Discussions By Condition: I cannot get a diagnosis.

Years of severe pain in both big toes at rest

Posted In: I cannot get a diagnosis. 8 Replies
  • Posted By: Anonymous
  • November 21, 2008
  • 09:58 PM

I am an 80-year-old male in excellent health except for a severe pain problem, which involves the big toes and surrounding areas of both feet.
Symptoms: Pain, burning, numbness in, and equally around, both big toes at rest. Standing, walking, running, is pain free. Sitting or elevating legs produces pain (sometimes very severe). Pain is centered in both big toes but is sometimes felt in adjoining area between toes. Affected area now seems to be spreading. Pain is almost never experienced when standing, walking, or hiking. Pain usually subsides in time when flat on my back, but on occasion, keeps me from sleeping. There is never any pain upon waking in the morning. Elevating feet in any way: sitting, driving the car, aggravates the problem. First symptoms appeared many years ago but symptoms have been intermittently slight or moderate until about a year ago. The pain has now become a major ‘quality-of-life’ issue.
I have seen a dozen different doctors as well as trying chiropractic. Have tried many medications,(Lyrica Neuromtin, Diclofenac, etc.) None have offered relief. I have had the following tests: X-rays of both feet, two sets of PVR tests, MRI of spine, a CAT scan, a Lower Extremity Angiogram. I have also tried acupuncture with electric stimulation and a number steroid injections. I have received conflicting diagnoses and achieved no relief from pain except through medication such as Hydrocodone, etc

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8 Replies:

