Pain in the big toe
introduction
Can have pain in the big toe multiple causes underlie; being basically between these too distinguish is that originated at great toe or that Big toe joint have, as well internal diseaseswhere joint pain is a symptom.
Pain in the joint
Illnesses or injuries that joint are a common cause of big toe pain. The joint that connects the big toe to the metatarsus, the so-called Big toe joint, is essential for the rolling motion when walking, which is why illness and pain are often perceived as extremely restrictive and uncomfortable there.
Especially those gout is a major cause of complaints that affect the metatarsophalangeal joint of the big toe. The metatarsophalangeal joint of the big toe is a Ball jointwhich the bone of Metatarsus connects with the big toe. If this joint is affected by gout, it can cause considerable pain.
Other diseases can also cause pain in the joint. So puts one arthrosis in the joint, then too Hallux rigidus Another common cause of pain in the area.
Injuries and broken bones can also significantly affect the joint of the big toe. It is important to ensure that there are no misalignments during therapy so that no permanent damage occurs after the fracture has healed, which could affect the gait pattern.
Figure pain in the big toe
Pain in the big toe
- Toe phalanx -
Phalanx distalis - Big toe joint -
Articulatio interphalangea - Phalanx -
phalanx proximalis - Big toe joint -
Articulatio metatarsophalangea - Sesame bone - Os sesamoideum
- Metatarsal bones -
Os metatarsi - Tarsus metatarsal joint -
Articulatio tarsometatarsi - Inner sphenoid bone -
Medial cuneiform bone - Middle sphenoid bone -
Os cuneiform intermedium - Scaphoid bone - Navicular bone
Possible causes:
A - gout (uricopathy) -
Illness by one
increased uric acid levels
B - Hallux rigidus -
Arthrosis in the metatarsophalangeal joint of the big toe
(also as a sequence of A and D)
C - fracture (fracture) -
Fall of a heavy object
on the toe or butt of the toe
D - Hallux valgus -
Toe misalignment (internal rotation
of the big toe and deviation of the
Metatarsophalangeal joint medially)
E - tendinitis -
caused by over or
Incorrect load (soccer players,
Ballet dancers)
F - nail bed inflammation -
bacterial infection
(acute or chronic form)
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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Possible causes
Broken toe
A fracture (Fracture) one of the two limbs of the big toe is usually Result of direct violence; it comes to either Fall one heavy object on the toe or with Butt of the toe on a solid edge. Amazingly, this breaks Basic link (the limb connected to the metatarsus) clearly more often than End link. A distinction can be made between one smooth fracture and one Splinter fracture.
character a fracture strong pain in the corresponding area, especially when touching or moving the big toe. In addition, a swelling on and it can turn into a bruise form (see: Bruise under the nail). There on the limbs of the big toe the Tendons of the muscles, which are responsible for moving the toe, is common in fractures when the tendons pull on the bone fragments Toe misalignmentwhich are also a clear indication of a toe fracture.
If the physician has the suspicion that a fracture has occurred based on the above-mentioned complaints described by the patient and due to possible toe misalignments, secures he the diagnosis using a X-ray. With their help, important information can be gathered that is needed to decide on the preferred therapy.
hallux valgus
The most common toe misalignment, of the hallux valgus, denotes the combination out Internal rotation (Inward rotation) of the big toe and one Medial deviation of the metatarsophalangeal joint of the big toe (towards the other foot). she is often socialized with a splayfoot.
Hallux valgus caused usually - apart from the cosmetic aspect - hardly any complaints. If a patient with hallux valgus suffers expectation again Pain in the big toe, then initially mostly only under load; at rest the patient is painless. Late develop Persistent pain even at rest that from the consequential damage result.
The deformity gradually leads to Formation of exophytes (bony extensions) on the first metatarsal bone, which is connected to the metatarsophalangeal joint of the big toe. This goes along with it because of the constant friction on the shoe a Bursa irritation in the metatarsophalangeal joint, the increasingly painful be and initially in the form of a swelling, later also in the form of a light one Inflammatory response (Redness, swelling, overheating). A further episode the incorrect load resulting from hallux valgus can be a Hallux rigidus (osteoarthritis in the metatarsophalangeal joint of the big toe).
