10 Signs Your Ankle Pain Could Be Gout

Ankle pain can be one of life's biggest nuisances. These joints play a vital role in allowing us to move effectively, and even the tiniest twinge or ache in them can grind your activity to a halt. But while ankle pain can often be relatively minor and clear up on its own, now and again it can be caused by something more serious — and gout can be one of these things. Gout has seen a huge uptick in its prevalence in the last few decades, with the number of people who have gout doubling since the 1990s, according to research published in The Journal of Rheumatology. In the United States, roughly 9.2 million people experience gout symptoms (per the JAMA Network), and while it's commonly thought of as a condition that affects older people, men can be more susceptible to it at a younger age, particularly between around 30-50 years old, says the Mayo Clinic.

Gout causes sharp, often excruciating pain in the joints, and while it's most likely to flare up in your big toe, it can affect you in many places that your bones meet — including your ankle. But how do we know that the pain in our ankle is gout and not something else? We're here to lay out all of the signs you should keep an eye out for.

If you're unsure whether your ankle pain is gout, it might be wise to consider what's happening on the outside of your body, as well as on the inside. Visible skin changes are common when it comes to gout, with your skin likely taking on a red tinge or swelling up. This is most common with acute gout attacks and is caused by what happens when uric acid builds up in your system, as the Hospital for Special Surgery rheumatologist Theodore R. Fields explains via Creaky Joints. "Urate crystals are released into the joint fluid and cause an inflammatory reaction, bringing in many white blood cells and releasing inflammatory chemicals that cause the pain, redness, and swelling," Fields states.

Your skin might also feel hot to the touch and especially tender, says Versus Arthritis. Additionally, it might look shinier than usual. As your gout attack starts to calm down, one skin change that can occur post-attack is peeling, as your skin starts to heal and regenerate. Applying a cold compress to your skin during a gout attack may help to bring redness, swelling, and pain down, although it's generally better to use this line of treatment if your pain isn't especially severe (per WebMD).

Some types of ankle pain typically deliver a dull, constant pain that follows you around throughout the day. But gout pain? It's fast. Very fast. Ankle pain caused by gout tends to ramp up very quickly and be very painful, with not very much prior warning that the pain is going to strike, explains Creaky Joints. Unfortunately, though, the pain can take a little longer to fade than it does for it to appear, with gout pain generally going away in anywhere from a few days to several weeks.

One of the strangest things about gout pain, too, is that when you're not experiencing a flare-up, it can generally be non-existent — you may have no symptoms for weeks, months, or even years. The problem, though, is that once you've had one gout attack, you may be facing more if you don't treat the condition. And the longer you go without tackling your gout, the more likely you are to experience a gout attack, and the more painful it can be when it rears its head without warning again.

Gout can be exhausting, y'all. And that's not just because once you've had a gout attack, you may be constantly looking over your shoulder to see when the next one will arrive. Gout in your ankle can cause fatigue alongside the pain, as Creaky Joints states. You can get so exhausted during a gout attack that it can resemble the flu in its severity, exacerbated by muscle aches and fever that can also come with the pain.

This, naturally, can make dealing with a gout attack quite difficult: Not only do you have intense pain to contend with, but tiredness too. That's why it's vital to know how to deal with a flare-up. Try as much as possible not to overexert yourself during a gout attack, and reduce stress and activity levels, as the Arthritis Foundation advises. Reducing any unnecessary stress will allow you to recover faster, while also helping to manage fatigue. It's also vital to stay hydrated. Managing your pain and symptoms with medication can also be a helpful move. 

When you have a gout attack, the tissue in your joints flares up and becomes inflamed, and one notable area that can be affected is your bursae, the sacs of fluids that keep your joints moving healthily (per Healthline). An inflamed bursa, known as bursitis, can prompt stiffness, which can then make moving around more difficult. Bursitis may also, in some cases, prompt infection, creating further complications and potential long-term damage to the joint.

Acute gout can also cause mobility difficulties thanks to the fact that it's very, very painful to walk or to do anything. If your gout is chronic, though, you may have mobility issues thanks to a different cause. Chronic gout causes constant low-level inflammation, as an article published by the Institute for Quality and Efficiency in Health Care states. Over time, this can alter the shape of your joints, which may further hamper mobility, made worse by the fact that your muscles can then get weaker and lose function.

One way to determine whether your ankle pain might be gout is to take a look at your lifestyle and your diet. Gout is determined by having higher levels of uric acid in the body, which is caused by higher purine levels, as the Cleveland Clinic discusses. Purines can be much higher in certain types of food, with certain meats — including red meats, organs, and game meats — delivering more of the compounds. Foods that have high fructose corn syrup in them, or that have a lot of fructose generally (as many sugary foods do) may also spike your purine levels. And one of the biggest offenders is alcohol, with beer being high in purines, and alcohol more generally inhibiting purine processing through the kidneys, resulting in a buildup of purines and uric acid.

As such, following a low-purine diet is useful both to prevent gout and to manage it if you've experienced a gout attack (per WebMD). Ideally, you should try and prioritize lean protein sources like chicken breast, as well as plant-based sources like lentils or beans. Try to consume as many fruits and vegetables as possible, too. One fruit you might want to eat more of is cherries, which have been found to be effective in bringing uric acid levels down and making gout attacks less likely, according to a review published in Evidence-Based Complementary and Alternative Medicine.

While ankle pain caused by gout can be a highly painful and irritating experience, it's important to remember that unless diagnosed by a doctor, it may not be gout at all. There's another condition that prompts gout-like symptoms without being gout itself: Pseudogout. While gout pain is prompted by the build-up of uric acid crystals, pseudogout is caused by excess calcium pyrophosphate (or CPP), WebMD explains. This buildup of CPP can then create crystal formations in the joints, like gout, and cause similar symptoms.

Mercifully, though, pseudogout usually results in less severe pain than true gout. It may be less predictable than gout, however, mainly because it can be tricky to determine exactly why people get CPP buildups sometimes. CPP release may be determined by your cartilage and could be prompted by cartilage damage from an injury. Pseudogout is generally more likely to occur in older adults, particularly people more than 60 years of age. Luckily, though, it is treatable with anti-inflammatory medication or anti-gout drugs like colchicine. Your doctor may also prescribe steroids or deliver steroid injections to help bring the inflammation down.

While ankle pain can be created by gout, it's important not to jump to conclusions. The fact is that ankle pain may be caused by a huge variety of conditions affecting your bones, joints, tendons, or muscles, as the Cleveland Clinic states. It may even be as simple as a sprain, an injury that is characterized by damage to the ankle ligaments that may occur during a sporting activity or by simply rolling over it. Tendonitis, a condition whereby the tendons become inflamed and damaged, may also be what's creating your ankle aches.

In other situations, the pain could be created by something other than your ankle entirely. If you have flat feet, for example, your ankles can take the additional strain and become painful and inflamed due to the lack of arch support in your foot. Generally, your physician will determine what's causing your ankle pain through a series of tests, which may include an X-ray or an MRI scan. Generally, ankle pain is treated using a combination of cold therapy, resting the joint, elevating your ankle and foot, and pain or anti-inflammatory medication, but for other conditions like gout, additional treatments may be required.