Toe pain -- what is the difference between a bone spur or gout?

Several things: Gout will cause a warm swollen painful toe usually around the first toe. A bone spur is a protrusion of calcium that will usually cause pin point pain when pressed or hit.

Causation: A spur is part of degeneration. This may be due to genetics, aging, old trauma. The toe may hurt, but usually is not hot, red, or swollen. Gout is a problem with metabolism; urate levels in the body are up and crystals will form, causing intense inflammation. A toe with gout with be warm, swollen, red, very tender. Gout is usually much more painful.

Degree of pain: Gout causes severe pain so you can't even put a sheet over it. A bone spur usually only hurts when weight is put on it. Gouty arthritis causes very red swollen tender that starts very suddenly.