and presentation in several national and international medical and neuro-spinal conferences
  • Board certificate by Iran Neurosurgery Board, 2001
  • Neurosurgery assistant training course, Isfahan University of Medical Sciences, Isfahan, Iran, 1996-2001 (In 2001, he graduated from Isfahan University of Medical Sciences with the first rank in the country.
  • His thesis the titled:The Application of human amniotic membrane in repair of dura matter in dogs.” ( It was happening for the first time in the world. )
  • General medical education, Tabriz University of Medical Sciences, Tabriz, Iran, 1984-1993


Published books:

  • CT scan of the brain for doctors
  • Etiology and treatment of painful spine disorders
  • Atlas of diagnosis, prevention, and treatment of spine disorders
  • The most common mistakes in the treatment of spinal disorders
  • Reading brain CT scan in simple language (3rd place in the book of the year)
  • Treatment of head and spine injuries

Publications and articles:

  • Bacteriostatic and bactericidal effects of DISCOGEL® (https://www.researchgate.net/)
  • Muscle recovery, reduction of pain, and improvement of movement strategies in patients with lumbar discopathy after injection of Discogel.
  • The article on the initial results of the treatment of intervertebral disc herniation with discogel injection, which won the second-best poster rank at the Pan Arab International Congress of Interventional Radiology (March 14-16, 2015) and was accepted for presentation at the Chicago Pain Congress.
  • The use of human amniotic membrane in dura mater repair in dogs, a study for the first time in the world.



  • Annual Congress of Physiotherapists of Iran, 2019
  • Chicago International Pain Congress, 2019
  • Iran International Pain Management Congress, 2018
  • Annual Congress of Physiotherapists of Iran, 2018
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Armenia for orthopedic specialists and neurosurgeons, 2017
  • First Live Workshop and Seminar on Minimally Invasive Disc Therapy (DISCON), 2017
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Azerbaijan for orthopedic specialists and neurosurgeons, 2016
  • Seminar of Iranian official managers, 2016
  • Presentation of Discogel as an innovative solution for the treatment of spinal disc herniation in Tajikistan for orthopedic specialists and neurosurgeons, 2016
  • International Neurological Intervention Congress in Iran, 2014
  • Educational seminar for nurses on treatment approaches for head and spine trauma, 2014
  • Educational seminar for general practitioners on treatment approaches for head and spine trauma, 2014
  • Speech at the Retraining Seminar for General Practitioners and Specialists in Dubai (Discon) in 2017
  • Speech in the internal retraining courses of Irani Hospital, Dubai
  • Holding lecture sessions and practical workshops on the treatment of intervertebral disc herniation with discogel injection in Azerbaijan, Tajikistan, Ukraine, Oman, and Armenia during the years 2015 to 2021.
  • Giving a lecture and holding a practical workshop for neurosurgeons in Vietnam at Ho Chi Minh City University in 2023

Dr. Majid Zohrabi started treating his patients in Dubai in 2022 and continues his activities in private medical centers in the UAE.