Hello and welcome to HCM, Gout is characterized by pain in the joints of feet and the most common joint is the first thumb joint. The pain of gout is episodic and is precipitated by protein rich foods and alcohol. The drugs prescribed for gout are usually very effective in controlling the pain associated with pain. If the pain is not controlled by drugs, you can consult your treating doctor for review of the treatment. High ESR can occur in gout as well as other conditions so it is not specific for gout. Frequent headache is also a non-specific symptom. Frequent headache can occur in cases of migraine, high intra-cranial pressure, etc. Thus clinical assessment and relevant investigations are required for making diagnosis and thus management. Thanks and take care Dr Shailja P Wahal