In addition, the complaints solve a Change in gait pattern of the patient; the Steps get shorter. Due to the "Displacement" through the big toe it can also get into the other toes and Metatarsal bones to complaints come. Also the Formation of corns to the Bruises of the metatarsophalangeal joint of the big toe can be caused by hallux valgus favored become. Based on the causal, characteristic malposition of the big toe, hallux valgus can be easily differentiated from other possible causes of pain in the big toe.
The diagnosis is predominantly through Outside inspection posed. In particular for Assessment of the joint condition with regard to exophyte formation and osteoarthritis (Hallux rigidus) can also apparatus procedures (especially X-ray) can be used.
Further information on this topic can be found at: hallux valgus
Hallux rigidus
At the Hallux rigidus is it a Arthrosis in the metatarsophalangeal joint of the big toe, this can result from one hallux valgus or one Gout disease be.
Hallux rigidus usually occurs one-sided on, concerns Men much more often than women and usually starts in Adolescence. Leading symptom are Pain in conjunction with a Restriction of movement of the metatarsophalangeal joint. This limitation mainly relates to the Extensibility of the joint towards the back of the foot, which is essential for the foot to roll and thus for a round, harmonious gait pattern.
in the further course the joint can even stiffen. Consequences are gait problems that arise in one limping gentle cycle express, which can also include rolling over the outer edge of the foot - to relieve the big toe lying on the inner edge. A Toe stand or even Tiptoe are no more or only in severe pain executable. In addition to pain and restricted mobility, there is one swelling of the joint, often accompanied by Redness and overheating.
Diagnosed Hallux rigidus is mainly caused by a X-rayon which the typical Signs of osteoarthritise.g. a narrowing of the joint space can be seen.
Further information on this topic can be found at: Hallux rigidus
gout
The gout (medical: Uricopathy) is a disease in which it is caused by a increased uric acid levels in the blood for the deposition of Uric acid crystals in joints and the resulting discomfort comes. She hits with more conspicuous Accumulation in combination with components of the "Metabolic syndrome" on - Obesity, diabetes, hyperlipidemia (Lipid metabolism disorders) and high blood pressure. In some patients, gout is caused by one increased seizure of uric acid and in others by one impaired excretion of uric acid.
Gout is common first in form of a sudden, Lasting hours to days, Joint attack in mostly just one single joint (monarthritis), the above all at night occurs. In the half of those suffering from gout, this is the case Big toe joint. The affected joint has the classic signs of inflammation on:
- Redness
- swelling
- Pain
- Overheating and
- Function restriction.
Especially if injuries and overuse can be excluded as the cause of these symptoms, gout is very likely as the cause. Because gout flares up, symptoms don't last, but rather regress until they come back with the next flare-up.
It is typical of gout that initially only one joint is affected, until the symptoms appear in other joints after a longer period of illness.
In the further course of a untreated gout will always more joints infested and it can chronic joint damage occur. Also unspecific symptoms such as fever or chills can be added. Another typical sign of a gout disease are the so-called Gout tophi. It refers to whitish nodules, the right under the skin - mainly from auricle, Hands and Feet - be able to lie and break up. Another possible consequence a gout disease is caused by the deposit of uric acid crystals in the kidney evoked Renal failure.
Further information on this topic is available at:
- gout
and - Attack of gout
The diagnosis gout relies on a few typical clinical manifestationswho also differentiate gout well from the other possible causes of big toe pain. So the doctor can according to the specifications of the German Rheumatological Society diagnosis Gout already as probably classify if the following three points are given:
- The complaints occurred suddenly,
- they disappeared again after a week or two and
- initially only referred to a single joint.
To Fuse the diagnosis will eventually be different Laboratory tests used.
