Running With Laces Tied Funny Pain in Toe and Behind Knees
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Second toe pain: possible causes and how to care for
Pain in the second toe is a common complaint in runners and active sportspeople. There are many possible causes of 2d toe hurting with different treatment options. So, it is important to get an early on diagnosis of second toe pain.
Anatomy of the second toe
The 2nd toe consists of basic and joints. The second metatarsal bone links your ankle with your 2nd toe. The toe consists of three bones called the proximal middle and distal phalanx. Between the metatarsal bone and the proximal phalanx is the metatarsophalangeal (MTP) articulation. These joints have a thin joint sheathing reinforced below by the plantar plate.
Causes of 2nd toe hurting
There are many causes of 2nd toe pain. Some of these conditions include:
Second toe arthritis
Both osteoarthritis and rheumatoid arthritis tin affect the second toe MTP joint. Generally, the base of the toe is painful and swollen especially when walking and running. Persistent inflammation of the second toe tin lead to a hammertoe deformity – which is a malalignment of the MTP joint causing the toe to take on a claw-like appearance.
In general, handling consists of the correct footwear, orthotics, and an injection.
Plantar plate injury causing second toe pain
The plantar plate is a thickening of the capsule under the MTP joint. Generally, information technology helps to back up the joint. Injuries to the plantar plate are more common in the second toe every bit this toe is longer than the other toes. Usually, pain presents at the top or lesser of the toe and is worse with walking, running, and sport.
When examining someone with a plantar plate injury, there is pain with pushing the toe into flexion and extension. Also, moving the toe upwards and downward shows greater move than normal.
Generally, both ultrasound or MRI tin detect a tear of the plantar plate.
Nigh cases can exist treated without surgery consisting of taping, orthotics, and a stiff-soled shoe. Generally, nosotros don't allow barefoot walking for at to the lowest degree 6 weeks. Taping should be inverse every two-3 days.
Freiberg's affliction: an uncommon cause of second toe pain
This is a rare status affecting the head of the metatarsal bone. While more than common in teenage girls, Freiberg'south disease tin likewise occur in adults.
Generally, we think the claret menstruum in the metatarsal head is disrupted. However, we don't exactly know why: trauma, excessive sport, or wearing high heels could exist factors.
Initially, the terminate of the metatarsal bone becomes painful and swollen. Then, the os begins to break downwards collapsing into small pieces. Finally, the caput of the os becomes flattened leading to arthritis. Importantly, detecting this status early is the key to preventing os collapse.
Frequently, imaging such as X-ray or MRI can diagnose the condition. Overall, handling consists of rest from impact activity such as running and orthotics to reduce the load on the second toe and spread forces to the other toes. As the os heals, you can slowly resume bear on activity.
2nd toe stress fracture
Similar to Frieberg's affliction, a stress fracture leads to bone fatigue, swelling, and breakdown. However, the site of the stress fracture is normally in the shaft rather than the head.
Generally, symptoms consist of gradually worsening pain with impact activeness. There may be swelling in the bone.
Overall, MRI is the investigation of pick. X-ray or ultrasound may also find stress fracture changes although they may miss some cases.
Treatment consists of rest from running in a walking boot followed by a graded return to running slowly over a few months. However, for stress fractures college up in the foot (near the mid-human foot), recovery tin take much longer.
Morton's neuroma
Morton's neuroma is a thickening of a nervus in the front end of the foot between the toes (interdigital nerve).
By and large, symptoms of Morton's neuroma include shooting or burning pain at the base of operations of the foot. Pian usually spreads to the two toes (so the second nerve spreads to the second and third toes). Besides, numbness or pins and needles may occur. Usually, symptoms are worse with walking, running, or wearing tight-fitting shoes.
Diagnosis is based on the clinical findings in addition to imaging showing thickening of the nerve between the two toes. By and large, ultrasound or MRI are used to confirm nerve thickening and to dominion out other causes such every bit articulation arthritis or plantar plate injury.
Overall, treatment consists of wearing shoes that have a broader forefoot to give your foot room to motion. Shoe inserts may also help distribute weight away from the Morton's neuroma. In some cases, a cortisone injection into a Morton's neuroma tin aid. Finally, surgical removal may exist needed.
Sausage toe or Dactylitis
Sausage toe refers to gross swelling of the toe making the toe look similar a sausage. Information technology is common in up to 50% of cases of psoriatic arthritis. Often, it is the kickoff sign of illness earlier other symptoms occur.
Symptoms of sausage toe include swelling, inflammation, redness, and pain. Often, symptoms can be present for many months.
If y'all accept a sausage toe, then we recommend blood tests and ultrasound or MRI to confirm the diagnosis and rule out other causes. Other causes of a swollen toe include gout, infection, and sarcoidosis.
More on injections for 2d toe hurting
Generally, cortisone injections are only used for certain atmospheric condition after failed uncomplicated treatment. These conditions include second toe arthritis and Morton's neuroma.
Overall, you should be aware of the potential benefits and side effects of a cortisone injection. Besides, injecting nether ultrasound improves accurateness and effectiveness and reduces chances of damage to other structures.
