The 4 Stages of Gout

Stage 1: High uric acid levels

Also called asymptomatic hyperuricemia, in this beginning stage of gout, uric acid is building up in the blood and starting to form crystals around joints, most often in the foot.

In this first stage of gout, the person has no joint pain, no red or swollen joints, just an elevated uric acid blood test.

Stage 2: Acute gout

Symptoms start to occur, causing a painful gout attack.

That sudden, unexpected nighttime flare-up of gout.

“This is when the person has pain, redness, and swelling of a joint, most commonly in the big toe, the foot, the ankle or the knee, but gout can start in other joints as well,

If you think you’re experiencing a gout attack, see your primary care doctor or a rheumatologist to begin treatment for the disease. 

Stage 3: Intercritical gout

Periods of remission between gout attacks.

After a first gout flare, 75 percent of people will have a second within a year; but some people can go years before another attack.

It is the nature of gout to have flares and then quiet down for a period of time before the next flare.

Even though it may seem like nothing is happening, this is the point in which a patient should begin long-term treatment.

Stage 4: Chronic gout

Gout pain and attacks frequent and tophi formation occurs in joints.

This stage is also called “tophaceous gout” because the uric acid deposits can form nodules called “tophi,” often at the bunion point of the big toe or at the elbow. But tophi can form anywhere in the body. 

It usually takes many years of uncontrolled gout for someone to get into this stage.

Without treatment, gout will usually progress.

So make sure you get treated for it.