big toe pain/numbness

A couple days ago I noticed whenever I strechted out my leg & pointed my left big toe, it has this pain which shoots down my foot to my toe and then it kind of goes numb/tingles. I can't feel the top of the skin on my knuckle after I stretch. It's only in my left big toe. The color is fine. When I stretch it almost feels like there's a vein or piece of muscle I'm stretching which goes over the knuckle to it's limit and it wants to snap.

Hi onehot_Redhead,
Sounds like you have irritated one of the superficial nerves on top of the foot. I do not think it is anything serious and should resolve itself, but if not, a visit to a foot specialist would be indicated.
Marc Mitnick DPM

big toe pain

2 yrs ago after a lot of walking on concrete floors my big toes got sore on the bottom (not the big toe joint). Eventually they found and removed a bone spur on the edge of my toe, but after recovery absolutely no help. I had a nerve evaluation and was found to be normal. I was recently fitted professionally with orthotics with negative results. They were sent back to better offload the toes, but I have no positive expectations. This greatly effected my quality of life and after 3 foot doctors, I am ready to give up. It appears to be similar to a callus but without the thick skin and looks perfectly normal. It would appear to be a simple problem which they can not solve. Also no diabetes and good circulation. Thanks

Hi,
If the pain is exactly on the bottom of the toes in the area where the toe bends, there is a very good chance you have an extra bone in your toe. It is actually more cartilage than bone but because of where it is placed it can be the subject of pain particularly if injured such as walking on a concrete floor.
It is called an interphalangeal accessory bone. Ask your doctor if you have one.
If not, and your pain is on the bottom of the toe then you may have damaged the tendon that bends the big toe downward.
In either event, ask your doctor about a cortisone injection for either diagnosis.
Marc Mitnick DPM

Toe cellulitis

This is in reply to a question already sent to you. How will the toe nail be removed and how long will she be out of comission. The doctor told her up to two days, but she can't take off work that long. Also, can just a regular family doctor do this or should she be seeing a podiatrist. One family physician suggested a dermatologist, which I am confused by.

Hi,
Although it is considered surgery, removing a toe nail is not major surgery so the recuperation should be quick. No one does this better than a podiatrist.
Marc Mitnick DPM

bunion?

by paige
(south windsor ct usa)

I had sx on my RT foot due to a bunion in 06'. Everything went well. Now my LT foot has been bothering me for 2 weeks. I had no bump on my right foot and none on my left. I know size doesnt matter. (Ha) My feet are exceptionally wide, let's put it this way, my nickname is "flipper". I am always barefoot, depending on the season. This is so painful, obviously there is no going back, I will have to go to the podiatrist. Is it likely that patients who have had one done, get the other done? thanks, flipper

Hi Paige,
It is very common for people to end up having bunion correction on both feet and not necessarily at the same time.
If you do have wide feet obviously you are putting a lot of shoe pressure on the bunion joint and that is why it bothers you.
If your first surgery met your expectations in terms of pain relief, and you are having the same type of pain on the other foot, I would certainly consider having the second foot corrected.
Marc Mitnick DPM

hallux rigidus

by Georgiann
(Pittsburgh PA)

Hi,

How successful is fusing of the joint for hallux rigdus?

Will I need more surgery later on from it?

Is there a more up to date discovery for this condition?

Thanks.
Georgiann

Hi Georgiann,
I do not know how old you are, but in general I am not a big fan of fusions particularly for hallux rigidus.
Depending on how arthritic the joint is, most people do very well having the joint cleaned out, all the bone spurs removed and perhaps an implant added.
The problem with fusions in general is that they then put added stress on the surrounding joints and this can cause problems.
I would suggest you look into having the joint remodeled, it ends up being a very successful procedure.
Marc Mitnick DPM

big right toe turning black

by sandy
(willow spring nc)

about an inch under my big toenail of the toe is turning black, sometimes it will get scaly and flake but it still remains black, I wear steel toes at work, can this cause this? It doesn't hurt, my feet are always cold so wouldn't notice a change in that, and yes I do smoke

Hi Sandy,
Those two black spots are right over the tendon that moves the big toe upwards. It also appears that the tendon is tight meaning it protrudes and thus presses on your work boots.
So the first question I have is, do your feet perspire a lot in thos boots and are those boots black in color, because without being able to feel the texture of the darkness or thickness, it looks like dye from your shoes.
In the picture I cannot see the base of your big toe nail, but if it is also black I would think it is from the steel tipped shoes.
Why not see a local podiatrist and let he or she figure it out?
Marc Mitnick DPM

Big Toe Numb

by Megan
(Greendale, WI)

I was recently diagnosed with sureal neuropathy, something with very little information to find out there... Three days ago, my feet got cold, then hot all of a sudden. After that I noticed that the outside half of one of my big toes had loss sensation. It feels as though a local anesthetic has been injected, and the lack of sensation wont let up. sometimes I'll bump the sideof the first joint of that toe and it sends a painful pins and needles sensation through the toe.

