Suggest Treatment For Severe Pain In Big Toe

Posted on Tue, 17 Mar 2015

Question: Hi, my husband has severe pain in his big toe (Rt) The pain was brought on suddenly , no injury, he has been sitting quite a bit . He has not consumed any alcohol. He has, tho, been drinking a smoothie every morning made with 2 oranges, 1 grapefruit, 2 celery stalks,2 carrot stalks and a bit of ginseng root. He has been drinking this for about a week and a half now. He is overweight. He has for the past two weeks been watching his diet carefully and has cut back on burritos and burgers quite a bit. He is in severe pain, it is a throbbing pain, no swelling that I would notice. I forgot to mention that he does have stairs to his office and we have a two story home.

Answered by Dr. T Chandrakant (24 minutes later)

Brief Answer:
May be Paronychia.

Detailed Answer:
Hi.
Thanks for your query for your husband.
Read the history and understood the problems.

The classical history of ''throbbing pain'' and stairs in house and office is more suggestive of an infection under the nails most probably or a start of Paronychia as we say in medical terminology. It takes a few days sometimes for the infection to be evident on examination.

You may just check if the pain increases on slight pressure on the nail-body and nail- tip.
Please also see if the elevation of the leg above the heart level in laying down position helps to relieve the pain within 10 to 30 minutes. (The elevated leg is rested on pillows or so, the heel has to be above the heart level in laying down position and is a part of the treatment)
If the pain is increases on pressure and relieves with elevation this goes in favor of infection.
The pain of neuropathy is burning.
The present pain may not be associated with changed diets.

I would advise in such a situation the following:
-Elevation of the leg as advised.
-A course of an antibiotic, anti-inflammatory with painkiller property like Ibuprofen in adequate dosage as per the weight three times a day after food preferably and with PPI like Pantoprazole or Omeprazole if you have.
-Apply liquid Povidone Iodine if you have at home to keep the area sterile. or you can simply apply spirit.
-Take rest.
-Watch for the symptoms and signs tomorrow and follow-up, Consult a Doctor if need be like if there is some other situation or need actual inspection and examination.

I hope this answer helps your husband and you.
Please feel free to ask further relevant questions if need be or if you feel there is a gap-of-communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (16 minutes later)

Hi, thank you for answering so quickly. I did apply pressure to his toe and toenail and there was not an increase in pain. Upon further questioning I determined that the pain is located more at that bone on the side, where you can get corns or bunions.
I have elevated his foot, and have given him some Aleve to see if that will help him. Is there anything else we can do?

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
Continue treatment as outlined.

Detailed Answer:
Thanks for your feedback.
Read and understood it.
It is good that you have given him Aleve (Naproxen). Please continue giving at 12 hourly interval.
Rest of the treatment as detailed in the first answer.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar