Gout in Hands, Fingers and Wrists

Gout is a painful type of arthritis that usually affects joints in your lower body, like your big toes, ankles or knees. But it can develop in your hands, fingers or wrists, too.

Gout happens when sharp crystals of uric acid clump together in your joints. Symptoms will come and go. These are called flares or gout attacks.

Visit a healthcare provider if you have new pain, swelling or stiffness in your hands and wrists. Especially if the symptoms come on suddenly.

Symptoms of gout in your hands

Gout attacks happen suddenly. Symptoms in your hands, fingers or wrists may appear overnight. The most common gouty arthritis hand symptoms include:

• Swollen hand joints that feel warm or hot
• Skin discoloration
• Finger joint pain
• Stiff hand, finger and wrist that make your joints feel tight or hard to move
• White bumps or nodules under your skin called tophi

What are the stages of gout in your hands?

Gout in your hands develops over time. At first, you might not have any symptoms. Over time, it can get worse and damage your joints. There are four main stages:

• Stage 1: Asymptomatic: The early stage of gout in your hands is when you first have too much uric acid in your blood. This is called hyperuricemia. Some people have no symptoms at this stage.
• Stage 2: Acute: This is usually when you’ll first experience symptoms. Crystals form in joints. This leads to sudden attacks that cause intense pain and swelling.
• Stage 3: Intercritical or interval: This is when attacks come and go. You’ll experience some time with no symptoms before another flare.
• Stage 4: Chronic tophaceous: If gout isn’t well managed, tophi can form near your joints. You’ll have white bumps or nodules under your skin.

What causes gout in your hands, fingers and wrists?

Having too much uric acid in your body causes gout. Your body creates uric acid as a byproduct of digesting chemicals called purines in some foods and drinks. Normally, your kidneys filter uric acid out of your blood. Then, it leaves your body in your pee.

Sometimes, your body makes too much uric acid. Or your kidneys don’t remove it from your blood fast enough. When your body has high levels of uric acid, uric acid crystals can build up and settle into your joints. This leads to gout. You’ll experience symptoms in your hands, fingers or wrists if the uric acid crystals clump together in those joints.

Red meat, certain types of seafood, and foods and drinks high in sugar or sweetened with high-fructose corn syrup all have lots of purines in them. Alcohol, especially beer, does, too.

You won’t get gout immediately if you have high uric acid levels. In fact, many people have high levels and never experience symptoms. But the longer you have too much uric acid in your body, the more likely it is that you’ll develop gout.

Risk factors

Anyone can develop gout. It’s three times more common in males. Females usually don’t experience gout until after menopause. People with certain health conditions are more likely to develop gout, including:

• Overweight or obesity
• Diabetes
• High blood pressure
• Kidney disease
• Congestive heart failure
• Blood cancer

You’re more likely to experience gout if you:

• Eat or drink foods and beverages high in purines often
• Drink alcohol regularly
• Have a biological parent or grandparent who has gout
• Take diuretics (water pills)
• Take immunosuppressants

Complications of gout in hands

Untreated gout can permanently damage your affected joints. It can also increase your risk of complications like:

• Changes to your joints’ shape
• Severe arthritis
• Kidney stones
• Heart disease

How doctors diagnose gout in hands

A healthcare provider will ask you about the symptoms you have and examine your hands. They’ll want to know about your medical history and which medications you’re taking. That’s because certain medical conditions and medications can lead to gout.

Your provider will likely want to remove some fluid from your affected joints to look for signs of gout. They’ll take a fluid sample with a joint aspiration. Needle-shaped uric acid crystals will show up under a microscope. You may also need a blood test. This will help your provider check your uric acid levels.

Your provider may want to take pictures of your joints with imaging tests, including:

• X-rays
• Ultrasound
• A dual-energy CT scan

Treatment for gout in hands

Treating gout in your hands is a combination of managing symptoms during a flare and reducing how often you have attacks.

Medications that your healthcare provider may recommend to treat flares include:

• NSAIDs: Over-the-counter medicines, like ibuprofen or naproxen, can reduce pain and swelling during a gout attack. They may not be safe to take if you have kidney disease, stomach ulcers or other conditions. Talk to your provider before taking NSAIDs.
• Colchicine: This is a prescription medication that can reduce inflammation and pain, especially if you take it as soon as you notice signs of a gout attack starting.
• Corticosteroids: These are prescription anti-inflammatory medications. Your provider may prescribe pills you take by mouth. They may also inject medicine into your joints or a nearby muscle.

The long-term goal is to reduce how often you have gout attacks. You may need medication to help lower your uric acid levels. Common examples include:

• Allopurinol
• Febuxostat
• Pegloticase
• Probenecid

Your provider will probably suggest some tweaks to your daily routine to help manage gout. You may need to:

• Follow a low-purine diet.
• Limit how much alcohol you drink.
• Get 30 minutes of physical activity at least three times a week.

It’s rare to need surgery to treat gout in your hands. But your provider may recommend it if you develop tophi. Surgery can:

• Remove them to make it easier to use your joints
• Remove them to cosmetically change the look or shape of your joints
• Control drainage or treat infected tophi

When should I see my healthcare provider?

Talk to your healthcare provider if you’re having more frequent gout attacks. Or if the symptoms are more severe than they used to be.

If you haven’t been diagnosed with gout, visit a provider if you experience sudden, intense joint pain. That’s especially true if you’re swollen and your skin is discolored. Gout shares many symptoms with infections that need immediate treatment.

What can I expect if I have this condition?

Gout usually responds well to treatment. But you should expect to have flares of symptoms that come and go.

Flares might happen more often if you don’t get gout diagnosed and treated by a healthcare provider. Untreated gout increases your risk of complications in your affected joints.

You may have more severe or more frequent attacks right after starting treatment. That’s normal. Your body needs time to adjust to new medications or changes in what you’re eating and drinking.

Take the medication your healthcare provider prescribes right away when you notice a flare starting.