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?

You need an MSK podiatrist or an orthotist. GP can refer you.
It sounds like you have a restriction in the joint and the walk has made it bend more than it wants to. Same thing happened to me.

This doesn’t look like infection, antibiotics failing confirms that.
It fits Hallux rigidus or early Osteoarthritis, especially with pain on push-off and movement.
Get an X-ray, wear soft wide shoes, and stop stressing the joint, don’t wait it out.

Any family history of psoriasis and any chance what your GP said was I had dreadful pain in my big toe and it was psoriatic arthritis. It was so painful I couldn’t have a sheet over it, you have my deepest sympathy.

Sorry, missed a bit. Any chance that what your GP said is infection in nail is nail psoriasis?

No, that definitely wasn’t mentioned. Have a family history of autoimmune stuff but no psoriasis.

will ask about a referral. Didn’t know you could see a podiatrist on the nhs….though at the length of the waiting list for a gp appointment I might just pay privately for a podiatrist appt.

Could in theory be the L5 nerve coming from the back. It innervates the big toes. Any inner ankle pain, stiff hips, wonky pelvis?

Nerves can get over sensitive it they are trapped somewhere along the course and can take a while to settle.

Entrapments are often not permanent. A lot are due to tight muscles, either temporarily blocking the way or temporarily pulling something out of place so it blocks the nerve.

You could look up nerve flossing - they’re gentle movements, not stretches, that encourage the nerve to glide better.

Are you taking statins by any chance? I've had a similar issue as a result of taking statins. It seems that my nerves have become inflamed and things have settled down since I stopped taking the meds. In fact that's how I found out what had caused the pain

Get to a podiatrist and get your feet assessed

I got capsulitis in my foot and it was agony. Dr shrugged and said they didn’t know- I paid for a podiatrist appointment and she diagnosed it, and I walked out pain free with the addition of three bits of tape. It did take longer to get rid of it totally and a steroid injection, but just taping made such a difference. Anyway, if you can afford it, pay to see a podiatrist

Could be sesamoiditis of the hallux (there is a little bone in the tendon under the big toe which often gets inflamed). This can lead to pain swelling and difficulty in bending the toe during the toe off phase of walking. Common causes are wearing shoes with poor cushioning (quite likely because they are old and the cushioning disintegrates over time) or an increase in activity or change in training service.
To help soft soled shoes or rocker bottom shoes like hoka or MBTs, cushioned insoles or metatarsal pad to offload the pressure

I know gout has symptoms that you don't seem to have, but the description sounds very like it just the same, although I think it only appears on one toe at a time maybe?

I had gout last year and it wasn't red, swollen or anything, a little inflamed but nothing to write home about. I had a uric acid test and yep, that's what it was. I had colchisine meds, and touching wood, no recurrence yet! It was bloody agony though, and your description of the pain on your toe touching the duvet resonated with me.

Sorry, scanning quickly because I have to get back to work

Gout?

@ALittleDropOfRain i have ongoing hip problems and historical ankle problems due to ehlers Danlos syndrome. Bad SI joint and suspected ankylosing spondylitis (I have an MRI report which says I have AS but rheumatologist won’t diagnose me). I have had peroneal tendon tear repairs and it keeps tearing.

@Pearlstillsinging not taking statins

GP has actually just texted after I sent another moaning ticket in earlier on….i now have an appointment for 4pm. Will ask about gout test and also podiatry referral but will pay if it’s going to take ages.

Bunion?

Sorry to labour this but are you absolutely sure you don’t have a family history of psoriasis that you may not know about it? Sacroiliac joint and toes are classic psoriatic arthritis symptoms.

I was 52 before I found out I have a family history of psoriasis as my Dad had his only patch of it age 84 shortly before he died and then I found my brother, aunt and cousin have it but had no idea. With hindsight my bad case of dandruff after my second DC was mild scalp psoriasis and I have mild nail psoriasis in my toes but hadn’t realised.

I know this might sound mad, but you haven't just changed your bedding have you. I had terrible pain in my toes and it stemmed from sleeping in a bed with the duvet tucked in at the foot of the bed. It was pulling my toes down when I was sleeping on my back at night.

When I went back to my own bed (duvet lighter and untucked) the pain stopped.

Did the GP tell you to stop statins? I thought it’s a bad idea just to stop.

I have AS and inflammatory arthritis affecting both big toes. It flares up randomly!

Most GPs can refer you to a physiotherapist these days. They might have a better idea although the wait may be just as long.

I'm watching this thread with interest because just last week started having pain at the base of 1 big toe. Also after I'd been on a walk, but a short one and with newish, but comfy shoes. My pain is starting to settle, but I was hobbling about the first few days.

Interesting. I have textbook AS symptoms and AS showing in my spine in an MRI….but not showing in my SI joints (but I have bad si pain in one side) so rheumatologist said I can’t have AS.

my dad had sjrogens syndrome and grand cell arteritis

my brother had thyroid issues and ME.

my daughter has fibro and coeliac disease.

i do feel autoimmune stuff runs through my family like crazy.

Mine had pain like this and were mildly coming out of joint. I had to learn to put them back. I saw a podiatrist who said they would eventually fuse as I get older. I had to be very careful with what I do with my feet e.g pushing off end of swimming pool, lying in bath with feet on taps.

I use to get striking pain in my big toe years ago, never knew what caused it.
Not had it now for years.

Having read you have EDS id definitely consider my case!

Gp thinks it’s flexor tendonitis now. Is sending me for an Xray. She pressed on my toe joint and I properly screamed.