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The response to the question below was authored by Marc Mitnick DPM

runners pain

by Christine Bradley
(Norton,MA )

runner with pain on top of big toe and underneath big toe

I have pain on top of my right big toe as well as underneath it. Here's background info. I had bunion surgery around 1994. It got stiff had cortisone shot 1995 and then another 1996 in which my toe was pulled out and bent back and forth. I started to wear inserts. I started competitive running in 2005 and have completed 4 marathons 2 of them have been Boston. I have had no problems until 2007-2008 pain in toe joint started to bother me. xrays show arthritis. I went to chiro and acupunture in 2008 to get me through my Boston training. In June 2008 I got another shot of cortizone in the toe joint. I started having problems with sharp knife pains in toe joint that started in October 2008. I went to a physical therapists who got mobility back in my toe joint but I started to have pain on top of the big toe and underneath. I went to a podiatrist got a block in toe joint and he pulled it out and bent it. Xrays showed not much change with arthritis and I could see the narrowing of the joint. I took 4 days off running. I started to run 5 miles and no pain. I did this 2 days in a row. The run was good but when I walk before or after I have pain on top and underneath toe. I have been xtraining and running every other day. Today was my first attempt to do a long run. I could only do 9 miles and the

pain was bad that I had to walk/run. The walking even hurt. I was on motrin 600 2 times a day. I did stop. I have been to 3 Doctors and they all explain a different surgery. I want to be able to run and I think that it could be a tendon or something. I would appreciate any help.
Thanks,

Christine Bradley

Hi Christine,
I tell my patients all the time that feet are like tires on a car, eventually they wear out. With your athletic background you have really put your feet to the ultimate test.
Evidently the big toe joint is worn out and you have limitation of motion in the joint which does not allow the joint to function properly and in that situation the accompanying structures like tendons and ligaments are put under extra stress and the area hurts.
You know, you can only patch a tire so many times, you may have reached the point where the big toe joint needs to be surgically repaired.
There are a number of bunion procedures out there and they all have different criteria for their use.
My best advice is that out of the three doctors you have seen, chose the one that has given you a thorough explanation as to why the procedure he or she is choosing is best for you, and go with it.
Keep in mind that surgery is not without its own inherent risks, but if you want to be able to run pain free again, then that might be your only option.
Read my section on "surgical considerations" to help you make a decision.
Marc Mitnick DPM

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Feb 14, 2010
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November 2009 I took your advice..... surgery
by: Christine Bradley

Many thanks Dr. for your advice. I do have to admit it took me a long time to finally decide on surgery. I went to 2 more Dr.'s. I choose the one that suggested a surgery that made sense and he took his time to explain everything. I had chielectomy surgery on Nov. 2,2009. My Dr. is a runner so he understood how much I wanted to get back to running. I ran my first mile 6 weeks after surgery. I felt great so the next day I did 3 miles and the next day after that I did another 3 miles. Well I did too much. I had a couple of shots of cortizone and now I am in physical therapy. Today I walked for 20 minutes and ran for 10 minutes and walked for 10 minutes. I am so happy because it was with hardly any pain. I am hoping to train for my first race in April. I would suggest that anyone who has this surgery it is well worth it. I am so impressed with the full range of motion my toe has. I think that it is important for anyone who is a runner that has this surgery to first be able to walk without pain before you start getting back to running. That was the mistake that I made. Many thanks for your help. I hope this helps anyone who may be considering this type of surgery.

Thanks for your help,
Christine

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Wonderful advice

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Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

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Jodi

location unknown

runners pain

runner with pain on top of big toe and underneath big toe

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