Gout is an inflammatory disease caused by the accumulation of uric acid in the joints which form crystals. The formation of the crystals causes acute pain, swelling and stiffness in the joints which eventually subsides when the uric acid is dissolved back into the blood streams. However, if uric acid levels remain high, the disease can become chronic and presents in a manner similar to arthritis. Although any joint in the body can be affected, it often presents for the first time in the first joint of the big toe as the condition is exacerbated by keeping pressure on the site such as that which is typical of wearing shoes.