Gout is typically a form of inflammatory arthritis with a chemical cause as opposed to a degeneration of the joints. It is caused from deposits of sodium urate (uric acid) in and around the joints and especially in the feet! Ordinarily uric acid is removed from the blood stream via the kidneys, which filters uric acid out of the blood stream. Any issues that prevent this from occurring creates hyperuricemia which is the primary risk factor for gout. Too much uric acid creates small needle like crystals that tend to collect in the feet and grind and irritate the synovial joints in the metatarsals. The feet tend to be the focus of these collections partly due to gravity and partly due to the slightly decreased temperature found in the extremities that allows the crystallisations to form. This creates inflammation and irritation of the joints and thus pain.