The big toe hurts. Reasons why, when walking, joints, nails, bone, pads

Your toes may hurt in people of different ages. The thumb swells and hurts with gout and arthritis in older patients, fractures and bruises are common in young people. The tactics of treatment depend on the exact diagnosis obtained with the help of X-rays and laboratory tests.

Possible causes of big toe pain

The greatest difficulty is the diagnosis of the disease on the basis of a single symptom.

Therefore, the survey is assigned based on the reasons that may be its source:

Disease	Short description
Gout	This is an inflammation of the joint cavity due to the irritating effect of uric acid crystals. The finger swells up, increases in size. The skin above it is red and hot to the touch. There is usually no pain or swelling on the other leg.
Arthritis	These are chronic inflammatory diseases of the joints and articular elements. Manifested by pain, stiffness of movements.
Bruises	In case of bruises, pain is localized clearly in the places of impact. Abrasions, wounds and bruises are also found there. With fractures, pain is severe, making it impossible to move the affected finger. Outwardly, pronounced deformation is possible.
Diabetic neuropathy	Neuropathy associated with diabetes in the sensory form is manifested by pain. It is constant, sometimes proceeding as "abscesses". Intensifies at night. Itching, unbearable burning sensation often joins. Against this background, the sensitivity of the feet in general decreases. Hallux valgus causes pain due to the fact that altered bones compress nerve endings and vascular bundles.

After an injury, consultation with a surgeon or traumatologist is necessary. To do this, they turn to emergency rooms or ordinary polyclinics. These specialists carry out the treatment of the wound, if any, and are also determined with a diagnosis using the examination methods available at hand.

The toe hurts (the big toe is injured more often than the rest of the foot), not only after injuries. It can be chronic or acute inflammation of the articular elements, as well as corns, felon.

With a mild pain syndrome, you can limit yourself to taking analgesics, but it is better to make an appointment with a surgeon or therapist. If the pain is unbearable, accompanied by edema and is "blistering" in nature, you should immediately seek help from the clinic, or call an ambulance.

First aid is provided by a surgeon or traumatologist. In his absence, this can be done by the therapist. In case of traumatic injury, anesthesia should be performed first.

For this, there are non-steroidal anti-inflammatory drugs, if they are ineffective, they resort to narcotic medications. To limit the area of ​​edema, ice is applied to the site of injury. In case of a fracture, the finger should be immobilized so as not to cause unnecessary movements that cause pain.

If an injury occurs, an aseptic dressing is applied after appropriate treatment. For pain associated with arthrosis, arthritis or gout, an injection or NSAID tablet is sufficient. In the absence, you can do with a compress with the addition of Dimexidum or Novocaine.

Diagnostic methods

The doctor visually assesses the contours of the joints, their configuration, the presence of deformation due to edema. Abrasions, bruises, or wounds may be visible on the skin. After examination, the affected area is palpated, the range of movements, the degree of their limitation are determined. Edema, hyperthermia of the finger (a local increase in the temperature of the skin) can be detected.

X-ray is the first diagnostic procedure for pain in the big toe. This technique is simple but informative at the same time. Based on the image, a competent doctor will determine whether there is a fracture, dislocation, or a joint lesion in front of it.

The joint space, its size, the evenness of the edges of the articulating surfaces, the presence of bone growths, as well as the integrity of the bones, the presence of cracks and displacements are determined. All these parameters will be taken into account when making a diagnosis, which will determine the tactics of treatment. The cost of foot X-ray is approximately 300 rubles. It is carried out in all emergency rooms and clinics.

In doubtful cases, tomography is prescribed. It can be MRI or CT, depending on which structures need to be assessed: if the alleged pathology in ligaments or cartilage, then an MRI should be performed, if a bone pathology is suspected, a computer tomography.

These studies should not be performed on your own, as they may be unnecessary. Therefore, it is necessary to make an appointment for a tomography only on the recommendation of a doctor. CT or MRI is not done in all polyclinics, and there are usually long queues for them.

This is a rather scarce research method that is not routine. In private clinics, it can be done for a fee. The average cost is up to 3500 rubles. The study does not require special preparation.

The ultrasound method is intended for rheumatologists. They are specialists in inflammatory diseases of the joints and their elements.

Joint ultrasound can evaluate the following parameters:

• the size and shape of the articular cavities;
• the presence of effusion, its volume;
• the nature of the effusion into the joint: blood, pus, exudate, transudate;
• the presence of damage to ligaments, tendons.

