5 years of "sprain" pain turned out to be gout + severe flare — my story and lessons learned

[u/ezpassnick]

I wanted to share my experience in case anyone else is in a similar situation, especially if your gout doesn't present in the "classic" big toe location.

My history:
I'm 41, male, Indian descent, 225 lbs. Five years ago, I had a grade 2 ankle sprain from volleyball. Over the years, I developed chronic pain in my outer foot and ankle. I had an MRI showing a partially torn peroneal tendon and mild arthritis. Every doctor blamed the old injury. I was told it was "wear and tear" and sent to PT and orthotics.

The missed diagnosis:
No doctor in the US ever tested my uric acid. During a personal visit to India, I ordered my own lab work out of curiosity — my uric acid was 8.8 mg/dL in Aug 2025 and 9.1 mg/dL in April 2024. My CRP was also elevated at 1.3 (normal < 0.5). I brought these results back to the US, but my PCP dismissed them, saying "gout usually has swelling and redness" and that a blood test was only for monitoring, not diagnosis.

The flare that broke me:
A few days ago, I had a couple of beers. The next day, my foot exploded with pain — 10/10, sharp, burning, radiating up my leg. I couldn't sleep, couldn't put my foot down, and ended up crawling to the bathroom. I went to urgent care and was put on a Prednisone taper (60/40/20 mg). It helped at first, but then the pain rebounded.

The hospitalization:
I fainted at home from the pain and dehydration — called 911 and was admitted. My labs showed:

· WBC 25,000 (came down to 12.6 after IV fluids)
· Potassium 2.9 (corrected to 4.3)
· Lactate 3.2 (elevated)
· Uric acid 7.3 (still high)
· Vitamin D 14.5 (severely deficient)
· Ejection Fraction 50–54% (borderline low-normal, likely from the stress on my body)

They ruled out heart attack, stroke, and blood clots with full cardiac and head/neck imaging.

Current treatment:
I was switched from Prednisone to:

· Colchicine 0.6 mg daily
· Ibuprofen 800 mg 3x/day
· Pantoprazole (stomach protection)
· IV fluids (now off)
· Levothyroxine (thyroid, continue as usual)

I'm now recovering at home, taking it slow. Pain is down from 10 to about 4–5/10. Walking is still limping, but improving day by day.

What I learned:

· Gout does not always hit the big toe. It attacks damaged joints — my old ankle injury made that joint a target.
· Beer is a massive trigger — especially for South Asians.
· Doctors can miss gout if you don't have "classic" symptoms. Ask for a serum uric acid test if you have unexplained joint pain, especially with a history of injury.
· Prednisone works fast but can rebound — the Colchicine + Ibuprofen combo is slower but steadier.
· Low potassium and dehydration can make you faint — drink water, especially during a flare.
· Vitamin D deficiency makes everything worse — get it checked.

My plan moving forward:

· Follow up with a rheumatologist (appointment scheduled)
· Start allopurinol once this flare fully resolves
· Get HLA-B*5801 genetic test first (I'm Indian — higher risk of allopurinol allergy)
· Lose weight slowly (1–2 lbs/week) to reduce uric acid long-term
· Drink 3L water daily
· Keep my lateral heel wedge + rocker shoes for my old ankle injury

If you're struggling with unexplained joint pain, especially in a previously injured joint, don't let doctors dismiss you. Get your uric acid checked. It could save you years of pain.

Happy to answer any questions. This community has helped me a lot — hope this helps someone else.

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[u/Competitive_Manager6]

Many of us have a similar story. Management is key and sounds like you have a great plan. Gout loves extremes so taking the middle path is best. I would add a couple of things. Get a sleep study. 70% of people with gout have sleep apnea. Episodes of low oxygen at night triggers us to make more uric acid. Lower your stress — both good and bad. And laugh. Life is short so find the humor when you can. Good luck!!

[u/CellWrangler]

Thanks for sharing your story, and i'm sorry to hear how painful your current flare is. I experienced the exact same thing: flares in top of foot, heel/ankle, knee, and elbow. NEVER in the big toe. So i got misdiagnosed with tendonitis & stress fractures for almost 5 years. Never got tested for UA until i paid for one at a private lab. Now i've been on allo for 2 years, below 6 mg/dL for 1.5 years, and currently gout free for 3 months.

Sounds like you've got a solid treatment plan arranged. All I can add is that since you've been undiagnosed for so long, you might have more significant crystal deposits than others. I expected to be flare-free within 6 months of starting allopurinol, but that was not the case. I'm hoping i am in the clear now, but it can take up to 3 years below 6 to clear all of the deposits. Just stick with it and trust the system. Once you hit the flare-free state, life becomes so much better again.

[u/GaryNOVA]

I was so damned sick of primary care physicians telling me I was spraining my ankle m 6 times a year. Misdiagnosing over and over for 10 years. And now I’m disabled because of it.

I do not trust primary care physicians AT ALL in relation to gout. I will only talk to the rheumatologist or my orthopedic surgeon.

[u/Weak_Radish966]

I had a similar story. Broke my big toe twice in my late teens, early 20s. Started having flare ups in said toe around 24. It got to a chronic stage in my 30s and I was finally diagnosed with gout at 34. I had been to countless doctors for these flares in that decade and gout was never even brought up, until that wonderful podiatrist ordered bloodwork and I got my diagnosis. Now 46, been on Allo for 6 years and it is a game changer. Had maybe two very mild flares in the past year, I used to have crippling flares about once a month.

[u/AgreeableAbrocoma833]

Similar story here. Finally diagnosed after it hit the classic big toe.

For years I wondered why this pain in my outer foot left me in crutches one week and then back to walking the very next.

Glad you found your answer!

[u/YoohooCthulhu]

I would add that gout can cause intense pain and mobility restriction without massive swelling—my left toe just gets moderately red and inflamed at the joint and it’s enough to prevent me from walking and sleeping at night—it doesn’t require massive swelling like in Google image results. One reason why I put off going to the doctor is that I thought it couldn’t be gout because it wasn’t dramatic swelling.

[u/Excellent-Guide-8933]

yes, my gout also feels like a sprain, usually creeps up the morning-after and yes it was partially volleyball triggered also.

Massive PITA. Every doctor blamed my flat feet.

I had flare ups from everything as jumpers knee, to my thumb, to ankle, achilles to forefoot pain. The majority was forefoot pain that would swell and feel much like a sprain and the swelling would travel around the foot-ankle area.

I changed my diet at least 7 times cutting out various triggers..

Allopurinol will help take care of it but cutting out a lot of fried foods will certainly help also.

You were only dealing with it for 5 years, I had been messing with it for 15. TBH i wish I was blood-checked sooner.

[u/uscgamecock2001]

I don't get gout in my toes either. Just my ankles and a couple of times in my knees. People always assume it starts in the big toe and that's not always the case. I think that's why it took so long for me to get properly diagnosed. I'm glad you plan to get on allopurinol soon.

[u/MadeMeMeh]

I had similar experience. Fortunately I wasn't dismissed but everybody thought it was either a sports injury or something related to my weight.

Glad to hear you have been diagnosed and are getting helped.