Coping with the symptoms of gout—painful, tender, and swollen joints—is already tough enough. But when you have gout, you also need to be on the lookout for its complications. These can be caused by the disease itself or by the medications you take to control it. What are these complications and what can you do to avoid them? Read on to learn more. Tophi. When you have gout, increased levels of uric acid in the body deposit needlelike crystals in your joints. These cause the painful gout attacks you likely know well. But if you've had gout for many years, you may also develop tophi. These are solid lumps of uric acid that develop under the skin of the toes, fingers, hands, or elbows. A two-pronged approached can help prevent tophi: (1) taking medication, such as allopurinol (Lopurin, Zyloprim) or febuxostat (Uloric), to control uric acid levels, and (2) making lifestyle changes, such as losing weight. Shedding pounds can be tough, but start by doing something simple. Taking a brisk walk every day can help you lose weight and feel better overall. Joint damage. If it's been a while since your gout diagnosis but you haven't kept your condition under control, you may develop a more advanced stage of the disease called chronic tophaceous gout. This can cause permanent damage to your joints. Large tophi can develop around your joints and tendons and lead to chronic pain and deformity. Keeping your gout under control is key to avoiding this advanced stage of the disease. To manage uric acid levels, your doctor may prescribe medications such as Zyloprim or Uloric. You may also need to adopt healthy habits, such as avoiding alcohol and scaling back on purine-rich foods, such as dried beans and sardines. If you already have chronic tophaceous gout, surgery may be necessary to treat existing joint damage. Heart attack. After smoking and a family history of heart disease, gout is the next highest risk factor for heart attack among men. Research shows that gout increases a man's risk of suffering a heart attack by 26 percent, and women with gout face a staggering 39 percent increased heart attack risk. Scientists are still trying to understand the link, but elevated levels of uric acid in the body may contribute to heart disease. Another contributing factor may be your medication. Doctors used to think that gout was simply a pain issue and treated it with nonsteroidal anti-inflammatory drugs (NSAIDs). The problem is that long-term use of NSAIDs can increase your risk for heart attack. Good news! Many of the same steps that help control gout, such as achieving a healthy weight and limiting your intake of fatty foods, can help keep your heart healthy. As challenging as these changes may seem at first, they'll become easier to maintain when you see how much better they make you feel. Kidney problems. Those painful uric acid deposits that can occur in your joints may also develop in the urinary tract and lead to the formation of kidney stones. In fact, about 15 percent of people with gout will develop kidney stones at some point in their lives. What's more, a buildup of uric acid in the body may damage the kidneys over time. Following the treatment plan your doctor has designed for you can help control uric acid levels and prevent these serious kidney complications from occurring.