I don't get it but about every 2-3 yrs. It typically happens if I don't eat well for a few days. I am currently going through one of the worst I've ever had. I've never got it anywhere but on my big toe. Right now its at my two middle toes on the top of the joints where the toes connect to foot. I've never had so much pain. I've done two doses of the apple cider vinegar with mother and water and it feels much better right now but that is the nastiest tasting shucks.