Ordinarily asked questions about second toe pain:
Exercise neuromas go abroad on their own?
Mostly no. However, some cases tin can go ameliorate with simple treatments such as a change in footwear and orthotics. So, a neuroma doesn't necessarily demand to be injected or removed for the pain to settle.
Why are my toes separating?
Sometimes, the ligaments connecting the side of the second toe (likewise called the collateral ligament) tear. This forces the toe to move to the other side increasing the distance betwixt the toes. Often, a tear of the collateral ligaments is associated with a plantar plate tear.
Tin I get gout in my second toe?
Yes. Although gout is more common in the big toe, yous can also suffer gout in other parts of the human foot. Usually, gout attacks tend to come on of a sudden with acute pain, swelling, and redness of the toe. Early treatment with anti-inflammatory medications is the key.
What is sausage toe?
Sausage toe refers to gross swelling of the second toe so that the toe looks like a sausage. Oft, information technology is a sign of inflammatory arthritis such every bit psoriatic arthritis.
Final word from Sportdoctorlondon about second toe pain
Given the many causes of 2d toe pain, it is important to run across a doctor with expertise in diagnosing and so the correct treatment can be started immediately. Also, if you lot are thinking well-nigh an injection, you should come across a medical doctor who has expertise in injecting under ultrasound.
Related conditions:
- Morton's neuroma
- Big toe arthritis
Dr. Masci is a specialist sport doctor in London.
He specialises in muscle, tendon and joint injuries.
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Source: https://sportdoctorlondon.com/second-toe-pain/
How long does information technology have to recover from friebergs disease? When can I become dorsum to sport?
How-do-you-do Charlie, Thank you for your question. It can take o=months to recover from Freiberg'due south affliction. The key is to pick it upwards early on. The earlier the diagnosis, the less time yous need to residue. You lot can go back to sport in one case hurting and swelling settle and you are able to tolerate a progressive walking and running program.
The index toe of my right foot is swelled up,is possible that I'm injured in my tendon?
Hi Chris, if you're toe became swollen for no reason then the possibilities include MTP joint arthritis or a condition called dactylitis. Dactylitis – which is swelling of the tendons of the toe- could have an underlying reason such as inflammatory arthritis.
Lorenzo
I have had pain in my pes for several weeks. Not sure what I did , but at that place was some puffiness and bruising on top of the human foot . The pain is in my second toe but too runs upwards the height of the foot to about half way up toward the talocrural joint.. it worsens with increased walking to the point where I'chiliad limping. If I push the toe downwards , the toe hurts , especially in the joint at the base of operations of the toe.
Is it likely to be a fracture or merely tendinitis ?
Hello Caroline, If you've increased your activeness, walking, or running, then it could exist a stress fracture. I'd see a doctor.
Right under my second toe if i squeeze it information technology hurts sometimes when i walk it hurts i deceit seem to effigy out whats wrong with information technology. It doesn't hurt all the fourth dimension which is weird.
How did you get to treat yours please
I have quite a bit of hurting in 2d toe , pain when touched – and if I put weight straight on information technology – merely non if flexed or extended. Any ideas?
hi Sue, it could still exist the joint of the 2nd toe – as outlined in the blog. Either degeneration or a plantar plate injury.
Lorenzo
I have a spot on my second toe that is directly under toenail and is very difficult. Virtually like another smash growing. It'south been there for several months and hurts every fourth dimension I barely bump information technology. What tin it possibly be ?
Information technology might exist a callous that has grown secondary to friction. i'd meet a doc about any spot that doesn't settle within a few weeks. LM
every few weeks i'd say i go a small swelling , with no/small amount of redness on my 2d toe on my correct foot i'yard not besides sure what it could be information technology simply hurts when putting shoes on walking for long times and if i press on it when i leave it it feels similar it burning ( similar when yous put anti-septic cream on a bite) information technology could be the shoes i clothing routinely as i didn't get it over the suspension when i didn't wear these shoes just i recollect it'southward very unlikely every bit information technology has merely started to get an result recently.
I stubbed the tip of my 2d toe so hard the nail split and I continue to have a dark purple bruise. It is very painful still, even though the injury was two weeks ago. How long will this take to heal?
Howdy, It should settle in the side by side few weeks. If not, then yous should run across a doctor. Lorenzo
The top joint in my second necktie just started hurting the other nighttime and had progressively gotten worse especially when I walk the pain shoots up the peak of my pes making it painful to walk! What can I practice for the hurting before I get into the dr because that might take a month?
Howdy, my 2nd toe on my right foot and my tertiary toe on my left pes both are very painful, swollen, blood-red and common cold to the touch. Hurts when I walk what could this exist.
Howdy Lisa, it could be inflammation of the joints of the toes (MTP joints). You demand to see a doctor if it doesn't settle.
Lorenzo
The top articulation of my 2d toe of the correct human foot started hurting. It is only in one modest area on the side of the big toe. The pain appears in the morning when I wake upwardly and in virtually v minutes afterward I start walking goes away. Information technology came and went away every couple of days for the by 3 weeks simply this morning was actually intense and it took fifty minutes to get away. Information technology was a sharp pain like a piece of drinking glass was stuck there or like a newspaper cutting. The toe is non ruby and at that place is no swelling. The pain was not affected past local ibuprofen. What can it exist? Thanks for your help!
