Gout is a common yet complex form of arthritis that can affect anyone. It's characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, most often beginning with the big toe. An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is warm to the touch, swollen, and very tender, making it intolerable to bear the weight of a bedsheet. Gout occurs when either your body produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needle-like uric acid crystals in a joint or surrounding tissue that cause pain, inflammation, and swelling. Risk factors include non-vegetarian food, alcohol, obesity, certain medications and medical conditions, family history of gout, age, and sex. During an acute attack of gout, medications should be given to reduce pain and swelling. Once resolved, medications can be started to reduce uric acid levels, as rapid reduction in uric acid can itself precipitate an attack of gout.