3 Conditions that Cause Agonizing Big Toe Pain

Big Toe Pain
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Have you ever experienced big toe pain?

One of the most important joints in the body is the Big Toe, or in medical terms known as the Great Toe.
The Big Toe allows us to walk heel to toe and balance our foot when we walk, run, jump, dance or
perform many other activities from sports to daily life. So it is not surprising that the Big Toe can be the
source of pain for many of us as well. Following are 3 major conditions that can be a source of Big Toe pain.

Arthritis and Big Toe Pain

Arthritis Injuries of the foot and big toe

When we talk about the Big Toe most people are referring to the joint at the base of the foot, called the
Tarsometatarsal (TMT) joint and occasionally the joint just distal to it known as the Proximal
Interphalangeal Joint. Because this is a major weight bearing joint, many painful conditions can develop.

One of the most common issues that develops in the joint is osteoarthritis of the MTP joint, this can
become prominent especially with runners and people who play high impact sports. The first sign is pain
and swelling of the joint. With time the joint can become thick and form bunions, which are bony
overgrowths of the joint that cause deformity of the joint and stiffness. Traditional treatment
approaches to treat Big toe pain due to arthritis include surgery to remove calcifications, physical
therapy and steroid injections https://charmaustin.com/relieve-pain-and-repair-injury/trigger-point-injections/ into the joint to reduce pain and inflammation. These all can offer temporary relief of pain.

Newer advances in medicine have brought about treatment with regenerative techniques,
such as Platelet Rich Plasma and Bone Marrow Aspirate Concentrate. These treatments
use solutions found within the body that work to heal a person when there is an injury.
Platelet Rich Plasma works to increase vascularization and blood flow to an injured area and uses
chemical mediators called Cytokines to recruit other healing components to the area thereby
encouraging tissue regrowth and repair. https://charmaustin.com/relieve-pain-and-repair-injury/platelet-rich-plasma-prp/

Bone Marrow Aspirate Concentration is obtained by drawing liquid bone marrow from the hip (iliac crest) region, which is then injected into the area of injury, in this case, the Big Toe. The BMAC solution contains adult stem cells that when injected into the damaged
area promote growth and repair of the damaged joint and surrounding tissues. https://charmaustin.com/relieve-pain-and-repair-injury/stem-cell-therapy/

Gout and Big Toe Pain

Gout Big Toe

Another condition that commonly causes Big Toe pain is Gout. The condition is characterized by rapid onset of a red, hot, swollen and painful big toe that often occurs after eating a rich meal over the holidays. Gout is a cause of Big Toe pain that occurs due to Hyperuricemia, which is an excess of uric acid in the body that occurs from the breakdown of food rich in Purines. The uric acid excess causes uric acid crystals to collect in multiple joints, most commonly the Big Toe. Purine rich foods include alcohol, organ meats, bacon, turkey, veal, venison and other meats.

Treatment of Gout can be managed in many ways including adjustment of diet to reduce intake of Purine rich foods and medications block uric acid production such as Allopurinol and improve uric acid removal such as Probenecid. http://www.niams.nih.gov › Health Topics

Extensor Tendonitis and Big Toe Pain

Anatomy of Foot Tendons

The third condition associated with Big Toe pain is Extensor Tendonitis. This condition of the Big
Toe is often seen with overuse due to tight calf muscles, arthritis of the MTP joint can also cause
inflammation of the extensor tendon. The condition is associated with pain upon extension of the great
toe, there are often calcifications of the MTP and PIP joints that inflame and thicken the tendon, causing
pain with many sports activities.

Regenerative techniques using Platelet Rich Plasma or Bone Marrow Aspirate Concentrate are used to increase strength of the ligaments and capsule that surround and support the joint, in addition to encouraging surface cartilage growth and repair.

Michelle Hall, PA-C

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