Podiatrist (Foot and Ankle Specialist) Questions Toe Injuries and Disorders

Dull pain in my big toe with no presumed cause, what is it?

For several years I have had pain in my right big toe. It doesn't matter if I'm in shoes or not. There is no obvious deformity. What could be wrong?

18 Answers

Could be Gout. You need an X-ray and a Blood test.
Could be a bone spur, nerve entrapment, inflammation of a tendon, type of foot you have, and the way bones are positioned, i.e., you could be putting more pressure on the big toe and less pressure on the other toes.
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You could have an exotosis on the bone that the hallux nail is on and the pressure is the cause of the pain
It is hard to say what the cause is without evaluating your foot. There could be biomechanical reasons why your toe hurts, such as limitations of end rom of the great toe joint, particularly when you push off the toe. I recommend you see a podiatrist to evaluate your condition.
Big toe pain is known for low levels of Vit D. Visit a podiatrist for Vit D serum blood levels.
Could be a lot of reasons; arthritis, circulation disorders, nerve entrapment, deformity in the toe joint, limb length difference, and others. Also, does this pain come and go with activity or is it constant? If during activity, what are you doing exactly and how long before the pain starts? Please e-mail me back your answers.
Could be deformity tvst affecting your biomechanics in the joint, could be uric acid elevation, could be arthritis of the joint. Do X-ray and blood testing.
Hello and thank you for your question. The most common reason I see ‘dull’ pain in the big toe without an obvious deformity is a condition called ‘metatarsus primus elevatus’. Basically, it predisposes you to arthritis in the big toe joint. There are many other reasons that could be causing it and it is difficult to know without a complete workup. If you have additional questions, please feel free to call the office during normal business hours. Thank you so much for your inquiry.
Big toe, or hallux, is known to have two main joints, four major arterioles
and four major nerves, four tendons and joint capsule/ligaments. The bones
themselves may have developed cystic changes within the medulary canal, or
closer to surface along the cortical layer, or through cortices pushing
against the periosteum (the bilayer of connective tissue rich in progenitor
cells responsible with bone repair and maintenance). There is also
arthritis, or periarticular degenerative bone changes (with or without
obvious deformities), or may be inflammation of the synovium tissue
responsible with production of synovium inside each joint space. There may
be gout, but typically this is episodic and not constant pain. There may be
a foreign body that is retained in the deep tissues and painful. There may
be soft tissue tumor or swelling that is pushing against a nerve structure,
sending pain signals. And lastly, pain. What kind of pain? Sharp, stabbing,
dull, achy, throbbing, burning, pins and needles, electrical like pain.
Each point to different aspects of causes. Burning is nerve specific
injury. Throbbing involves the blood flow. Does it improve with elevation
and gets worse with bringing the foot down? Stabbing or sharp is something
of acute nature, and typically severe such as fracture or infection. Dull
ache is typically chronic and can be associated with arthritis or
ligamentous injury such as sprain or tendinits. If there were color changes
associated with the pain, such as violet, red, or purple skin changes, that
is episodic, it may mean a form of vasculitides, inflammation of blood
vessels or may be spastic vessels such as Raynaud's. What do you take to
make it better? NSAIDS? What do you take to make it worse? Aspirin? Was
this helpful?
There can be a variety of causes for this discomfort. Some can include osteoarthritis, sesamoiditis (Two small bones under the big toe joint) or even tendonitis. A full evaluation of how you walk, functional and structural evaluation of the foot and ankle and possibly an x-ray can generally lead to a diagnosis and treatment plan.

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You could have arthritis in your toe, nerve injury or tendinitis. You would have to go see someone and start by getting an x-ray.
check the nail, it may be thick or nerve entrapment need an evaluation to determine. call 4194253338
If it is the end of the toe it is probably an ongoing toenail. If in the
joint it is probably arthritis. But it could be 10 other reasons and you
need professional evaluation.
Geoffrey Bricker, DPM
Well, first thing would be to establish if this is Musculoskeletal versus vascular disease and or a nerve condition. I recommend you see a foot and ankle specialist for complete work up , X-rays etc.
There are several things which can cause dull pain like you are describing.
Two of the most common are arthritis to the big toe joint and possibly a
thickened nail which can cause pressure and soreness to the toe. It is
important to see your podiatrist to determine exactly what may be causing
the pain, as there are other possible causes and treatments can vary
there are potentially many reasons for the cause of a general dull ache to
the big toe. These can include musculoskeletal problems, vascular and
neurologic. From a musculoskeletal consideration one would have to consider
arthritic processes that cause joint pain. This may have resulted from old
trauma, repetitive mechanical injury or systemic cause for arthritis.
Vascular complications can include arterial insufficiency. Unfortunately
tobacco misuse has caused identified diseases of the peripheral arterial
system which can cause insufficiency and secondary pain. We also frequently
appreciate this in our diabetic population as this disease also impacts
peripheral circulation.Finally nerve processes can also produce chronic
pain. There are many reasons for peripheral neuropathy to include the
previously mentioned diabetes. There can also be nerve compression and
previous nerve injury. Regardless, if this pain is chronic and has not
found to improve on a timely basis or in fact has been worsening, it would
be best advised to seek specialty medical care in order to have a good
examination to include potential x-rays and other necessary laboratory
studies to better understand why he may be suffering from this discomfort.
It could be early arthritis or some other type of joint inflammation. I would recommend an x ray.
Pain in your big toe could be premature degeneration of the joint. In the absence of a history of trauma, possibilities include, but are not limited to osteoarthritis, gout, and infection.