pain in great toe joint

by Ann
(Staten Island NY)

one of my students accidenttally put a chair down on my left big toe joints and sat down hard. Since then I have had pain in the area and can't wear any shoe that puts pressure there. I wear flip flops and some flat boots. I have tried alcohol shots to deaden ther nerve, accupuncture but nothing helps.

I already had great toe joint replacement on my right foot after a computer table fell on it. What kind of doctor should I see now for the left foot?

RESPONSE
Hi Ann,
Since I am a podiatrist I am partial to podiatrists as they are the doctor who best knows the diseases and conditions of the foot.
So far, it seems, you have not had any treatment that makes any sense for the trauma that you suffered on your great toe.
I would have hoped that you at least had an x-ray to see the extent of damage you did to the joint, or the adjacent bones. If there is no sign of a chip fracture or any other kind of fracture for that matter, then I would recommend you consider undergoing physical therapy for a month to see if you can get the joint to stop hurting.
I know nothing about your age or overall health but suffice it to say that if you required an implant on your other foot then this foot probably exhibits some degree of arthritis.
Once again, if the x-ray was negative then all you did was inflame the joint when the chair hit your foot.
Usually physical therapy possibly along with anti-inflammatory medication (if you can tolerate it) can go a long way in reducing your symptoms.
Additionally, a cortisone injection may also be of benefit.
During this time period you should stay in a rigid type shoe; a shoe that does not bend easily at the ball of the foot. The point to that is that the less the shoe bends, the less demand that is put on the toe to try and bend and the less pain you will experience.
If this course of therapy works great, if not, then you can always consider surgery and once again I would recommend you see a podiatrist.

Marc Mitnick DPM
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