Is this a result of the neuropathy? Or could it be symptamatic of something else. I for some time have suffered from widespread, bilateral joint pain, stiffness and swelling, that is so far idiopathic after test for autoimmune disorders came up negative. I also recenlty was diagnosed with hypothyroidism, I've heard that that can cause simmular problems...Any suggestion?

Hi Megan,
Your complaints could be stemming from any one of the issues you mention and from a thousand miles away I cannot really help you.
My best advice would be to get your neurologist and rheumatologist together and let them decide where the source of your complaint is coming from.
Marc Mitnick DPM

Underside of big toe joint

by Dave
(devon)

I bought a new pair of boots at the start of the season and recently have found sudden discomfort on the bottom of my big toe where it joins to the foot. I believe my boots have lost their shape and can actually feel this bit of the foot having no support and is almost hanging off the side of the boot with no prtection of the boot. Seems very odd to me seeing as these boots were a perfect fit and were expensive. Thanks for your help

Hi Dave,
Two conditions come to mind, sesamoiditis and capsulitis (read my sections on each). One would think that a new pair of expensive boots would not stretch out after one season but anything is possible. Unfortunately if your boot is causing your foot to hurt you may have to stop wearing them. One thought, you might try an arch support in the boot (if you can get it in) as that might make up for the over-stretching of the boot.
Marc Mitnick DPM

numbness in the right big toe

by Emilie
(Ottawa, Ontario, Canada)

The whole left side as well as the tip of my big toe has been feeling numb for about 4 days now. About a month ago, I switched from from an office job to a job on a military base where I'm on my feet for 8 to 10 hours a day (if not more sometimes), 7 days a week. I don't think my shoes are too small, but they are new (they're track shoes). I've been trying not to wear them, and even now, after 24 hours of wearing nothing but crocs instead (they're a size too big for me, so there's no excess pressure that's for sure), the numbness has not ebbed one bit. What could be causing it?

My left toe has also been a bit numb for the same amount of days, but it's really just the tip, so it doesn't bother me as much.

There is no pain involved. Just numbness. I can feel pressure, but I get the feeling that I could cut through my toe and not feel any pain.

Hi Emilie,
More than likely you have irritated a nerve that passes superficially along the side of foot and is being aggravated by your shoes. Eliminating the shoe will not make the numbness subside immediately but it should improve over the course of a few weeks.
That would be the most common cause of your problem. Your next place to look would be a nerve irritation coming from your lower spine, but based on your "story" I would go with shoe irritation.
Marc Mitnick DPM

discoloration of big toe on both feet

I had spinal surgery a few years ago due to a tumor on my spinal cord from c-2 thur c-4. The tumor is wrapped in and around the spinal cord. The surgeon was only able to get a small portion of it. Right after surgery both my legs and feet went numb. My left leg and foot got a little better over time but my right leg and foot stayed the same. Just here in the last few months both of my feet have become more numb. I have now noticed that on both feet the large toe is becoming discolored (a purple blackish color). As far as the toes go--they do not hurt. What could my problem be? Could it be that my legs and feet are not getting the circulation that they need? Would that cause discolored toe nails?

Hi,
You need to have your feet and legs examined by a vascular specialist to rule out poor circulation as a source of the toe discoloration. Do not put this off.
Marc Mitnick DPM

Hallux Limitus

by Beth

I had something dropped on my foot and this broke some of the smaller bones around the big toe (on the top)and this created the bone spur. I had the surgery to repair this on 11-13-07. The problem I'm having now is the swelling and pain around the joint (big toe connecting to foot).The toe seems to be bending good but the swelling and pain still around that joint is still bad. The dr gave me a cortisone shot in that joint 1 week ago and has started me on methylprednisolone for 1 week. Is there anything else that I can do or have done to get some results. The Dr.says that it should be 100% well by now and he doesn't know why it's not. This was my second opinion Dr.before I decided to have the surgery. I think he did right by the surgery but I need understanding on the joint swelling and pain. I can send you a picture if you need one.HELP!
Thank you,
Beth

