Gout and bursitis can cause severe and debilitating pain in the joints. While gout affects the joints themselves, bursitis affects the fluid sacs called bursae that help eliminate friction at joints or spots where the muscles and tendons rub over bony projections. Gout occurs when sharp urate crystals accumulate in the joints and surrounding areas. In contrast, bursitis occurs when bursae become inflamed from any cause.
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Bursitis most often affects the joints of the hips, elbows and shoulders, but can also affect the heels, knees and big toes. Gout usually attacks the joints of the big toes, but can also occur in the feet, ankles and knees, and hands and wrists. Unlike gout, bursitis often occurs as a result of simple overuse, especially in middle-aged people, according to PubMed Health. Repetitive motions that focus on a particular joint, such as throwing a baseball over and over, or holding positions that press on a particular joint, such as kneeling for a long time, can inflame the bursa. Avoiding such triggers can solve the problem for many bursitis sufferers.
Gout is a form of arthritis, and patients who have arthritis have an elevated risk for developing bursitis. Arthritis encompasses a range of conditions that cause inflammation and gradual destruction of a joint. The inflammation can spread to the bursae, causing bursitis. MedlinePlus.com classifies gout as a type of arthritis.
Gout results when levels of uric acid in the blood rise too high, causing formation of spiky urate crystals that invade the joints or the spaces around them. Uric acid forms as the body breaks down purines, a protein component found in many foods, and also made by the body. Normally, the kidneys efficiently filter out uric acid from the blood, but crystals can form if the kidneys falter or the body makes too much uric acid. The Merck Manual states that although the exact cause of bursitis often remains a mystery, it can result from invasion of crystals into the bursae.
Both bursitis and gout become more common in middle-age, perhaps because of accumulated wear-and-tear on joints and the development of other conditions that affect the joints. For example, people with thyroid disease have an elevated risk for bursitis, while diabetes increases the risk of both bursitis and gout. Other risk factors for gout include kidney disease, high blood pressure and high cholesterol, drinking alcohol and eating purine rich foods, because all of these factors increase the levels of uric acid in the blood.