Howdy Alina,
You may have inflamed the last articulation of your 2d toe, also known as the DIP joint. If it's non red, then it's unlikely to be joint wwswelling. I suggest your doctor should see it if information technology doesn't become meliorate soon. Lorenzo
Hello Lorenzo, I came across this page while looking for info on Morton's Toe (as in Greek toe, rather than Morton's neuroma), and was surprised non to run across information technology mentioned. Perhaps yous might consider adding it in? The distinctive callous design includes a thick draconian under the head of the 2nd metatarsal. Thanks for writing the page, good reading.
cheers. Yes, I recollect I may. Lorenzo
I have pain under both second toe plantar MPT joint for a year. This started nearly v months after a surgeon unnecessary did a pernicious tenotomy on both 2d toes. I also have a crushed seisimoid on right pes . What would be the right type of orthotics to become equally I have not much success. The metatarsal padded 1 irritate human foot . The cut outs for 2nd toe put pressure on seisimoid. Should I triage ?? Thank yous
Hi Joanne, oh sounds complicated as offloading sesamoid will upset the second toe and vice versa. I'd suggest seeing an expert podiatrist with an interest in biomechanics and orthotics. Lorenzo
Hi, I take had half-dozen months of pain on the plantar surface, over the second MTP and proximal phalanx. Progressive Swelling of proximal phalanx. Getting progressively worse despite orthotics, nsaids, ice, steroid injection. I had an MRI today showing pulley system injury with detached flexor tendon and flexor tenosynovitis. Wondering what treatment options are available. The radiologist told me information technology's similar acute trigger finger of the second toe, and he has never seen this in a toe before.
hi Bradley, I wonder whether you have a condition called dactylitis. This is also called sausage toe. It is oftentimes the commencement sign of inflammatory arthritis such as psoriatic arthritis.
You should speak to your doctor about tests to rule out inflammatory arthritis.
Lorenzo
Hi Lorenzo,
My symptoms lucifer Bradley Kutha's question as i have had pain for final 4mnths left foot 2nd toe. X-ray ruled out fracture & now awaiting specialist appn. Pain at times radiates to knee & hip. It may be a form of arthritis just its constant.
My second toes ( right beside the big toe) on both feet are both very sore. It looks like I'one thousand going to lose the nail on both of them. With golf opening I accept been doing a lot of walking. Any ideas?
I'd see a podiatrist to review your footwear and consider padding/orthotics. Lorenzo
Howdy Lorenzo
I just had a cortisone injection 4 days ago in my correct foot (sort of neuroma) and I was wandering if I would be able to accept an oral handling with anti inflammatories to get rid of the inflammation for adept.
I deceit observe whatsoever infos nearly having had a cortisone injection and taking an anti inflammatory handling for few days.
would you know a bit more than on this Delight. Thanks for your answer
Hi Lorenzo,
I literally am struggling to walk as my feet seem to accept thickened up and frozen.
I'grand now hobbling! Both anxiety struggle to bend when I get up to walk.
The hurting is extreme throughout the front of my anxiety particularly and in my toes.
I accept bunions developed on both anxiety at present and bunionettes. My toes feel cleaved. And then hard to bend.
I effort to stretch them out autonomously from each other without touching my feet which is agonising simply I feel is the only thing I can exercise
to stretch and get some relief. I did go to a trained ppdiatrist a twelvemonth agone who gave me exercises only it is merely so much worse now.
My anxiety are at present much wider and admittedly kill me when I put my running shoes on in spite of
the laces existence loosened to the last mm in broad plumbing fixtures shoes.
I don't know what to exercise. I think I am developing some grade of arthritis.
My Mum died of osteoporosis in her threescore'due south and I am approaching that age, imminently.
I am very agile and used to walk, 5km a day. Now, I can't go exterior with the pain and discomfort.
Delight can you suggest handling or what to do next? I don't want to fuss.
Thanks then much
Hi, I sprained my talocrural joint a year agone and somehow it affected my index toe. My index toe is stiff. Whenever i tried to bend my alphabetize toe, my whole feet will be bloated. What's incorrect?
You may accept injured the joints of your 2nd toe – MTP or TMT joints. I'd speak to your doctor if it doesn't settle.
Hi. I had cheilectomy and Weil osteotomy washed in October and am still recovering. I originally got the procedure done due to feeling an excessive amount of pressure being put on my second mtp joint when standing. As of now I even so have that same feeling in my second articulation simply worsened now. And on pinnacle of that, the entire ball of my foot is at present inflamed to the betoken of my toes not laying apartment on the floor when I stand. I've had multiple injections and gone thru PT. Apart from doing daily stretches and icing I'm not certain what else I can do. The doctor tells me it'south not common to take and so much inflammation in the ball of my foot still at this betoken, but it could also be a mixture of internal scar tissue likewise. Any thoughts?