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The response to the question below was authored by Marc Mitnick DPM

Second toe swollen/trouble walking

by BT
(NYC)

second toe is swollen (right foot)

second toe is swollen (right foot)

second toe is swollen (right foot)
comparison of normal toe/foot (left foot)

My second toe (right foot) began hurting a bit on Sunday. After a decent amount of walking and changing subways (I live in NYC and take public transportation and walk to get around) on Sunday, I started limping. I woke up Monday and it felt okay until I started walking to work and it began hurting again (it felt tight and sore). By the end of the workday (I work a desk job, so I am not on my feet often) and headed home, I could barely put weight on my right foot. The toe is swollen and not really red. The pain is in the base of the toe and only really hurts if I press on it or put my weight on my foot to walk normally. It also feels like a marble on the bottom of my foot at the base of this toe. Barefoot or ballet flats are impossible. I bought a medical shoe at the drug store and have taped my second and third toe together for the last two days. The pain and swelling are a bit less but I still can't fully bear down on the foot or walk normally. Otherwise, no other toes hurt or other parts of my foot. I can't tell if it would be gout (but my first toe is okay), capsulitis or a fracture (I do have a bunion on this foot and have had issues with plantar fasciitis). Also, outside of work, I am wearing Birkentocks or other supportive sandals or shoes and I am a 39-year-old female. Thanks!


RESPONSE

Hi Brooke,

You have mentioned all the possibilities of what might be causing your pain and swelling in the second
toe. The only other thing I can think of is an arthritic flare up at the level where the toe attaches into the metatarsal bone, which would be the base of the toe.

I am not leaning toward gout as that is a rare occurrence in pre-menopausal women, but certainly capsulitis or even a stress fracture are a possibility.

Without actually examining you and no x-rays to refer to, I can only guess what might be wrong with your toe.

My first suggestion would be to go see a local podiatrist and get an accurate diagnosis.

Short of that, you could try wearing the surgical shoe constantly for a few days to allow the inflammation to calm down. This means no cheating, no walking barefoot or wearing other types of shoes. You could also supplement this with anti-inflammatory medication on a regular basis for a week, this is assuming you can tolerate that type of medication.

You might get better, but the downside is that if you do not improve, you have wasted a week of your life walking around in a rigid shoe. Since you do a lot of walking on a daily basis, the shoe may actually begin to bother you; in most cases it will end up aggravating your back.

If you want me to "guess", since this problem began after doing a lot of walking, I would be leaning towards capsulitis. My next best guess would be a possible stress fracture, but usually they occur a bit further back in the metatarsal and generally do not cause the toe to swell.

Like I said, seeing a local doctor would probably be the smart move on your part.

Marc Mitnick DPM
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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