"What's going on with my toe?" This question may run through your mind if intense pain in your big toe disrupts your sleep. One possible answer is gout, a type of inflammatory arthritis that usually affects the big toe.

Gout causes pain and swelling because of needle-shaped uric acid crystals that form in the joints. Symptoms occur in flares. This means you'll experience symptoms for a week or two before they go away, only to return weeks or months later. Treatment can't cure gout, but it can reduce and control flares – and boost your quality of life.

Your body makes chemical compounds called purines, which you can also get from certain foods, such as red meat. When the body breaks down purines, it produces a waste chemical called uric acid. The kidneys filter most uric acid from your blood so it can leave your body in urine.

Sometimes, too much uric acid – a condition known as hyperuricemia –  builds up in the body. This happens when the kidneys have trouble removing uric acid from the blood or when you eat too many purine-rich foods. Hyperuricemia can cause acid crystals to accumulate in the joints, bursae (sacs between bones and tissues), and elsewhere in the body, leading to gout.

Men have a higher risk of gout – they're three times more likely to develop it than women, according to the Arthritis Foundation. When women develop gout, it's usually after menopause.

Obesity also increases the risk of gout by causing the body to make more uric acid. Excess weight makes it more difficult for the body to get rid of uric acid.

Additional risk factors for gout include:

• Drinking too much alcohol or too many beverages with high-fructose corn syrup
• Eating too many high-purine foods
• Family history of gout
• Having diabetes, high blood pressure, heart failure, or kidney disease
• Taking diuretics or beta-blockers

Gout flares can take you by surprise. They typically happen suddenly, and the first one is likely to affect one of your big toes. Unfortunately, that doesn't mean your other joints are in the clear. Gout can also affect your knees, ankles, fingers, and other toes.

The main symptoms of gout are pain and swelling around the affected joint. The pain can be severe and, if left untreated, may affect your mobility and ability to perform daily tasks or participate in favorite activities. You may also notice redness and heat around the painful joint.

Looking for a silver lining? You're unlikely to experience symptoms in multiple joints at once – gout typically occurs in one joint at a time.

Gout worsens over time and can progress through four stages:

• Hyperuricemia. You have too much uric acid in your blood and uric acid crystals are accumulating in your joints, but they're not causing symptoms.
• Flares. Symptoms of gout occur over days or weeks.
• Interval or intercritical gout. Gout is calm and you don't experience symptoms.
• Tophi. This is advanced gout. Large concentrations of uric acid crystals called tophi affect the joints and soft tissues. Some tophi may be visible as lumps beneath the skin. These lumps can cause kidney and joint damage.

Gout tends to progress slowly, and treatment can help you control it. If you're dealing with pain and swelling in your big toe or another joint, don't wait for it to go away. Tell your primary care provider (PCP), which is the first step to getting the treatment you need.

To determine what's going on, your PCP will start by asking you about your medical history and the symptoms you've been experiencing. You'll want to tell your PCP when the symptoms began, when and where they occur, what they feel like, and how they affect your quality of life. Your PCP will perform a physical exam and inspect the affected joints.

Many conditions cause symptoms similar to gout, so your PCP may not be able to make a definitive diagnosis based on just a medical history and physical exam. One way to be more certain gout is present is to take a sample of fluid from the affected joint. If uric acid crystals show up in the sample under a microscope, it's a strong indicator of gout.

In addition to a joint fluid analysis, your PCP may order other tests to check for signs of gout. For example, a blood test for uric acid can show whether you have an elevated level of this waste product in your blood. An imaging test, such as an X-ray, ultrasound, or MRI, can allow your PCP to see uric acid crystals in the joints.

There is no cure for gout, but don't let that keep you from seeking treatment. Gout is one of the most manageable types of arthritis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. However, success largely depends on early diagnosis and commitment to treatment. Delaying diagnosis and treatment can lead to tophi and may increase your risk of complications, including chronic kidney disease, kidney stones, heart attack, and diabetes.

Your PCP may refer you to an orthopedic specialist or rheumatologist to treat gout. The physician will develop a plan to help control flares and reduce the chances that more will occur. Your management plan may include:

• Healthy eating. Follow a healthy eating plan to help you lose weight and avoid triggering gout flares. Minimize or avoid consumption of liver, red meat, shrimp, crab, oysters, lobster, alcohol, and soda, which can worsen gout. On the other hand, water, low-fat dairy products, citrus fruits, and green vegetables may help protect against gout and uric acid buildup.
• Exercise. Low-impact exercises, such as walking and swimming, can strengthen your joints without stressing them. Along with a healthy diet, regular exercise can help you lose weight. Need help finding an exercise program that works for you? Consult a fitness specialist for tips.
• Medications. Your physician may recommend a nonsteroidal anti-inflammatory drug, such as ibuprofen, to manage pain during a gout flare. You may also need to take medication to reduce uric acid.

With commitment and an expert's help, you can keep gout from standing in the way of a healthy, happy future.