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Pain in big toe - gradual onset

Discussion in 'Ask your questions here' started by Unregistered, Sep 23, 2009.

  1. Unregistered

    Unregistered Guest


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    Hope you can give me some advice - I am waiting for some test results but am very frustrated and can do less and less every day. I would apreciate another view while I'm awaiting the x-ray results, as my doctor appears to be less than certain about the right course of action and I had to push for an x-ray.

    where does it hurt - left foot, big toe. originally just there but with time the pain has spread to the arhc of the foot

    how long has it hurt for - started on labour day (15 days ago)

    how bad is the pain - at first not too bad but now it really, really hurts anytime I put weight on (not really possible now) and is swollen. at night it is disrupting sleep as it throbs (I assume this is the swelling)

    what where you doing when it started - I was walking in a city - doing about a 4 mile sightseeing tour in extremely sensible sports type sandals (cushioned soles, straps across toes and around ankle). I've done many miles in them this summer in great comfort!

    what have you done for it so far - started by just resting it - it felt like a sprain; when I got back from my holiday last week (8 days ago) I went to the doctor and he prescribed NSAIDs. The swelling went down temporarily, but I had an allergic reaction to the drugs and had to stop using them after one day. Had a test for gout - came back negative. Now on steroids to keep the swelling down and waiting for x-ray results (which are taking forever - or so it seems)

    anything relieve it - first few days on steroids I thought it was improving, but not any more; since I started to reduce the dose of predisolene (as per doctor's instructions) there seems to be little benefit. I am icing the foot regularly and trying to keep it elevated.

    what have you been told about it so far - doctor originally just thought it was 'over-use' as there was no known trauma; then he thought it might be gout which has been disproved; now he's thinking it may be a stress fracture but he seems really uncertain

    is it affecting your ability to work or play sport - can't put any weight on anything except the heel of my foot. swollen and painful to do anything. keeping it elevated and resting lots and lots. can't do anything much now and my other leg feels strained when I do try to walk about

    do you have any other sorts of symptoms - other than frustration and the understandable muscle strain in my other leg when I do walk, no!!

    what country you are in (different countries have different health systems; different scopes of practice of different disciplines; access to care might be different) Canada

    I appreciate you can't offer a definitive diagnosis online but any suggestions you can give about what to ask my doctor or what to suggest to him would be so useful and make me feel I'm doing something.

    Many thanks

    FJT
     
  2. FootDoc

    FootDoc New Member

    I realize that the administrator (not me) posted some guidelines for asking questions, but unfortunately almost everyone who has followed them took it as a question and answer test rather than facts that should be included in a comprehensive, chronological description of the problem. I have not found that method of asking questions particularly helpful to my understanding of complaints. Missing in your post is the basics of what elicits the pain . . such as whether it is painful when the toe is put through its range of motion, and if so, which motion is painfu,l whether it is painful only on weight bearing, off of weight bearing or both, whether there is any swelling, heat, or redness, what the doctor might have considered would be ruled in or ruled out by the x-rays, what presumptive diagnosis the doctor had made before prescribing prednisolone, etc. All that being said, forums are not appropriate venues for making most diagnoses as it afford nothing of the diagnostic process other than the patient's descriptions.
     
    Last edited: Sep 23, 2009
  3. Unregistered

    Unregistered Guest

    Ok - to answer some of those questions! Yes the big toe is swollen, red and hot and at times the neighbouring toes are also swollen. There is pain when trying to put weight on it and walk. I can move the toe when there is no weight on it with only minimal discomfort although I do feel slightly nauseous if I do this. My foot as a whole aches most of the time - especially the arch of the foot and I'm assuming that this is just strain from walking so oddly (when I walk anywhwere at all!). Having a shoe on is uncomfortable - i only have one pair of shoes that I can get on with the swelling and walk in. Without a shoe on though I can take just a couple of steps before I have to sit right back down.

    I believe the steroids were prescribed because I couldn't take NSAIDs to reduce the swelling (hasn't worked!). My GP was talking about a possible stress fracture of one of the big toe bones, but he didn't seem very convinced.

    Thanks

    FJT
     
  4. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    With a great toe that is red, hot, swollen and painful in spite of no history of trauma, my initial thoughts would be the possiblity of either gout or an infection. Either can be check out without a great deal of difficulty, and in my view, should be done before progressing further into the diagnostic process.
     
  5. Unregistered

    Unregistered Guest

    Many thanks for your assistance.

    FJT
     
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