Gout in the hands and fingers is a type of arthritis resulting from an excess of uric acid in the body. This buildup causes the formation of crystals, or tophi, in and around the joints, causing pain and swelling.

Gout can affect any joint in the body. Although it occurs most commonly in the big toe, it can also affect the hands and fingers.

Gout is a painful and potentially disabling form of arthritis. Evidence suggests that gout affects more than 3 million people in the United States and roughly 41 million people globally. It typically occurs more often in males, postmenopausal females, and people with kidney disease.

Some people may refer to the condition as “the disease of kings,” a term that references its previous association with an overindulgence of food and wine that only the rich and powerful could afford.

However, health experts now understand that the condition relates to uric acid metabolism and the body’s inflammatory response to uric acid crystals. It develops when too much uric acid accumulates in the bloodstream, resulting in the formation of crystals in joints.

In this article, we explain how gout can affect the hands and discuss the signs and symptoms of this condition.

An x-ray of the hand showing gout.Share on Pinterest
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Gout is a common form of inflammatory arthritis that is often very painful. It typically affects the joints, particularly those toward the ends of the limbs. It most often begins in the big toe, in the metatarsophalangeal joint. However, while gout usually occurs in the lower extremities, other common sites include the elbow, wrist, and finger joints.

A typical gout attack, or flare, involves joint pain and swelling that usually last 1–2 weeks. The symptoms can develop rapidly and suddenly, and they may slowly resolve on their own without treatment. After a gout attack, a person may experience a period of remission — which could last weeks or even years — during which they have no symptoms. However, without treatment, gout flares may last longer and happen more often.

Gout causes similar symptoms in the hands as it does in other joints. A person may notice the following symptoms in the affected joint:

If uric acids levels remain high over an extended period, people may develop white, chalky deposits around the joints and tendons. These deposits, called tophi, appear as visible lumps under the skin and can result in permanent damage and deformity.

Gout can affect any joint in the body. However, it occurs more commonly in certain joints, such as the toe, ankle, and knee. If gout progresses without treatment, or a person is unable to manage the condition, it can affect multiple other joints, such as the fingers and hands.

Similar to other joints, gout in the hands occurs due to an accumulation of uric acid in the blood, which results in the formation of uric acid crystals that collect in the joints. Uric acid is a waste product that usually forms when the body breaks down substances known as purines. These substances are present in many foods, such as liver, shellfish, and alcohol.

The kidneys are usually capable of filtering uric acid from the blood and eliminating it in the urine. However, if a person produces too much uric acid, or the kidneys are not functioning correctly, uric acid can accumulate in the blood and form uric acid crystals. After a long period, these crystals can deposit and build up in the joints, forming tophi.

Gout is the result of too much uric acid in the body, which doctors may refer to as hyperuricemia. However, hyperuricemia does not always cause gout, and if a person does not experience gout symptoms, they may not require treatment. Uric acid is a waste product that the body produces when it breaks down purines, which are substances present in meat and alcohol.

Some individuals have an increased risk of developing gout. The Centers for Disease Control and Prevention (CDC) state that these people include:

  • males
  • people with obesity
  • those taking diuretics
  • people who drink alcohol
  • individuals who eat foods high in purines
  • those who eat or drink foods high in fructose

Various medications, including cyclosporine, immunosuppressants, and some blood thinners, are also associated with gout. Individuals with certain health conditions are also at higher risk of having gout. These conditions include:

A doctor will diagnose gout by assessing a person’s symptoms and performing a physical examination. They may also order an X-ray and additional laboratory tests to detect uric acid crystals in the joint. It is easiest to diagnose gout during a flare, when the joint is painful, swollen, and hot.

The symptoms of gout are not specific, and a person could mistake them as being due to other inflammatory conditions. Therefore, it may be necessary for a rheumatologist to make the diagnosis. A rheumatologist is a doctor who specializes in gout and other forms of arthritis.

People can typically treat and manage gout with medications and self-management strategies. A doctor will usually suggest treatment plans to help control the symptoms and prevent future flares. For example, they may recommend the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil). Alternatively, they might suggest a steroid medication or an anti-inflammatory drug, such as colchicine (Colcrys), to help manage pain.

A doctor may also advise taking other medications, such as allopurinol (Zyloprim), febuxostat (Uloric), and pegloticase (Krystexxa), which can help lower uric acid levels. A person may need to change or stop any current medications that are associated with hyperuricemia, such as diuretics.

Self-management strategies, such as changes to the diet and lifestyle, can also help reduce the severity and frequency of flares. For example, people can adopt a gout-friendly diet, get regular exercise, and maintain a moderate weight.

Other conditions may also cause a person to experience pain and swelling in joints, such as the hands. For example, many people often confuse gout with calcium pyrophosphate deposition disease, or pseudogout. While both are forms of arthritis, they result from the buildup of different crystals in the joints.

It is possible to mistake other types of arthritis, such as psoriatic arthritis (PsA), osteoarthritis (OA), and rheumatoid arthritis (RA), for gout due to the similarity in their symptoms. Joint pain and swelling can also be due to an infection of the joint tissue and fluids, which is called septic arthritis.

In some cases, different types of arthritis may occur together. Evidence shows that it is possible to have more than one type of arthritis and that gout can occur alongside PsA, OA, or RA.

Anyone who suspects that they may have gout should contact a doctor for a diagnosis. Other conditions that may cause similar symptoms will also likely require treatment. Gout and other forms of arthritis that go untreated can cause joint damage.

People with a diagnosis of gout should attend regular appointments with a doctor. During these, they should mention any worsening of symptoms, new symptoms, or concerns about other conditions that may occur alongside gout.

Gout is a common form of arthritis that causes severe pain and swelling in one or more joints. It occurs due to high levels of uric acid in the blood, which form needle-like crystals in joints and soft tissue. Although gout usually begins in the big toe, it can target other joints, such as the fingers and hands.

Gout is a very painful condition, but it is manageable with medications and self-management strategies. If a person suspects gout or notices a worsening of gout symptoms, it is advisable for them to contact a doctor.