I just always read that gout always has swelling
Not really. Swelling is common. But, it can be so slight as to be barely noticeable. Gout pain is an immune system reaction to uric acid crystals. And every gout sufferer has different reactions. As well as swelling, we often see redness, itching, and fever as symptoms of inflammation.
So, it’s definitely gout. But, I’m concerned that your doctor hasn’t offered a few months of gout pain prevention therapy.
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