Hi Beth,
May I assume you did not have in implant put in the joint? If you did then you may be having a reaction to the implant.
Otherwise, if you have a good range of motion but are still having pain and swelling I would suggest you try physical therapy; it can go a long way towards reducing the pain. At three and a half months after surgery most patients are doing better although rarely are they completely healed, however, it sounds as if your discomfort is greater than one would expect at this point in time.
I hope this information helps, good luck.
Marc Mitnick DPM

Painful bump on bottom of big toe

by Rose
(Signal Mountain, TN)

I saw a podiatrist for a painful lump on the bottom of my right big toe. He said it was either an extra sesmoid bone or some calcified cartilage. He did not x-ray it, saying that the treatment was the same for both. He had me buy some orthotics, which were no help at all. My chiropractor sold me a different set of orthotics, which make walking easier, but I don't think it's a permanent solution. If it is calcified cartilage, will it go away if my pronation is corrected? What can I do?

Hi Rose,
You can consider two other alternatives. One would be a cortisone shot in the area which may reduce the inflammation and the pain. Secondly, you may also consider having the extra bone removed. These are typically cartilaginous in nature (like the end of your nose) and it is not a major operation to remove it.
Correcting your pronation probably will not help.
Marc Mitnick DPM

I have sharp pains in bottom of left foot and big toe

by Mac
(Houston, Texas)

I have a spinal fusion on L 345 and S1 pressing on L5. Have started having sharp pains in left big toe five or six weeks ago---thought is was an ingrown toenail on big toe but have determined it is in the bottom of big toe and bottom of left foot---sharp burning pains like electrical shots---they come and go. Can you give me some advice? Thanks

Hi Mac,
The obvious conclusion would be that you have a radiculopathy or nerve impingement from you lower back causing your foot pain.
I would recommend you first discuss this problem with your back doctor; if it is determined it is not coming from your back, the next thing I would consider would be a tarsal tunnel.
Marc Mitnick DPM

Sharp Pain Down the Left Side of The Big Toe and a Severe Burning Sensation in the Joint Behind The Big Toe

by Dennis
(USA)

I have seen 2 Podiatrist for this problem and have been told that I have nerve damage in my foot. I have been given 2 injections of cortisone. The first one given did help the the burning sensation in the arch of my foot. This pain has improved by 90%. The second injection did not help. The "Nerve Pain" in the Left Side Big Toe and Severe Burning Sensation in the joint behind the Big Toe is still there. I have been taking Physical Theropy for 4 weeks ( 2 times a week ), which has improved the sharp pain in the big by 50% but has not helped the severe burning pain in the joint behind the big toe. Is this burning pain coming from Sesamoiditis? I have done everything suggested by the Podiatrist and Physical Theropy, i.e., ice, exercise, and resting the foot. I have ordered metatarsal pads and should have them in a few days. I don't know if they will help but I have to try something. I have had this pain for about 4 months and need to get some releif. I also take 4 Advils a day. If the Physical Theropy does not work it has been suggested that I have the "Nerve" destroyed via Cryosurgery. I am not in favor of surgery but if it will eleviate the pain I will give it serious consideration. Any suggestions will be greatly appreciated. Thank You.

Hi Dennis,
I do not think this is sesamoiditis, it sounds more like a nerve entrapment at the local level where the pain is occurring.
On the surface it seems like you are making some progress, so certainly follow through with the advice you have been given. Give the inserts that were ordered a try over a period of a few weeks to a couple of months to allow their effect to "kick" in.
Although somewhat invasive, cryosurgery is not an overly invasive procedure and you should certainly consider it if all else fails.
Since it sounds like the two podiatrists are in agreement on the diagnosis, then the condition is being properly treated.
Marc Mitnick DPM

my right big toe keeps going numb

Every five or ten minutes, my right big toe start to tingle. A few seconds later, it goes completely numb!! I can still walk on it, but it feels kind of funny!! It also turn a purple and blue color, everytime I touch it.

Hi,
You should see a vascular specialist immediately. Although I do not have the luxury of examining you, it sounds like it may be a circulatory problem.
Better safe than sorry, see a vascular specialist.
Marc Mitnick DPM

pain in joint where big toe bends when walking.

When I walk or wear shoes with the slightest heel, I have constant pain and even
swelling in the joint on top of my foot where the big toe connects to the long
bone on top.(right where it bends as you take a step)The podiatrist told me about
6 months ago there was a spur. What can I do to relieve it without surgery?
Also, what is it called, I don't remember?

