Gout symptoms often come on quickly, sometimes overnight. The classic flare is a joint that becomes intensely painful, swollen, warm and red over a matter of hours. If the diagnosis is uncertain, see how gout is diagnosed; if you are in an active attack, see gout flare relief. A red, hot joint can also be an emergency when joint infection is a possibility.
Common symptoms
- Sudden severe joint pain
- Swelling and warmth
- Red or shiny skin
- Extreme tenderness, sometimes even from light contact such as a bedsheet
- Reduced movement because the joint hurts to use
Not sure whether a sudden attack could be gout? See Could This Be Gout? Sudden Joint Pain With No Injury for a symptom-first guide that also explains when to seek medical care.
Where does gout hurt?
The big toe is the best-known location, but gout can affect the midfoot, ankle, knee, fingers, wrist, elbow and other joints. More than one joint can be involved, especially in longstanding or poorly controlled disease.
What are the early warning signs?
Some people report tingling, stiffness or a sense that a familiar joint is becoming tender before a full flare. Others get no useful warning at all. There is no single symptom that can reliably predict every attack.
How long do symptoms last?
Untreated flares often last several days and may last a week or longer. Effective anti-inflammatory treatment started early can shorten and reduce the severity of a flare.
What happens between flares?
Symptoms may disappear completely between attacks even while urate crystals remain in the joint. That symptom-free period is called intercritical gout.
When symptoms may not be gout
A hot, red, swollen joint can also be caused by infection, pseudogout or another inflammatory arthritis. Seek prompt medical care if this is a first attack, you have fever or feel systemically unwell, or the diagnosis is uncertain.
This article is educational and is not a substitute for medical advice.
Sources
Evidence checked September 2026.