Gout 

Another form of arthritis, gout occurs when higher than usual levels of uric acid in the bloodstream lead to the formation of crystals in the joints, which in turn causes sudden swelling and pain. The most common site for a gout attack is the big toe, but ankles, feet, knees, wrists, elbows and fingers can also be affected. Risk factors include age, family history, drinking alcohol and certain foods and medicines.

Gout is regarded as one of the most painful conditions to experience, mainly because the symptoms can start very abruptly and build very quickly – even the touch of a bed sheet on the joint can be excruciating.

Gout requires a two-pronged approach to management: relief of symptoms when an attack takes hold, and longer-term preventative treatment. The latter not only reduces the chance of further episodes, but also lowers the risks associated with having high uric acid levels, including longer-term accumulation of crystals in the joints and kidney problems. NSAIDs can be taken to relieve pain and reduce inflammation, alongside measures such as resting and elevating the affected joint and applying an ice pack. Colchicine or steroids can help shorten the duration of an attack.

Lifestyle changes may be all the prevention that is needed: reducing alcohol, sugar and purine-rich foods such as red meat, offal and yeast extract; increasing intake of fruit and vegetables and low fat dairy products; staying hydrated; and getting to and maintaining a healthy bodyweight. Medicines that reduce uric acid production in the body – allopurinol and febuxostat – may be prescribed and need to be taken for life.