big toe pain

I don't know if this has been talked about, or, if anyone has experienced the same sensations. Anyways, my two big toes have been experiencing pain lately. Mostly the pain will occur after long stretches of climbing. It is localized at the joint. I was first told it might be arthritis (by a consultant), but curious if this is a problem others may have had, and treatments. I was told just to take some aspirin and it would be fine. There is no swelling, just pain. Any thoughts?

bigger shoes perhaps?

too much slab in too soft a shoe. time to switch over to the old-man edging shoes or else give up the low-angle routes for a while.

I've been dealing with big toe pain in both big toes for about 5 years now. It got bad enough in my right big toe that I had lost almost all range of motion in it and could not climb, run, or do anything putting extended pressure on my toe by the beginning of last summer. After getting bounced around between different PTs, MTs, and doctors, I finally ended seeing Dr. Clanton at the Steadman Clinic in Vail, CO. He confirmed a diagnosis of Hallux Rigidus, or degenerative arthritis, in both big toes.

Dr. Clanton performed a cheilectomy on my right big toe about 9 months ago. It has helped the pain significantly and returned range of motion, but introduced a different set of issues that I am back at the PT dealing with now. My left big toe continues to ache and hurt, but I still have full range of motion in it. Based on my experience with recovering to full activity from this surgery, I'd be very happy to never have my left big toe operated on.

I have returned to alpine climbing in boots and mild running, but am having a really hard time returning to rock climbing more a than few pitches in a row. This sucks and is counter to the reasons I had the surgery.

Feel free to PM for my experiences. There are a few things I could of done earlier on to help my toes and either avoided or pushed back the surgery. Not everyone is going to have the specific problem that I had, but I've learned a ton about big toe pain and home treatment options throughout this whole process.

I had some pain like that and I ended up going to a local chiropractor who pulled the joint back into line. It was literally like someone switched off my pain. It was stiff for months afterwards though...

I periodically get pain in either big toe on the top of the toe over the joint. I can usually clear it it in a day. I take a lacrosse ball and roll out my arch, there's usually some tender dime sized point (trigger point) that I hang out on and that does the trick. Check out trigger points.

I am dealing with this right now as well.It started last fall as a bit of pain on the bottom and side(think bunion)of the big toe and got worse come ice season from boots that were a little to snug for me.I missed six weeks of the ice season and had to buy new boots.

Like Doug,I went to two different doctors before finally seeing a specialist about a month ago and got a diagnosis of Hallux Limitis which is the stage before Hallux Rigitis(stiff big toe)a form of arthritis.
I had to buy all new shoes.It occurred to me that I was wearing all my shoes too tight and also have a longer than normal first metatarsal bone in my left foot that has been getting jammed for years and now the damage is done.I may get some custom orthotics for everyday use as that seems to be my only option right now(outside of the cortisone shot he gave me for the swelling).
As for climbing,I am still trying to figure that out.Trying different shoes(bigger,stiffer,ect).Still hurts to climb on it.
I wish I could just get a new foot!
Good luck

Any history of gout in your family? Pain in the big toe can be a sign of the onset of a gout attack, which is a buildup of uric acid crystals in the joints. It can be controlled pretty easily with diet and certain medications, if so.

My initial searches of "toe pain" state gout as a possible cause, but I don't seem to have any other symptoms besides pain. There is no swelling or redness and they appear to be, visibly, no different than any other toe on my feet.

I got the run around that I might have gout as well, because of a family history. I never had any redness or warmth in my toes, just pain and limited motion. They did a lot of blood tests and messed with my diet, all of which told us it wasn't gout.

I was finally diagnosed when the bone spurs forming at both my big toe joints were big enough to feel through the skin. This is a late stage symptom, but a good foot doctor should be able to take an x-ray and at least point you on the right path.

Also, I think there's two basic ways to go on this. One is MD's, orthotics, surgery, etc. The other is the barefoot philosophy (which for some reason really pisses some people off). Check out some of Egoscue's thoughts on feet as well, which are in line with barefoot. If you go barefoot, go slow, not all at once.

David Carrera wrote:Also, I think there's two basic ways to go on this. One is MD's, orthotics, surgery, etc. The other is the barefoot philosophy (which for some reason really pisses some people off). Check out some of Egoscue's thoughts on feet as well, which are in line with barefoot. If you go barefoot, go slow, not all at once.

