Sharp Pain On Top Of The Base of Big Toe

by Glen
(Arlington, VA)

About a year and a half ago, I developed a pain when walking at the top of the base of my big toe. In one form or another, it's been there ever since - sometimes barely noticeable, sometimes more pronounced.

The pain developed suddenly, and it has precisely manifested itself it slightly different locations (all on the top of the foot near the joint at the base of the big foot) over time. Frankly, I have always felt it was a pinched nerve of some sort that would, in the fullness of time, work itself out.

One trick I have used when the joint became somewhat more painful is to manually manipulate the toe while providing a little traction by pulling in away from the foot at the same time.

This morning my little trick may have backfired on me, because when doing so I developed - quickly - a very sharp pain (and quickly reduced mobility). I'm icing it down as I type. But I'm thinking that my problem may be more severe than I realized.

What observations might you have, and what should be my next course of action?

Thanks for your fantastic service.

RESPONSE

Hi Glen,
The short story is that it sounds like you may have a bone spur on the top portion of your foot at the level of the joint. Usually it occurs over time and is a result of the big toe jamming into the first metatarsal bone and the result is the formation of a spur or bone overgrowth which then becomes painful.
The pain generally worsens over time and is aggravated by the types of shoes that you wear and your level of activity.
At times it will flare up and other times it might not be painful at all, but eventually the pain does come back and in many cases it worsens over time.
Manipulating and stretching the joint with traction may actually bring relief but it is not a cure.
There are varying degrees of bone spurs. When they become large enough you can actually feel a lump on top of the first metatarsal bone, just slightly behind the bend in the joint.
Sometimes in fact when the spur is large enough, they sometimes fracture and then become more painful.
I do not know to what degree your problem has progressed but the bottom line is that it might be time to see a foot specialist in your area and have the foot evaluated. These types of problems, depending on how they impact your life style can become issues that you can choose to live with or without.

Marc Mitnick DPM
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