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Sunday, June 22, 2014

Big Toe Swelling: Email Advice

Dear Dr Blake, 

     My big toe on my right foot is very swollen. It is about twice the size of a regular big toe. The swollen part is very warm, and very painful if I touch it .I can't wear a shoe on my right foot, it is very painful to even try to put a sock on my right foot. My toe and foot have been this way for over 2 weeks now. I'm still unable to wear a shoe. I can wear one of my husband's big socks. I do try to walk on my foot during the day, but the pain on the bottom and left side of my right foot is sometimes too painful to even try. I haven't been to a doctor, yet.....just like other people in  the USA, it's a money problem. I'm not asking for a 'hand out' or anything, like that. I would just like to know what's going on with my foot. Thanking u in advance for any help I can get from u for the diagnosis of my toe.

Mari (name changed)

Dear Mari, 

     Pain and swelling in the big toe area is infection or gout until proven otherwise. There are also other more rare causes like fractures and sprains, but you would have had to know you did something to cause that. Please email back with answers to these questions:

  1. Do you see any sign of an ingrown toenail that got infected? Did you cut your nails 4-5 days before the onset of pain? 
  2. Do you have any infections in your body at this time or at the time of onset? Respiratory, urinary tract, etc.
  3. Can you send a photo of both big toes?
  4. Do you have any systemic signs of infection like fever, malaise, chills, or painful areas above your foot?
  5. If you read about what causes gout dietary wise, is your diet high in purines? (see my post on foods that increase the chance of gout)
  6. Do you tend to stay hydrated or not?
  7. Is there a family history of gout or another systemic disease?
  8. Could you have been exposed cold somehow?
  9. How is your overall circulation in your feet and extremities?
  10. Did anything happen in the 3-4 days prior to the onset of swelling like dropping something on your toe or starting a new exercise program or changing shoes?
  11. Send me a close up on the nail itself please. 
  12. What medications are you on for some can cause gout?
Hope this information gets us moving in the right direction. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.