  • sounds a lot like gout:http://www.arupconsult.com/Topics/RheumatologicDz/Gout.html Even though my uric acid was okay, I swear I had it with 6 months of pain in my toe. I finally found a product called "goutrol" that took months and months of pain away:http://www.biogro.us/goutrol.html
    Monsterlove 2921 Replies
    • November 22, 2008
    • 02:29 AM
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  • If you're not having any luck with all the drugs and stuff, I would definately try Sporta-Flx Organic Massage Gel.
    drumrunner 8 Replies
    • November 23, 2008
    • 06:23 PM
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  • Hallux rigidus (arthritis of the big toe) Some questions answered What is hallux rigidus? What causes it? What problems does it cause? Why have I got this condition in my twenties? What will happen to me? Is there any thing I can do myself? What can be done about hallux rigidus? Can an operation help? What is hallux rigidus? Hallux rigidus is arthritis of the main joint of the big toe in the ball of the foot. It is a wearing out of the joint surfaces. It is called "hallux rigidus" because its main feature is stiffness ("rigidus") of the big toe ("hallux"). Sometimes only the upper part of the joint is affected and the rest of the joint is all right. In other people the whole joint is worn out. back to top What causes it? In most people there is no definite cause - it just develops. Probably the main reason why this joint is particularly subject to wearing out is that it is under tremendous stress in walking. With each step, a force equal to twice your body weight passes through this very small joint. In a few people it may be caused by an injury or another medical problem such as gout or an infection in the joint. There are a lot of theories about why the joint becomes arthritic but as yet none of them seem very helpful in treatment or prevention of the condition. back to top What problems does it cause? The commonest problems are: Pain in the big toe around the joint. In some people the pain is present whenever they walk or even at rest, but in others it only occurs when they turn the big toe up as far as it will go Stiffness of the big toe. the ability to turn the big toe upwards is lost, although it can usually be turned downwards. Sometimes it gets so stiff it points downwards and cannot be laid flat on the floor A bony bump ("osteophyte" or "dorsal bunion") may develop on top of the joint. This is your body's natural response to the worn joint. The bump may rub on the shoes. In some people this is their only problem. Because of the painful big toe some people tend to walk on the side of the foot. This may produce pain in the ball of the foot or down its outside border. Sometimes the joint wears down more on the outer side, towards the lesser toes, than on the inner side. This may make the toe tilt towards the second toe, and the toes may rub together. back to top Why have I got this condition in my twenties? It is well known that hallux rigidus may begin early in life, even in the teens. The reason is unknown. Fortunately, the chances are that your toe will not get progressively worse, and (apart from your other toe) you are not much more likely to get arthritis in other joints, such as your hips and knees, than anyone else. back to top What will happen - will I be crippled by this condition? Research shows that although the joint remains arthritic and stiff, it tends not to get much worse in the majority of people. Even after 20 years the joint was much the same as it had been when the people who were studied first went to the doctor. However, in about 20-25% the joint becomes progressively more stiff or painful and treatment may be required. back to top Is there anything I can do to stop it getting worse? Keep yourself generally fit and activeWear shoes that comfortably fit your feet.Don't get overweight. - all the usual advice for good health in fact! There is nothing else that reliably helps. Many people find some particular activity, exercise or other treatment that is useful for them. back to top What can be done about hallux rigidus? You can take simple pain killers for the pain if it bad and interfering with your life. Try paracetamol first as side-effects are rare if you stick to the correct dosage. If this does not work your doctor may prescribe stronger pain killers or anti-inflammatory medicines if these are considered to be safe for you. Because the joint is usually most painful when the toe is bent upwards during walking, it sometimes helps to stiffen the sole of your shoe so that it does not bend while walking. If you do this, you may need a small "rocker bar" on the sole of your shoe so that you can rock over this while walking instead of bending your toe up. This can be done for you by an orthotist or chiropodist. One disadvantage of this treatment is that the stiff insole may push your osteophyte up against the shoe. If the toe remains very painful, it may be worth injecting some steroid mixed with local anaesthetic into the joint. This reduces the inflammation inside the joint. The injection can usually be given in the outpatient clinic, although sometimes you may have to come into hospital as a day patient. The toe may be painful for a few days after the injection and any improvement has usually occurred by a week. If your toe is improved by an injection the effect may last for a few days, weeks or months; occasionally the improvement seems to be permanent. back to top Can an operation help? If none of the above operations helps, an operation may be useful. You would need to discuss this with an orthopaedic foot and ankle surgeon by referral from your GP. There are five main operations for hallux rigidus:If only the upper part of the joint is involved, the upper part of the joint can be trimmed out and the joint washed out. This operation is called a cheilectomy. Most people who have a cheilectomy get less pain and a useful improvement. In about 75% this improvement is permanent. The others develop worsening of the arthritis over the following years and some will eventually need another operation. Either as a separate operation or at the same time as a cheilectomy, the bone in the base of your great toe (proximal phalanx) may be reshaped to make the most of the movement you have left. If the whole joint is involved, there are three main options, depending on the age and activity of the patient: In young fit people, especially those doing heavy jobs, a fusion of the joint would be recommended. This removes the painful joint and stiffens it completely. 95% of people will get rid of their pain. However, the toe is stiffer than before and the choice of shoes is more limited. A few people will go on to get arthritis of the small joint in the middle of the toe after a fusion, but this is not usually troublesome. In retired, active people, a plastic("silastic") replacement of the joint may be offered. This gets rid of the painful joint and, unlike a fusion, keeps some movement. This makes it easier to walk and to choose shoes (though high heels are still not advisable). However, the joint may wear out and if it does the toe may become very inflamed again. This can be difficult to treat and another operation may be needed. This is why replacement is only advised in people who are not very physically active. In an elderly person who walks very little, the simplest operation is simply to cut out the arthritic joint (Keller's procedure) and leave the toe a little floppy. This can be quite successful in people who walk very little. However, in the more active person the toe may become deformed and pain tends to develop in the ball of the foot because of the weak big toe. Could be?
    maggiemay 68 Replies
    • November 23, 2008
    • 11:33 PM
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  • quote your source..:cool:
    Monsterlove 2921 Replies
    • November 24, 2008
    • 07:12 AM
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  • Better than quoting 'your' arrogance - at least 'I'm' trying to help!
    maggiemay 68 Replies
    • November 24, 2008
    • 09:34 AM
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  • It's considered a copyright violation to quote work as your own when you have gotten it off of a web site. I always link to the source when I am finding information elsewhere. I don't think suggesting gout is too off-hand or "arrogant" since he has the symptoms of it. If you were taking a class in college, you'd get a "F" for not citing your source. Good thing it's not a college class, right...
    Monsterlove 2921 Replies
    • November 25, 2008
    • 06:11 AM
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  • I don't need you preaching to me about copy right - I'm a writer and any fool could see I was obviously not quoting the page as my own with all the different information on it, I was trying to be helpful and save time. I did not suggest 'gout' was arrogant? I don't know where you got that from? I suggested quite rightly having read many of 'your' blogs that you are - often quite arrogant and not at all sympathetic with the person you are responding too. A little christian charity would not come a miss when you are offering advice to those in need of a little compassion - check out the word in the dictionary. And I don't need to go to college thanks I've been to university and have 2 Bachelor of Arts degrees to prove it!:p
    maggiemay 68 Replies
    • November 25, 2008
    • 02:43 PM
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  • So, ETROK I don't know about all this other stuff that is being printed here, (it's way too technical for me), but I do know what the Sporta-Flx Organic Massage Gel has done for me. I know it sounds simple, but for me the simpler the better :)
    drumrunner 8 Replies
    • November 25, 2008
    • 03:12 PM
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