The cause of the development of gout is in almost all cases a functional disorder kidney. This can have different causes, but it usually develops due to other diseases such as Diabetes mellitus, Alcohol addiction or other metabolic diseases.
tendon
The big toe and its joints are used by some Tendons that restrict the movement of the joints and thus give the toe the necessary stability. However, there are times when these tendons are the cause of severe pain. The tendons can cause discomfort, especially if they are over- or improperly used. In particular, the tendon of a muscle, which is responsible for the flexion of the big toe, can be of a so-called Tendinitis to be affected. This is not an inflammation caused by bacteria caused, but only caused by an overload of the tendon.
Mostly young people with a typical risk profile are affected. Football players and ballet dancers, for example, are often affected by the disease. Symptoms of such an inflammation include severe pain in the big toe when moving, and an impaired ability to bend the big toe. An acute inflammation of the tendon can develop into a chronic disease that requires therapy. In addition to conservative therapies with pain relievers and anti-inflammatory drugs, surgery on the tendon and neighboring structures can also provide relief.
Please also read our article on this Tendonitis on the ankle and Tendinitis in the foot.
Inflammation of the nail bed
The Inflammation of the nail bed is a bacterial infection the one from the nail covered skin (nail bed). It can be divided into acute and chronic forms.
The acute Inflammation of the nail bed shows the typical signs of a inflammation - redness, swelling, overheating and pain. Also forms often pus from expression of the inflammatory reaction. The signs of inflammation occur in one characteristic consequence on: on an initial one Redness follow first Swelling and redness. It only occurs as a result of the swelling Pain, the often described as pulsating as they are for Pulse rate in the small blood vessels of the nail synchronous occur. Also a itching can often be associated with the symptoms mentioned. Especially severe, rare cases acute inflammation of the nail bed can also Fever and swelling of the lymph nodes cause.
The chronic Nail bed inflammation is less strongly associated with the typical signs of inflammationwhich means that it is often noticed late. Usually only one is shown here reddish to bluish discoloration of the nail. Another difference to the acute form is the occurrence on several nails at the same time.
Inflammation of the big toe
Inflammation on the big toe can manifest itself in different ways.
Usually unspecific symptoms of inflammation such as reddening or swelling appear first.
Depending on the cause of the inflammation, the swelling can be limited to the nail bed or the entire toe.
The course of the inflammation can also vary, it can appear suddenly or it can be gradual.
Pain in the big toe after exercising
Pain in the big toe after exercise can have different causes. For example, if you are unfamiliar with the job you are doing, it is most likely that you are overworking or under stress. Unsuitable footwear can also be responsible for the pain and the strain on the toe and the affected joint can become too great.
In the case of pain that can be traced back to improper or excessive exercise during exercise, the tendon or the associated muscle is usually affected. This can lead to painful tendinitis, which, depending on the severity and progress of the disease, even has to be treated surgically. Also Pulled muscles can cause pain in the big toe and thus be the reason for discomfort after exercise.
Also other diseases, such as a Hallux rigidus, can cause discomfort at the beginning of the disease, especially with increased exercise and exertion.
In any case, if the pain in the big toe persists, it is advisable to consult a doctor after exercising foot Thoroughly examine and, if necessary, use imaging techniques so that the individual diagnosis can be made and the reason for the symptoms can be found. With the correct diagnosis, adequate therapy can be initiated, with which usually a satisfactory improvement can be achieved.
When rolling
The big toe and especially the metatarsophalangeal joint of the big toe are essential for a harmonious gait pattern and for the foot to roll correctly. A disease that causes pain in the big toe or even restricted movement in the metatarsophalangeal joint usually restricts the gait and in many cases prevents the foot from rolling painlessly. Joint diseases in particular are responsible for the pain when rolling. So can an existing gout be responsible for the pain in the metatarsophalangeal joint of the big toe. This is especially likely if other metabolic disorders exist, such as a Diabetes mellitus. But also one arthrosis in this joint, Hallux rigidus called, prevents rolling and can cause pain when walking. In young people, overstressing the tendons in this area is also a possibility, which can cause unpleasant symptoms.
In summary, a number of diseases can be responsible for the discomfort when rolling. In order to find out the individual reason for the pain, a visit is necessary Orthopedists necessary, who can examine the foot and possibly use imaging procedures so that a correct diagnosis can be made for the symptoms and individual therapy can be initiated.
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