The most common symptom of gout is sudden and severe pain in one or more joints, typically your big toe. Gout is extremely painful.

Symptoms often develop at night, although they can occur at any time. Other symptoms include:

• your joint being very tender, to the point of being unable to bear anything touching it
• swelling (inflammation) in and around the affected joint
• red, shiny skin over the affected joint
• peeling, itchy and flaky skin over the affected joint as the inflammation subsides

The intense pain that gout causes can make walking and getting around difficult. Even the light pressure of a bed cover or blanket can be unbearable.

Which joints are affected?

Seventy per cent of people with gout experience their first attack in the big toe and most people with gout experience pain in their big toe at some point.

However, gout can affect almost any joint and can occur in more than one joint at the same time. The joints towards the ends of the limbs tend to be affected more often and may include:

• the midfoot (the area where your shoelaces would sit)
• ankles 
• knees
• fingers
• wrists
• elbows

If gout is left untreated, it is more likely to affect more than one joint as it progresses.

Pattern of symptoms

It is difficult to predict when an attack will occur. Symptoms typically develop rapidly over just a few hours and usually last for 3 to 10 days. After this time, the joint will start to feel normal again and any pain or discomfort associated with the attack should eventually disappear completely.

Just over half of all people with gout (62%) experience a repeat attack within a year. You may experience symptoms every few weeks, months or years, but it is impossible to predict when the condition will recur.

Although some people may experience just a few attacks in their lifetime, the vast majority of people with gout experience attacks that increase in frequency over time. New joints will often start to be affected.

When to seek medical advice

Always see your GP if you suspect you have gout, particularly if it hasn't been previously diagnosed.

It is important that a diagnosis is confirmed because more serious conditions, such as an infected joint, can sometimes cause similar symptoms.

You may also require treatment with prescription medication that only your GP (or a specialist) can provide.

When to seek immediate medical advice

Contact your GP immediately or call NHS 111 if you have both:

• a high temperature of above 38ºC (100.4ºF)
• joint pain and swelling that is still getting worse after the first 24 hours

You may have an infection inside the joint (septic arthritis).