Should I strap up my painful toe joint and just try to get on with things, or should I rest my foot?

When your foot is really agonizingly painful, you won't want to walk around and should definitely rest it. You can have a warm bath or use a warm pack on the foot - but make sure it is not so hot that you scald the skin and underlying tissue. Try some natural remedies for gout that can help alleviate the pain. Podiatrists (foot specialists, who might also be called chiropodists) don't encourage the use of cold packs for gouty inflammation, because they may tend to encourage the urate crystals to form. However, cold packs are effective at reducing the pain and you may find it easier to lay your hands on a bag of frozen peas than a hot water bottle. Gradually you will be able to put weight on your foot and to walk around gingerly.

If you decide to use a walking stick, be sure that it is the correct length to be used without bending your arm or twisting your body. The top of the stick should be on a level with your wrist when your arm is hanging straight down. Best support is given by using the stick on the same side as your unaffected foot; then the stick can take your weight, like an extra leg, instead of the gouty foot.

As an acute attack draws to a close, you will need to wear soft and comfortable shoes to accommodate swollen joints, and they should be easy to get into - soft slip-ons, or trainer-style with a Velcro or buckle closure rather than lace-ups - or, if worse comes to worst, bedroom slippers! Look for shoes with a rigid sole, or use a specially made insole to help to absorb the shock of contact with the ground and to restrict bending of your toe. For regular temporary swelling or for more permanent deformity causing pain or difficulty in walking, a podiatrist can help by relieving pressure with padding, reducing the size of corns, advising on footwear or providing supports for inserting into your shoes. Shoes can be made wider, or a 'balloon patch' can be inserted into your shoe's upper near to a very swollen or deformed joint, to relieve the pressure. Although specially made shoes can be very costly, 'semi-orthopaedic' shoes can be obtained at a more reasonable price and with a more acceptable appearance.

If you have to wear boots with steel toecaps at work, you may find that they cannot accommodate more than a small amount of swelling or deformity. Ask your podiatrist for advice on getting a larger pair or perhaps on adjusting the reinforcement (a steel balloon patch?).

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