The technique allows you to determine the type of arthrosis or arthritis, as well as to distinguish between hemarthrosis (joint hemorrhage) or pus in the cavity. An ultrasound of the joints is performed privately, the estimated cost is up to 700 rubles. The main thing is to find an adequate specialist, because not all functional diagnosticians know the technique of visualizing joints, especially small ones.

Laboratory research methods are considered separately. This is the lot of therapists or rheumatologists. First of all, a general blood test is performed. In the presence of panaritium toe, the content of leukocytes increases manifold, mainly due to neutrophils, as well as the erythrocyte sedimentation rate.

With arthrosis, the platelet count may increase, which indicates severe inflammation. ESR also increases. A biochemical blood test is intended for the differential diagnosis of articular syndrome.

The following indicators are important:

• uric acid;
• rheumatoid factor;
• blood glucose;
• C-reactive protein;
• ASAT and ALAT.

C-reactive protein is a universal marker of inflammation. The norm is up to 6 g / dl. When this value is exceeded, articular inflammatory syndrome occurs. To determine the nature of the disease, all of the above indicators are taken into account.

With an increase in the concentration of RF or rheumatoid factor, one should think about rheumatoid arthritis. The survey is complemented by ADC and MTsV. These are immunological studies specific to the diagnosis of rheumatoid arthritis.

Gout is characterized by an increase in uric acid levels of more than 600 μmol / L. Blood glucose is determined if there is a suspicion of the formation of Charcot's foot - a complication of diabetes mellitus.

Toe hurts (the big one is affected more often than others) with reactive arthritis, ankylosing spondyloarthritis (peripheral form of ankylosing spondylitis), psoriatic arthritis.

To diagnose these diseases, an ELISA for the HLA-B27 antigen is prescribed. The research costs about 1,500 rubles. It is carried out only on the recommendation of a rheumatologist in private laboratories.

Treatment methods depending on the diagnosis

The tactics depend on the specific nosology (disease). With a panaritium, an abscess forming, a furuncle requires surgical intervention. In case of a fracture, it may also be needed. In other cases, in the first place, they resort to therapy using injectable or tablet forms.

Medication

With pain syndrome, the primary goal of treatment is pain relief. The first line of drugs is represented by non-steroidal anti-inflammatory drugs or NSAIDs. They have a pronounced analgesic effect, eliminating edema, painful impulses and other components of the inflammatory response.

First, with severe pain, injectable forms are prescribed. It can be Ketorol, Diclofenac, Amelotex. Then they switch to oral administration if necessary. Nimesil, Nimulid are used more often, and Ortofen, Diclof, Nise, Ketonal Duo can be in tablets.

A pronounced negative effect of NSAIDs on the mucous membrane of the stomach and duodenum is known. In persons with a history of ulcers, suppositories with NSAIDs or topical forms (ointments, creams) can be used.

Usually the toe hurts due to swelling. On the thumb, you can use a compress with Dimexide and Novocaine. Sometimes Diprospan or another steroid component is added to this mixture.

If the cause of the pain lies in arthrosis (osteoarthritis), then the drug treatment described above is sufficient. You can use more selective NSAIDs instead of Diclofenac, which have fewer side effects on the gastrointestinal tract. For example, Movasin, Meloxicam. To improve the trophism of cartilage, Diaflex can be prescribed. The course of treatment is 1-2 months.

Chondroprotectors are used only at 1-2 radiological stages of osteoarthritis. It could be Rumalon, Alflutop or Hondroguard. First, the injection forms are shown, and then there is a smooth transition to tablets or capsules. The course of admission can be prolonged up to 2-3 months.

Rheumatoid arthritis requires specific therapy. These are agents from the group of anticancer drugs. For example, Sulfasalazine or Methotrexate. These drugs are prescribed only by rheumatologists. Their reception requires constant monitoring of blood parameters, since their effect on the erythrocyte and leukocyte lineage is known. Uncontrolled reception is dangerous.

With gout, for the first 7 days, a therapy similar to the treatment of osteoarthritis is prescribed. Then a specific drug is prescribed that reduces the uric acid content. This is either Allopurinol or Adenuric. The dose is titrated according to the level of uric acid.

Psoriatic arthritis requires biological therapy. These are monoclonal antibodies: Imatinib, Azalimumab and other agents. They are also prescribed only by a rheumatologist. In case of severe course, methotrexate is also prescribed.

