The big toe is the most common joint affected, but it can affect all joints in the body, especially the weight bearing joints, the ankles of the knees. In a person who does manual labour it can affect the hands, elbows or shoulders, or in the sportsperson such as a golfer - the wrists, the hands or the elbow.

Gout is caused by the accumulation of urate crystals in the particular joint affected. Urate crystals come out of the bloodstream, which is overloaded with uric acid, so a person who suffers from gout has a higher than normal level of uric acid in their bloodstream. This can be checked by your local doctor with a simple blood test.

Gout is a genetic condition, and that means people are born more susceptible to these increased levels of uric acid. It is debatable as to what causes the increase of uric acid levels in a person who is susceptible. Diet is said to play some part.

Foods high in purine: liver, anchovies, meat extracts, shellfish, crab or prawns may or may not play a part in the increase in the uric acid levels. Alcohol can also do this.

Later in life, with recurring attacks, damage the joint may lead to deformities. Uric acid crystals are also deposited in the kidney where they can cause damage. High blood pressure, kidney stones, kidney failure can be associated with long term gout.

In an asymptomatic patient - that is a person who is not suffering from symptoms but has a mild increase of uric acid levels in the blood, then no treatment may be necessary.

For an acute attack, bedrest may be necessary, as the pain may be so intense that you just can’t walk.

Simple analgesics in the early stages of pain and Colchicine tablets may help but generally once an acute attack is established, it is the non-steroid anti-inflammatory tablets which are the most effective means of curing an acute attack.

After the acute attack is over, then if necessary, long term medication, to reduce uric acid level