Big Toe pain in MTP & PIP joints as well as redness on top

Hi doc,

I have a question regarding my big toe pain that I have been experiencing for the past 6 months. I injured it back in May from running (I’m a runner). I thought I just sprained it so I started icing and resting it but still ran a couple times a week.

After 2 months of it still bothering me, I went to see a podiatrist and she told me that I injured the ligaments in my big toe and that I needed to keep my big toe as flat as possible and do all that I could to not bend it so that it would heal. So I buddy taped it to the toe next to my big toe and limited my running and walking while icing and elevating. After 2 months of it still bothering me, I decided to take 4 weeks off from any type of running and walking and focus on it healing completely. So for 4 weeks I didn’t do any running and exercises that bent the the big toe back (lunges, jumping, etc.). After that 4 weeks, I started easing back in to walking and running and it still bothered me, but now I was beginning to see extreme redness on the top of my big toe joint (between the MTP & PIP joints).

I went to see a different podiatrist this time and he had me do blood work (for an infection & for possible gout), x-rays, and an MRI to see how the bones and ligaments were doing (all were negative, but the MRI showed ligament inflammation). He thinks I need to be wearing orthotics, which has me puzzled because I have never worn them nor has any of my previous podiatrists suggested that I needed them. He gave me some hard inserts to try out for 2 weeks to see how I would do and they seem to help in my walking and running a little bit but I am still seeing redness on the top of my big toe between the MTP joint and PIP joint, and both of these joints are sore. I’m at a loss because I don’t know what else to. It seems like I might have turf toe but my podiatrist hasn’t said it was. What do you think it is and what would you suggest that I do? I am still doing alot of icing of the joints.

concerned runner

One Response

  1. Foot-com

    Hello and thank you for your question. Without examining you it is difficult for me to say exactly what may be causing your foot pain, however I will give some general guidelines.

    As a runner the most common joint in the foot that is stressed is the great toe or 1st MPJ. This excess stress can lead to joint inflammation (capsulitis), sesamoiditis, early arthritis (hallux limitus) and bunions. Did the X-ray show any arthritic changes in your joint? Have you had any injections in the joint or ligaments that show inflammation?

    The stiff insole will provide relief if it is early arthritis or capsulitis as this is limiting the flexion of the joint. Another option is to try an orthotic with a 1st ray cut out or even dancer pad. I would discuss these options with your Podiatrist as they will allow you to resume running while preventing the pain in the great toe.

    Good luck!

    Dr. Emily Splichal
    Please be advised: we do not provide medical advice, diagnosis or treatment.
    By law, we cannot give specific medical advice over the Internet.

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