Complications of gout 

Complications of gout can include small lumps forming under the skin (tophi), joint damage and kidney stones. These are more likely to occur if gout is left untreated.


Gout is caused by a chemical called uric acid forming small crystals in and around the joints. These crystals also often build up under the skin and form small white or yellow lumps known as tophi.

Tophi are usually painless, but they can form in awkward places, such as at the ends of your fingers and around your toes. Sometimes they can make everyday tasks such as preparing food or getting dressed difficult.

They can also can become inflamed and produce a toothpaste-like discharge.

Tophi can develop anywhere in the body, but usually form on the:

  • toes
  • heels
  • knees
  • fingers
  • ears
  • forearms
  • elbows

It normally takes several years after the first attack of gout for tophi to develop, but some people develop them even before experiencing an attack. They're usually a sign of severe gout and a good reason to start treatment to reduce the level or uric acid in your body.

Successful treatment will prevent the tophi from getting any bigger, and long term treatment often gradually shrinks them.

If you have very large or painful tophi, they may have to be surgically removed.

Joint damage

Without treatment, gout attacks may become more frequent and prolonged, and your likelihood of developing permanent joint damage will increase.

In the most serious cases, surgery may be required to repair or replace a damaged joint.

Kidney stones

Occasionally, high levels of uric acid can lead to the formation of kidney stones.

Some kidney stones interfere with the flow of urine, resulting in pain when you pass urine, and can make you feel that you need to pass urine more often.

Some kidney stones interfere with the flow of urine, resulting in pain when you pee, and can make you feel that you need to pee more often.

You may be prescribed medication to make your urine less acidic, which should help dissolve any kidney stones that have developed. Read more about treating kidney stones.

Psychological and emotional effects

Gout can also affect your mood, work and home life. The severe pain that gout causes can make it difficult to do everyday tasks and to get around, which in turn can lead to feelings of depression or anxiety.

If gout is affecting your mood or making everyday life difficult, talk to your GP. They will be able to offer treatment and support.

There are also a number of organisations that offer information and advice for people who have gout, including The UK Gout Society, Arthritis Research UK and Arthritis Care.

Read more advice about living with pain.

Page last reviewed: 24/09/2015

Next review due: 24/09/2017