Question
I have searched the Internet for an answer to my symptoms, but I have not been able to find an example with similar symptoms. I get a sharp, burning, tingling sensation in my left big toe that is quite painful.  It only occurs when my foot (ankle) is extended downward and the pain begins when I start pointing my toe down as well. The pain is in the joint where my foot joins the big toe and the pain then extends down the toe to the next joint in my toe. When looking at both feet, the tendon that runs across the top of my foot to my big toe is more pronounced near the big toe in the foot where I am receiving pain than compared to the unaffected foot.

These same symptoms occured a few years ago, but it went away after a couple of weeks.  This has now been going on for over a month, and the pain is getting worse over time.  I like to run for a half hour a day, but I have not run for the past three months since the treadmill broke down. The pain in my toe started about a month or two after I stopped running.  I did get a new pair of leather shoes for work in October that were very tight fitting, but have broken in fairly well over time. My left foot, where the pain resides, is slightly larger than the right. I am in my late thirties and otherwise healthy.

Any ideas?

Answer
John,

It sounds like your pain could be caused by one or two different problems.  One could be the tendon being too tight.  If you can see a prominent tendon on one toe compared to the other, it can cause spasm in the toe and increased stress to the bottom of the toe.  Trying to stretch and lengthen the tendon is helpful but sometimes it needs to be surgically lengthened.  The other problem could be the actual joint.  Increased stress to the joint from high impact activity such as running or history of running can cause arthritis to the joint.  Usually joint arthritis feels like an aching or throbbing in the joint, possible swelling around the joint as well.  Lifting up on the ball of the foot such as toe raise can increase the pain.  I would try to use an anti-inflammatory and use supportive tennis shoes until the pain resolves.  Possibly getting an orthotic can help decrease stress to the joint or the tendon as well.


Sincerely,
Dr. Leslie Johnston, DPM

Tampa, FL
Advanced Podiatry

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