Pain in the joint of my big toe (top)

[Brandon Rogers]

Greetings!

Here's the situation. I ran a 10k last Sunday and after the race I had calf pain (both) and top of foot pain (left foot only). Not too terrible, I took a 1.5 mile walk later in the day and it went well.

Monday, same pain just a little bit more. Not too troubling, though.

Tuesday (today) : Little to no calf pain, little to no top of foot pain, moderate to intense pain in my left foot at the "joint" of my big toe (didn't feel it when I felt to sleep - felt it as soon as I woke up). It hurts directly on top of it and also towards the right side of it (but still on the joint). It hurts enough that it bothers me when I push off when walking.

Extra info: I ran in five fingers (kso). I may have ran a little too much on my toes... I also sprinted at the finish (no pain in the joint of my big toe at any point in the race).

What do you think?

Thanks,
Brandon (Ann Arbor, MI)

 

[Dr. Mark]

Brandon,
Be cautious with any localized pain on a bone. this is concern for stress reaction /stress fracture. hard to say more over email but try to localize the pain.

if it is bone pain you need to be very cautious.

Mark

Greetings!

Here's the situation. I ran a 10k last Sunday and after the race I had calf pain (both) and top of foot pain (left foot only). Not too terrible, I took a 1.5 mile walk later in the day and it went well.

Monday, same pain just a little bit more. Not too troubling, though.

Tuesday (today) : Little to no calf pain, little to no top of foot pain, moderate to intense pain in my left foot at the "joint" of my big toe (didn't feel it when I felt to sleep - felt it as soon as I woke up). It hurts directly on top of it and also towards the right side of it (but still on the joint). It hurts enough that it bothers me when I push off when walking.

Extra info: I ran in five fingers (kso). I may have ran a little too much on my toes... I also sprinted at the finish (no pain in the joint of my big toe at any point in the race).

What do you think?

Thanks,
Brandon (Ann Arbor, MI)

randon,

 

[Brandon Rogers]

Thanks Dr. Mark! The pain has increased since Tuesday. Localized on my left foot at the "joint" of my big toe. Difficulty putting socks on, difficulty putting shoe on, almost could not push the clutch down in my car. Going to ER for scan/x-ray.

 

[Barefoot Dama]

Brandon, X-rays don't show a stress fracture until the bone has healed so if you have an x-ray it might come negative for a fracture.

 

[Backfixer]

Just my 2 cents, yes, this is likely a stress fracture, and a bone scan will likely confirm it better than an x ray. The concern I always have is how it got there. Often I hear the term over use, however, I wonder why it is over use for some and others never have issues. The answer has to do with body mechanics. My guess is that there is more going on mechanically that needs to be addressed than just a probable stress fracture. My guess is that you under stride on the side of the stress fracture and that your calf and the back of the leg is tight. It is also likely your pelvis and core are compromised.

I would recommend that you have this evaluated by a local sports chiropractor since you will likely sustain other injuries if your body mechanics are impaired.

 

[Brandon Rogers]

Ended up seeing a podiatrist. X-rays came back fine (he seconded that stress fractures take time to show up). His diagnosis is Gout!

Reasons? The pain is in my left MTPJ, night before that part of my foot was fine and in the morning it was not (sudden onset).

Treatment: Cortisone shot directly on joint (OW!!), RX for an anti inflammatory, literature on foods/drink to avoid.

Also received a blood test for uric acid levels. Going back a week from today.

 

[Hobbit]

Hi Brandon,
my first thought when I read your description was: gout!
I had similar problems a couple of years ago and I know how painful it is.
Cortisone however can have quite heavy side effects and I never wished to be treated with it.
Fortunately there are also other possibilities.
Nutrition is the first to look at and change if necessary: the big no no's are foods or drinks with high acidity (coffee, soft drinks, alcohol, chocolate, sugar, white flour products (as opposed to whole grain products), any kind of highly processed and conserved meats and even some kinds of vegetables like spinach)
Daily foot baths with a spoonful of baking soda in the water create an alkaline environment with helps to get some of the acidity out of the system.
Another natural remedy is daily intake of quince (I'm not sure, I got the spelling right, it's a kind of fruit and it can be eaten under any form you like, such as jelly, jam, raw, cooked...) minimum one spoonful every day (or more if you like the taste, which is, admittedly, not the case of everybody!)
All these help with the pain, but they don't get the gout's crystals out of your articulation, which means the gout is always lingering there and the pain can be back any time the acidity levels in your body rise (it's not only food, the culprits can also be stress, depression, cold weather...)
To dissolve the crystals you could try and g..gle for slackstone.

 

[NickW]

My step father has gout pretty bad. He has to really watch what he eats and we can always tell when he cheats on his diet. Two years ago or so his gout flared up really bad and he is now on an experimental drug that seems to work wonders wonders for him because none of the normal methods was getting rid of the pain or swelling. He used to only have gout in his knee but it seems to have spread to his wrist and knuckles also. Good luck and I would really watch diet very closely, gout can be a horrible and debilitating problem if you aren't really careful and avoid whatever flares it up. I think certain alcohols can cause it to flare up as well.