Crystals that form in joints, in the bursa. Think of it as similar to arthritis, but worse because there are crystals instead of bone on bone. Normally in the toes, however, it can be in the knee's as well. Apparently, drug intake increases chances of getting gout.
I'm not sure what happens exactly. However, I do know that sometimes liquid or crystals pack up inside the bursa to an astoundingly painful extent. The joint will swell and become more painful. At this point, some of the liquid or crystals need to be taken out or the area will keep swelling. A giant needle is used to take some of the liquid and crystals out.
I have a 33 year old friend who has gout in his knees, toes, fingers, almost every joint. He constantly plays frisbee golf and video games. Even so, he still has problems with these tasks. Because of his gout, he cannot work and cannot be put on financial aid. Too many people fake gout for money from the government and he is under the age of people normally getting gout. It is saddening that those who need help, cannot get it.