Gout vs. Arthritis in the Foot: How to Tell the Difference

Foot pain is one of the most common reasons patients visit our office. Often, they come in convinced they know the cause—“It’s probably arthritis,” or “I think it’s gout.” While both conditions can cause significant discomfort, gout and arthritis are very different diseases, and confusing one for the other can delay proper treatment.

At Restore Foot and Ankle Specialists, we frequently diagnose both conditions, and telling them apart is critical for relieving pain and preventing long-term joint damage. Here’s how to understand the differences—and when it’s time to seek professional care.

Why Gout and Arthritis Are Commonly Confused

Both gout and arthritis can cause:

• Joint pain

• Swelling

• Redness

• Stiffness

• Difficulty walking

However, the underlying causes, progression, and treatments are not the same. Treating gout like arthritis—or vice versa—can allow symptoms to worsen over time.

What Is Gout?

Gout is a type of inflammatory arthritis caused by elevated levels of uric acid in the blood. When uric acid builds up, it forms sharp crystals that deposit in joints—most commonly in the foot.

Classic Signs of Gout

Gout often has a very distinct presentation:

• Sudden, intense pain (often overnight)

• Severe swelling and redness

• Warmth in the affected joint

• Pain so severe that even a bedsheet touching the foot hurts

The big toe joint is the most common location, but gout can also affect the ankle, heel, midfoot, and toes.

Gout attacks tend to come in flares, with periods of little or no pain in between.

What Is Arthritis?

Arthritis is a broad term describing joint inflammation and degeneration. The most common forms we see in the foot include:

• Osteoarthritis (wear-and-tear arthritis)

• Rheumatoid arthritis (autoimmune-related)

Common Signs of Arthritis

Arthritis symptoms typically develop gradually and may include:

• Achy or sore joints

• Morning stiffness

• Pain that worsens with activity

• Reduced range of motion

• Progressive joint changes over time

Unlike gout, arthritis pain is often chronic and ongoing, rather than sudden and explosive.

Key Differences: Gout vs. Arthritis in the Foot

Onset of Pain

• Gout: Sudden, severe, often overnight

• Arthritis: Gradual, worsens over time

Pain Intensity

• Gout: Sharp, intense, debilitating

• Arthritis: Dull, aching, stiff

Swelling & Redness

• Gout: Significant swelling and redness, skin may appear shiny

• Arthritis: Mild to moderate swelling, less redness

Pattern

• Gout: Comes in attacks or flares

• Arthritis: Persistent or slowly progressive

Common Location

• Gout: Big toe joint (most classic), ankle, midfoot

• Arthritis: Any joint, often multiple joints over time

Why Proper Diagnosis Matters

Treating foot pain without knowing the cause can lead to:

• Repeated flares

• Permanent joint damage

• Loss of mobility

• Chronic inflammation

Gout requires management of uric acid levels and inflammation, while arthritis treatment focuses on joint protection, reducing wear, and controlling inflammation long term.

How We Diagnose Gout vs. Arthritis at Restore Foot and Ankle Specialists

Our diagnostic approach may include:

• Detailed medical history

• Physical examination

• Imaging such as X-rays

• Laboratory testing when indicated

• Evaluation of gait and joint mechanics

Accurate diagnosis allows us to create a personalized treatment plan rather than a one-size-fits-all approach.

Treatment Options Differ Significantly

Gout Treatment May Include:

• Managing acute inflammation

• Preventing future flares

• Lifestyle and dietary guidance

• Coordination with primary care or specialists when needed

Arthritis Treatment May Include:

• Custom orthotics to offload joints

• Anti-inflammatory strategies

• Activity modification

• Supportive footwear recommendations

• Advanced therapies to reduce pain and improve function

When Should You See a Podiatrist?

You should schedule an evaluation if you experience:

• Sudden, severe foot pain

• Recurrent joint swelling

• Pain that limits walking or daily activities

• Foot pain that does not improve with rest

• A history of gout or arthritis with worsening symptoms

Early diagnosis can significantly reduce long-term complications.

The Bottom Line

While gout and arthritis can feel similar, they are not the same condition. Gout tends to strike suddenly and intensely, while arthritis usually develops gradually over time. Understanding the difference is essential to protecting your joints and maintaining mobility.

At Restore Foot and Ankle Specialists, our goal is to identify the true cause of your foot pain and provide targeted, effective treatment—so you can stay active, comfortable, and confident on your feet.

If foot pain is disrupting your life, don’t guess. Let a specialist help you get answers. Contact our office today with Dr. Gireesh Reddy or Dr. Sirisha Pokala by calling (469) 573-3427 or by booking an appointment online.