It's a not a black or white situation. I am a fairly minimalist runner in terms of shoes, etc... and I definitely pursued all non-surgical options before finally realizing that I was only making things worse once I could not physically flex my right big toe any longer. I actually continue to work (and prefer to work) on my posture, running gait, etc... with physical therapists and things like the Egoscue program. I really don't think it's in your best interest to lump things into "two basic ways". I would pursue all options and figure out what combination is going to best enable both pain relief and a sustained athletic life.

If you do have structural damage and arthritis (which you may or may not), then causing the joint to undergo more flexion and stress is only going to make things worse. This is what I did and I definitely regret it. Now I'm dealing with the after-effects of that even after having the surgery.

If it is a soft tissue or other issue (such as gout) then increasing the flexion/stress will not be a bad thing once you solve the issue causing you toe pain.

Again, I really encourage you to pursue all options and see what makes sense to you. Your goal shouldn't just be pain relief but a plan to keep your toes healthy and have a long athletic life.

Doug Shepherd wrote:....Based on my experience with recovering to full activity from this surgery, I'd be very happy to never have my left big toe operated on. I have returned to alpine climbing in boots and mild running, but am having a really hard time returning to rock climbing more a than few pitches in a row. This sucks and is counter to the reasons I had the surgery. Feel free to PM for my experiences. There are a few things I could of done earlier on to help my toes and either avoided or pushed back the surgery. Not everyone is going to have the specific problem that I had, but I've learned a ton about big toe pain and home treatment options throughout this whole process.

Hi Doug, I have been diagnosed with hallux rigidus in both big toes too. I would love to know what the home treatments are that you have and what complications did you have from the surgery. Was your surgery orthoscopic? Please inform me as I would like to delay surgery as long as possible and inform myself about the complications of surgery.

My history of HR is that I have had pain on and off for the last five years. In 2008, I saw a podiatrist in Fort Collins, Dr Anderson, who told me nothing could be done to help my condition except orthotics. So, I bought the half-sole carbon orthotics that don’t seem to help at all. My mom and brother have the HR too, so I figure there might be a genetic component in the way that I am built. My brother who is a grappler has it really bad. He was told by his doctor that his joints are worn from bending and pushing hard on the mats. The pain in my 1st MTP joints have become unbearable for the last 5 to 6 months, so I inquired around to find the best podiatrist in Boulder, CO. I was referred to Dr. Shonka, who works on a lot of runners in boulder. He told me that the condition was caused by my first metatarsal being elongated and elevated. He recommended that he do an osteotomy to reduce and lower the first MT and do a cheilectomy of both my right and left fist MTP joints. I watched a couple of videos on foot surgery and osteotomies, saw how serious it was, and then sought out a second/ third opinion. I turned to the Steadman clinic and saw Dr. Clanton. He told me that a lot of people have elongated and elevated first metatarsals, but they don’t have joint issues. He doesn’t recommend an osteotomy. He said that I had a lot of water being retained in the bones surrounding the joints, but the joints themselves were not quite yet bad enough for surgery (unless the pain was on bearable). He recommended that I get bigger climbing shoes and postpone surgery as much as possible. He gave me cortisone shots in each toe and put me on mobic, an anti-inflammatory. He told me that my next option, if my condition does not improve, was to have orthoscopic surgery where he would conduct microporation of the first MTP joints and inject stem cells from the bone marrow in my hip. He said that I need to get the swelling down before it causes more damage. He did not give me any home remedies. I immediately got bigger climbing shoes (scarpa boostics), but feel like I cannot blame my condition on my old la sportive testarossas because I climbed in them for years without them hurting my big toe joint. For now, I will stick to the boostics. The toe box in the boostics is bigger and keeps my big toes straighter than the testarossas. However, heal is practically empty and I feel like I’m climbing in clown shoes. My toes don’t hurt unless I’m smearing, so I try to pick climbs that do not require too much friction climbing. I am ten days past the cortisone shots, and I feel much better but am not pain free yet. A PT friend of mine gave me some toe splints that pull my big toe away from my little toes when I sleep. This seems to help but my improvement might be the cortisone and the anti-inflammatories. Icing seems to aggravate the joint pain. I am trying hot Epson salt baths and elevating my feet afterwards.

MP user 'slim' recommended Dr. Weber, a podiatrist in Boulder familiar with climbers.

