Big Toe Pain

More Big Toe Pain!

Thought I'd add to my original post:

It is now the middle of the night and I can't sleep. The pain and swelling in my toe has increased and it even bothers me to have the bedsheet brush against it. Walking on the edge of my foot is more difficult now because the vibrations irritate the toe. This is an awful feeling!

 

Gout might be a consideration, but as you are going to see your doctor today, it seems useless to fill your head with expectations which can be ruled in or out in just a few hours. After you see your doctor, post again and offer his/her impressions.

 

Thank you for your reply. I saw the doctor this morning. She's says it's gout, although no tests were done. After seeing how inflamed my toe (joint) was today, she didn't want to hurt me more by sticking a needle into it. She prescribed indomethacin and plans to test my uric acid levels after the gout subsides. As of right now, I can't walk on the foot.

This is very painful. I do not know of anyone else in my family ever having gout, I consume very little alcohol, and I don't consume an over-abundance of rich foods. I am 46 and have hormone and thyroid issues (had a thyroidectomy 3 years ago), but doubt it has any correlation. I am a little overweight (10-15 lbs) and if it will help prevent future attacks in any way, I'll certainly make the effort to lose it.

Several times in the past couple of weeks I felt as though I was developing a urinary tract infection, with burning in my lower abdomen, but the sensation went away after a few hours, so I never called my doctor. Thought I'd mention it in case the timing of it could be related in any way. In the meantime, I'll wait patiently for this to subside and hope it never comes back!

 

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Thank you for your follow-up post. Having now read your latest description and your mentioning both inflammation (rather than slight swelling) and severe pain (rather than non-excruciating pain) the diagnosis of gout is far more of a no-brainer, though I think that I would have preferred to give you a quick local anesthetic block and aspirate some fluid from the joint, as the microscopic finding of monosodium urate crystals in the fluid would be a cincher, while findings of blood uric acid level can be of uncertain diagnostic value. The bed-sheet contact pain comment is demonstrative of a classic symptom. Of course, bacterial infection is always a reasonable consideration with such symptoms and must be ruled out. I believe that too much is made of gout being associated with certain types of food, and it is even commonly precipitated simply from the use of diuretics. A confirmed diagnosis is important, as the treatment you have been given is palliative, and it may be that you will eventually need definitive treatment for prevention of attacks rather than just treatment when they occur. I am of the opinion that, as gout is a systemic condition, in contrast to its valid podiatric treatment in the acute stages, ongoing preventive treatment should be under the care of a general medical doctor rather than a podiatrist. True gout is an inborn error of metabolism, and technically out of the purview of a podiatrist for its management and preventative treatment. I have found indomethacin an effective treatment for the acute stages of gout, but I never prescribe more than a 5 day supply for my patients, caution them about GI irritation and often prescribe concomitant medication intended to ally such side effects.

 

Re: More Big Toe Pain!

What sort of diet you are having daily..? It would matters on your health part. Hope you would recover soon...! Take care.