Gout attacks most often start in parts of the lower limbs -- big toes, ankles, insteps, etc. As time goes by gout begins to attack parts of the upper limbs -- wrists, fingers, etc. Gout can co-exist with different types of arthritis.
Gout attacks are often triggered by over-use, injuries, and flares of other types of arthritis, in the gouty joints, because under these unhealthy conditions the ph of the joints drops to cause the shedding of the urate crystal coatings and trigger gout attacks. Keep the hands and feet warm, avoid over-use and injuries, do appropriate exercise, avoid acidic foods and drinks, can also be beneficial.