What’s wrong with my big toes, GP has no idea

[JulietteHasAGun]

I have had very bad pain in both big toes for a number of weeks now (over a month, probably 6-7 weeks). Right toe is worse than my left toe. Toes look normal, no swelling, no redness, no discharge. Right toe is agony, left toe is sore.

It started after I’d been for a 4 mile walk in some hiking boots I’d not worn for a bit and I thought maybe it was the boots…..but I’ve had this boots for a decade and never had this problem before. 4 miles isn’t an unusual distance for me to walk, but I haven’t worn those boots in a year.

pain seems to be in the joint and hurts even if I try and push the duvet up at night with my toe. For the first week or two i couldn’t sleep on my front as if the top of my toes was on the mattress it hurt too much. I thought it was getting better for a while but seems to be back to early days again and I haven’t worn the boots since. If I crunch my toes up it hurts. Just went to push the hoover forward with my foot and screamed in agony due to explosion of pain in my toe. It hurts when I walk when I’m pushing off my foot.

i thought it might be gout but the GP said no and declared I had an infection in my toe nails …..no visible sign of infection but guess no visible sign of gout either. Prescribed me antibiotics which haven’t worked.

I have been trying to make another GP appointment and they said I’m on a waiting list for another appointment but that it’ll be a six week wait. 🤷‍♀️. 😡

Any ideas? I’m 50. Can you get arthritis just in your big toes?

Big toe arthritis can get very painful, and joint fusion is often the last option when other treatments don’t help. Glad you eventually got relief, even if it took going private.

I posted above, but when I had similar symptoms (big and three middle toes on both feet red, swollen and painful, going into arch), it was two impinged nerves sensitised by the cold. Painkillers didn’t touch it, warmth didn’t make much of a difference, cold made it worse.

As well as being trapped in the spine (hence both sides), mine were also being trapped near the hip as my hip doesn’t sit properly so the muscles were tightening. I think you mentioned hEDS - connective tissue disorders also cause muscle guarding.

I agree that we‘ve all got some arthritis and it shouldn’t be causing that much pain.

Do a gentle sciatic nerve glide and see if it affects numbness or tingling in some way. Also do some gentle cat-cows which decompress your back and see the same. The L5 nerve (lowest back) goes into the big toe and the S1 nerve (one vertebrae lower at the top of the sacrum) innervates the arch and the three middle toes). They and the other lower spinal nerves travel in a bundle down the legs and can get (re-) trapped at the hip, knee, calf and inner ankle.

If you have a sports Dr or sports physio near you, they tend to be better at looking at the bigger picture.

Good luck! I‘ve got mine mostly under control (just some painless Winter swelling now) and am active and mostly pain-free one year later, but it felt absolutely hopeless at the time.

@ALittleDropOfRain thank you, I never thought about trapped nerves. I have previously fractured my L5 and do have an SI joint/pelvis issue so that’s possible. I do have a very good sports physio I’ve seen before so think I’ll go back to her.

All the best! It does take a while to clear. Feel free to dm me if you want to know more about my experience.

I’m not a medical professional, but I was also told by the Dr it must be arthritis although the severity of the symptoms didn’t match the imaging. My physio started to make the connection- I‘d gone to him for sciatica and hip issues (and SI) when suddenly my feet ballooned.

This happened to me. I’d been digagnosed with gout, but my blood test came back clear. One night I realised I was drifting off to sleep with my big toe curled under at a weird angle, and I’d been doing it every night. I stopped and haven’t had the pain since.

Yes, I have arthritis just in my big toes

I haven’t changed my sheets or duvet. The only thing is since Xmas I’ve been sleeping with bed socks on. I got what I assume were chilblains on the smaller toes on my right foot and felt socks would keep my feet warmer and protect my toes. Those have gone but I’m still sleeping in socks to act as a buffer between my big toe and duvet.

I don’t think I’m having my toes in a weird position

You may need an x ray as that how my hallux rigiditus was diagnosed- have a look a the symptoms online and see if it makes your symptoms- I mostly manage with no/ minimal pain now with the correct footwear and insoles

have you had a blood test?
sounds awfully like gout

No, I’m going to message the GP tomorrow and ask for this to be done.

@JulietteHasAGun I have AS, only one side of SI joint is affected and doesn't show in the blood. Plus I'm HLA-B27 negative. I also have Halux Rigidus in big toe (had it for 15-20 years and I'm late 40s) and other one now starting.

Tendinitis? Osteoarthritis?

Did your GP test your kidney function and uric acid levels or did they just decide it’s not gout simply by looking at your toes? It sounds like textbook gout presentation.

Gout!