Question
Last night I experienced extremely sharp toe pains while in bed... were very painful.  Today, it was fine, but a little "achy".  Again tonight I am experiencing really painful stabbing sensations.  I have a very high pain tolerance, so this is odd.  More confusing is that standing up makes it stop.  I am 40, pregnant (only 10 weeks) on 5 mg. of prednisone BID, 50 mg. of progesterone BID, baby aspirin, prenatal vitamins & folic acid.  The pain was sharp enough that I would have gone to a Dr...  but I can't have X-rays or take (more!) medicine.  Any advice would be GREATLY appreciated!

Answer
Sandra,

If this was sudden and no injury, you may have Gout.  This is a very painful condition typically around the big toe joint.  It comes on suddenly and is described as being extremely painful.  It often occurs at night in bed or early morning.

You may have a fracture and immobilizing the joint could be helpful.

You should see a Podiatrist and also have a blood uric acid test.  If this is high, you have gout.  If it is normal, you could have had an attack and then the uric acid levels went back to normal. So, you could still have gout with a normal uric acid. Sometimes diet modifications help.  Gout can occur while taking certain medications.  See my website for more information.

You may need the foot and toe immobilized and possibly medication for treatment that is OK in pregnanacy. Gout will improve on its own and you may require no medication.  After the baby is born, if you have attacks you could then get an x-ray and start medication if needed.

Good luck with your foot and your pregnancy.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.theTampaPodiatrist.com
http://www.TampaCryosurgery.com