Sounds like you have what is known as hallux limitus which is usually due to a bone spur on top of the foot.
Non surgical approach would include an orthotic with a Mortons extension to better support the joint. You would also want to stay in low heel conservative shoes that have an adequate toe box.
Sometimes a cortisone injection can be very helpful, but usually only for a short period of time.
Marc Mitnick DPM

left big toe behind on ball itches every night

by Deanna
(Petersburg, IL)

On my left foot behind my left toe, like at the ball it itches all the time, most of the time in the evening every day What could it be My skin is not really dry there either Please let me know what it could be Deanna Powell

Hi Deanna,
If there is absolutely nothing in the skin then you may be suffering from a neuritis or nerve irritation.
You can either put up with the discomfort or see a podiatrist who may be able to help either with oral medication or perhaps a cortisone injection.
Marc Mitnick DPM

bunions

Two podiatric surgeons have agreed that I need bunion surgery to relieve my pain. I do not have pain at the site of the bunion; rather, my bunions are apparently structural (bone dformity). I understand that I should consider surgery at the point the pain starts to intefere with my life. The thing is, I have discovered MBT rocker bottom shoes. I am able to walk for two miles fairly comfortably, or more if during a leisurely day outside. In normal flat shoes, even atheltic shoes, I would not be able to walk more than a block. My question is....is it OK to use my MBT rocker shoes to put off surgery for perhaps a year? Or, am I hurting myself in delaying the surgery? I am a 61 year old, female law school professor, heavily booked this summer with conferences (and vacations, to be honest), and I really can't see how I can have the surgery during the school year unless I take medical leave for an entire semester (no such thing as missing only two or three weeks). Next summer, I could plan for surgery on both feet, with three months to recover....but I don't want to hurt myself by waiting.

I would ask my own doctor this question, but I don't think that would be fair...after all, this is how he makes his living.

Final question, could you explain the role of a surgical boot? Does it stay on for weeks, or can it be taken on and off? My doc says that with the surgical book, crutches will not be necessary.

Hi,

Bunion surgery is elective surgery and if the pain you are experiencing at this point is tolerable then you can live with it and you can certainly wait until next year.
How long you have to wear the surgical boot will depend on the type of bunion procedure that is performed. If a simple bunionectomy is done, then you should only be in the boot until the stitches come out, although I now get my patients into sneakers before the sutures come out which is usually two weeks post surgery.
If a more involved procedure is done then you may have to wear the boot for upwards of 6-8 weeks or until your doctor is satisfied that you can try a regular shoe.
Marc Mitnick DPM

Severe pain in the joint of the big toe and behind the heel.

by Stanford Pereira
(Chittagong. Bangladesh)

Firstly I experienced pain in the big toe joint, with the passing of days the pain was getting worse,excruiating pain, and it became very difficult for me to walk, the area became swollen,red and shiny, it was a pounding pain, after some test done as requested by the Dr, he told me that the Uric Acid Level in the blood was a bit high, the Dr.prescribed Voltarin tablets to be diluted in water, later when there was hardly any improvement, the Dr changed the medicine and prescribed Servinaprox Tablet-500 along with Vitabion tab, after ten days or so I felt much better, and felt I was cured, now the pain is behind the heel, and am again gone back to the previous tablets. Please can you advise for type of test required, and thereafter medicine to be prescribed. Thank you very much for your concern and consideration, look forward to hear from you. Best Regards - Stan Pereira.

Hi Stan,
In gout, many times the uric acid levels will be normal during the actual attack. So, my advice is to wait until you are not having any pain, then go see your doctor and let them do a 24 hour uric acid test. This needs to be done to see if either your body is producing too much uric acid, OR, the body is not excreting enough uric acid. Either situation will lead to gout attacks.
Marc Mitnick DPM

My left big toe is very sore-

About a week ago my left big toe started to get very sore, I took off my nail polish to see what was going on. I have a bruise at the base of my toenail near my cuticle, and it extends a little up to the left side. I thought maybe I had dropped something on it and thought the pain would subside, which it did. But then it has been hurting again but even worse here of late. It has been bad enough that I have not been able to sleep. Now, the tissue around the side of the nail and along the nail cuticle is swollen and glossy looking, it is a red color, and it is extremely tender to touch. I have no idea what is going on or what I should do.

Hi Allie,
I would think the smart move would be to see a podiatrist as it sounds like you may have an ingrown nail. Hard to tell if it infected or not at this point. But if the pain has persisted then there is a very good chance it is not going to go away on its own and a doctor's intervention is needed.
Marc Mitnick DPM