Antibiotic therapy is indicated for abscess, infected wounds, panaritiums. Surgeons give preference to broad-spectrum antibiotics. These are drugs of the penicillin series or fluoroquinolones.

Surgical

Wounds in the area of ​​the first toe undergo primary or secondary surgical debridement. If necessary, the edges of the wound are sutured (sutured). These manipulations are performed in a small operating room of a polyclinic or a trauma center.

Operations in cases of fractures are indicated only with sluggish consolidation or an initially unfavorable type of fracture (comminuted). Knitting needles, pins or other metal structures are used.

Superficially located panaritiums are first treated conservatively, followed by surgery. With the subungual form, the nail plate is carefully removed under local anesthesia and the exposed painful area is treated with an antiseptic, Levomekloevaya ointment.

Bone or articular varieties of panaritiums are immediately treated promptly, since in these situations there is a high risk of further spread of the infection. Pus is evacuated, and the affected area is thoroughly drained and cleaned. With pandactylitis, amputation of the thumb is indicated due to the threat of infection of the soft tissues of the foot.

An ingrown toenail is a common outpatient procedure seen by a surgeon at an outpatient clinic. After removal of the nail plate, antibiotics are prescribed and careful care of the skin of the toes.

Physiotherapy

The toe hurts (the big toe is more effectively involved in the movements of the foot) for a long time, both with arthrosis and after injury. To accelerate recovery or the onset of remission, physical methods of influence are used.

They potentiate the action of medications (mutually reinforce). But it is impossible to use physiotherapy for edematous syndrome during a period of obvious exacerbation. It is better to do this on days 4-5 of intensive therapy. Otherwise, the pain syndrome may increase.

Ozokerite and paraffin keep warm well and therefore are effective in joint pathology. Foot baths are also used.

Ultrasound is indicated for the chronic course of arthrosis. Constant pain disappears or dulls markedly. It is better not to do more than 7 ultrasound sessions on the big toe.

Electrophoresis combines the effects of galvanization and the effects of drugs. This method can be used even with exacerbation. As a medicine, Diprospan is suitable, as well as Dimexide, Novocain. After 3 procedures, the patients' well-being improves markedly.

Treatment with folk remedies

Alternative therapies should not be considered as separate therapies. They are used in addition to the officially accepted treatment protocols. It is better if this is done under the supervision and with the permission of a doctor.

The toe hurts (the big toe is quite often affected by pathological damage in diabetes) with the painful form of diabetic neuropathy. The sensations are very strong and unpleasant, sometimes unbearable. Blue clay lotions have a good distracting effect.

Layers of material soaked in water are applied to gauze cloths. Make several layers of cheesecloth with clay. You can leave these lotions overnight if there is no allergic reaction or irritation.

With arthrosis of the foot, baths help. Balneotherapy not only improves blood flow, but also stimulates the formation of cartilage, resorption of synovial fluid. The water temperature should not exceed +40 ° С. Baby soap drenched in boiling water and salicylic acid are added to it. You can add turpentine, but provided there is no allergic reaction. Procedure time - no more than 20 minutes.

With gout, the emphasis is on herbal remedies. Infusion of lilac flowers is used externally for exacerbation (attack) of gouty arthritis, as well as inward, 30-50 drops before meals. The course is not more than a month.

Infusion based on garlic and lemon can reduce the level of uric acid in the blood, joints, and achieve remission. To do this, grind a few cloves of garlic and half a lemon in a blender. Then the resulting mixture is added to 600 ml of boiling water and insisted for about 3 days in a dark place. The resulting liquid is consumed in 10 minutes. before meals, 50 ml.

Finger bruises can also be treated with traditional methods. Plantain leaves in the form of a compress on alcohol reduce pain and swelling of soft tissues. Proper care of your feet allows you to prevent problems with your feet.

There are a number of useful rules for this:

• feet should not be hypothermic;
• shoes should be chosen as comfortable as possible, preferably in orthopedic salons;
• shoes made of airtight materials are not allowed;
• every day, twice your feet need to be rinsed with warm water and soap;
• for diabetics, the frequency of treatment of the skin of the feet is increased to 4.

Excessive overloading of the legs are factors that predispose to the development of arthrosis, hallux valgus. Therefore, exhausting running is contraindicated.

The soft tissues of the toes can hurt for various reasons. The thumb is more likely to suffer from gout or bruises. Treatment includes the use of NSAIDs and physical therapy. Surgical treatment is indicated for hallux valgus, trauma and panaritium.

Article design: Vladimir the Great

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