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Sunday, February 28, 2021

Gout-like Pain Post Vaccine Shots: Common Symptom for a Podiatrist to Hear About

Hi Dr. Blake,

It has been over 2 years since we have been in touch and I am happy to report that I have recovered well from my accident. I am very active again, including long bike rides and even jogging 3 miles once a week. However, I have new and debilitating pain in my right big toe that I think must be related to the Shingrix vaccine.

I had the second dose of the Shingrix vaccine 9 days ago. When I stepped out of bed the next morning I noticed I felt like I had stepped on something. When I reached down there was nothing there but a swelling under my right big toe. At first this wasn't really painful unless I stood on it, at which point it became a bit of a pressure point. I have been resting, icing, and taking ibuprofen but over the past week it has gotten worse, much worse now so that I cannot sleep. It still is not painful to move the joint, but there is a sometimes constant pain and a sharp burning pain when I touch the skin or put pressure on my toe. It seems like pain has radiated from the original spot (most distal toe joint) out towards the distal end of my toe. There is some swelling but not a lot to see. With all my past injuries, I need to stay active or things deteriorate fast, but right now I can't do much.

I had not exercised the 2 days before my shot and onset of symptoms, and also with the unusual symptoms, I am sure this is not a typical trauma or repetitive stress injury like I have had in the past. Due to the sudden onset after the vaccine, I think whatever is going on is due to the vaccine. I looked online and found that the Mayo Clinic website (link below) says contact your doctor immediately if you have "Ankle, knee, or great toe joint pain" after this vaccine. I have had a video call and a phone call with my doctor and now have a video appointment with a podiatrist, but so far nobody has been able to say anything about why this may be a vaccine side effect or what it means. Unfortunately I had to switch to Kaiser this year for financial reasons so my podiatrist appointment is not with you.

Have you ever heard of anything like this? Any experience with this type of reaction to Shingrix or what the implications are of such a reaction? I am at a loss. I realize you cannot diagnose my toe without a visit but I am wondering whether you have any experience with or knowledge of similar issues, because I am not finding any useful information that may explain what I am experiencing.

Kind Regards,

Dr. Blake's Comment: Sorry this happened to you. I am seeing alot of this post Covid 19 Vaccine. I am treating it like a gout attack, which it may be. Gout attacks are brought on by changes in the metabolism something that can occur dramatically with vaccine shots. If you were in my office, I would take an x-ray but that will be inconclusive (however an important baseline). I would have you super hydrate next week (at least 4 eight ounce glasses of water minimum), 3 advil 4 times a day for next 5 days, and the important ice soak 10 minutes (cold water with ice cubes) three times a day. I would fit you for a removable boot and apply a dancer's pad to float the big toe joint just so you can get around. If it was not feeling a ton better in a week, I would order both uric acid levels and an MRi (as you could have a stress fracture say in the sesamoids under the big toe joint or just some arthritis popping up). I sure hope this helps. Everyone (about 5 patients so far) that have got this post Covid shot immediately got better with this approach. 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.