Here's some discussions about pain and treatments associated with arthritis mountainproject.com/v/osteo…

I personally cannot say enough about this product; australiandream.com/
From their website:
"The active ingredient in Australian Dream® is histamine dihydrochloride. This is a vasodilator, which causes the size of the blood vessels to increase, allowing for greater blood flow to the painful area. Pain relief through increased circulation is actually the body's natural response to pain and injury."

I used it 3x daily as instructed with the first small jar and had great results after a couple of weeks use.

I purchased the larger size jar the 2nd go around and only needed to apply the cream once a day.
I am now on my 3rd jar and and use it so infrequently that it should last quite a while. I have very little arthritis pain in my knuckle at all.

If you try this product, please let me know if it helps, or if you think it's total bullsh@t. YMMV
Regards,
Tom-o

Sharon Talley wrote: Hi Doug, I have been diagnosed with hallux rigidus in both big toes too. I would love to know what the home treatments are that you have and what complications did you have from the surgery. Was your surgery orthoscopic?

Hi Sharon,

The home treatments I used are pretty much what you have done. And none of them worked for me. The PT exercises I have after surgery are helping me maintain the strength and some flexibility in my left big toe (the non-surgery toe), but it is still degenerating.

The only doctor I saw who seemed to have a good idea of what to do was Clanton. So I'd keeping working with him. However, my surgery was not orthoscopic. It was supposed to be, but they decided they needed to get into the joint capsule and cut my toe open to do this. I have a couple inch scar on top of my toe and I think this is part of the reason it took so long to heal.

Because my left big toe continues to degenerate, I'm sure I'm eventually heading towards the surgery with that one as well. I will say that the joint in my right big toe no longer hurts and I've regained almost all my joint flexibility, but I developed sesamoiditis in the process of coming back to fast and am now on a complete break from climbing to deal with that. The trials continue....

One thing I will say is that a stiffer and larger climbing shoe is KEY. So something more like a TC Pro or Astroman or Ace will help your foot more than just using a bigger shoe. I've even gone so far as to put custom insoles in my climbing shoes to keep them stiffer so that I don't bend my toes as much.

PM me if you'd like to chat more about this my experience with Clanton as a surgeon.

Cheers,
Doug

HI Doug, Thank you for replying and sharing your information. I really appreciate your helpful advise. I hope that your toes get better.

Sincerely,Sharon

Me too. Pain across the top of the big toes, first one foot then the other about a year later. The pain intensifies at any time.

Bigger shoes have been the fix but it's taken some years to improve. Now I'm back to shoes that are comfortably tight with the big toes just touching the end of the shoes.

Which joint are you folks talking about? The middle of the big toe, or where it joins the metatarsal?

If doing a lot of climbing mileage in tight shoes where the big toe is slightly bent and the shoes stay on all day, I can get gnarly inflammation in the joint at the metatarsal. Typically occurs in one more than the other. Looser, stiffer shoes and generally less activity have solved my problem before it got out of hand. Velcros for the gym, and taking them off (or popping the heels out at least) when resting between problems/routes helps. Even at the worst, I've never had issue with the other, distal joint in the middle of the toe.

I also don't run, period (slight lumbar scoliosis means that running = lower back and hip problems for me), and tend to wear a different pair of shoes daily to work (rotate between 4-5 pair) to spread the stresses around. But that's easy when you're in an office, not so easy when you're on a job site.

Surgery seems pretty drastic unless you have serious anatomical anomalies. And yes, gout does tend to manifest in the big toe first for many people. Good luck to you.

Will,
The large joint where the big toe meets the foot not the knuckle.
It is the same joint where people also get bunions and yes,gout.

Hi All,

I know this is an old thread, but hoping some people here still have some insight on the matter. My Dr. diagnosed me Hallux Rigidus after x-rays and what not and seemed to think it's a pretty straightforward case of it.  I've done the cortisone and that helped immensely for like 6-7 weeks, but the pain is coming back.  She thinks I'd be a very good candidate for a cheilectomy on the toe.  My questions are basically related to getting back to climbing at your limit.  How long it took, if ever, power loss in the big toe, etc?  Also, what specific complications you ran into with the surgery/recovery, ways to avoid the issues described etc.  Thanks in advance!

Alex

Uhh, welcome to rock climbing...Considering what we ask our toes and joints to do, I'm shocked whenever someone tells me they're not in pain somewhere.

I've dealt with toe pain by taking 15 minutes every night to stretch them forward and backward.  That's helped a ton.