Gout why like to gnaw hands and feet, its good cause is multi-factorial: (1) temperature: gout is a systemic disease, but it mostly occurs in the distal joints of the limbs, such as exposure to the peripheral environment of the hands and feet and ears. Low temperatures reduce the solubility of uric acid, leading to more urate crystals forming. The formation of gout stones is specifically related to the gradient difference between the body’s central body temperature and the temperature of the distal limb and peripheral joint cavities. According to the Loeb study, at a certain pH, urate solubility in the body increases with increasing body temperature. Take care that the quilt covers both hands and feet at night. (2) Trauma and pH: There is a clinical correlation between acute attacks of gout and physical trauma, such as toe bumps and sports activities. In vitro studies have shown that supersaturated urate solutions increase nucleation of urate crystals under mechanical shock, and acidified solutions and added calcium ions also increase nucleation. Low pH values have a direct effect on urate crystallization and increased calcium ion activity enhances urate crystallization. The authors hypothesize that local trauma indirectly increases nucleation by lowering the PH of the bursa. Thus, the susceptibility of the foot to injury may help explain the preference of gout stones for the foot. This is the reason why it hurts to go home after more activity during the day and more walking. (3) Cartilage surface destruction and osteoarthritis: Osteoarthritis of the first metatarsophalangeal joint is significantly more prevalent, but it has not been studied or given as much attention as the common knee and hand joints. Osteoarthritis results in increased chondroitin sulfate, degradation of polysaccharide proteins, cartilage fragments that enhance uric acid crystal formation and epicondylar nucleation. When a joint with osteoarthritis is overused, it can lead to an acute exudation of joint fluid. When the patient sleeps, the joint is rested and the exuded fluid is reabsorbed into the blood plasma at a faster rate. This results in an instantaneous increase in the concentration of uric acid within the synovial fluid. This makes the uric acid concentration supersaturated to form urate crystals, which is why it is not painful during the day but deadly painful at night.