Sharp pain in top of big toe, usually when walking
by Valerie
On 1/8/11 I slipped in a pool of water at a hotel. My left leg extended out in front of me and was uninjured, but my right leg went behind me. I had a scrape on my knee and on the top of my foot just below the ankle. My big toe was overextended (downwards, I guess, but I can't totally recall). Upon arising, I knew I was injured but didn't know what to make of it. Now, 30 days later, I am left with a very painful big toe. The pain occurs when I try and walk through a normal step - I can generally avoid the pain by slightly altering my step towards the outside of my foot a bit, but this has its obvious limitations, as I am very active and work out every day. The thing that makes the pain worse is when I am wearing a stiff leather shoe - like a clog. When trying to walk with a clog on, the pressure from the shoe hitting the top of my toe creates an very sharp, needle-like pain straight through my toenail and down to the underside of my toe. I went to my family doctor who suspected turf toe. Xray was negative. Is there some other explanation? Something different I can do? Hi Valerie, If the xray is negative for bone pathology then obviously your pain is from soft tissue trauma. You state that you think your big toe plantarflexed (bent downward), if this is the case then you overstretched all the structures on the top of the toe. The most common structure to be affected would be the tendon that actually brings your toe upward. The pain shooting into the nail area suggests to me, at least, the possibility that the tendon is partialy torn. An MRI would bare that out. I would say that pain in the area six weeks post trauma would require the services of a foot specialist, someone who is familiar with the anatomy in that area. Most simple sprains or strains would have cleared up by now. Marc Mitnick DPM DISCLAIMER
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