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What Causes Intermittent Sharp Pain In The Knuckles?

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Posted on Wed, 21 Mar 2018
Twitter Thu, 22 Mar 2018 Answered on
Twitter Tue, 18 Jul 2023 Last reviewed on
Question : Hi. I am a 42 year old caucasian male, weigh 160lbs., and am 6' 1" in height. I went to bed last night around 12:30am. I woke up 2-3 hours later. And as I was lying there trying to deduce what had awakened me, I began to experience a sharp, lancing pain in the large "knuckle" of the big toe on my right foot, which occurred approx. every 10-15 seconds and lasted indefinitely into the night. Not sure when it stopped: I simply woke up again around 6am and found it had ended. I had experienced similar discomfort several years ago, though to a much lesser degree, as well as an enlarging of the joint there. I never had it officially checked out, as I was also dealing with a more serious gastrointestinal issue at the time (issues are still ongoing, to a degree) and couldn't afford the time or payments for doctor visits for both. I have been suspecting rheumatoid arthritis as the culprit this whole time and have been adjusting my diet/alcohol intake accordingly. However, I did have two shots of a sipping liquer with a malty Guiness two hours before bed. Could this likely be the cause of the excruciating pain all night? Is there a more likely cause that I haven't considered? Thanks in advance for any help or advice you may provide.
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Answered by Dr. Suresh Heijebu (7 hours later)
Brief Answer:

Possible Gouty arthritis

Detailed Answer:

Hello,

As per your symptoms, the possibility of Rheumatoid arthritis is unlikely.

The worsening of symptoms with alcohol intake may point towards underlying Gouty arthritis.

Gouty arthritis episode is usually sudden in onset and associated with the involvement of big toe.

To confirm the diagnosis, it's advisable to consider the estimation of serum Uric acid levels and 24 Urinary Uric acid levels.

Further management if any is largely based on test results.

Meanwhile, pain-killers (eg. Acetaminophen/Tylenol) during the course of pain episodes will be very handy.

Please check with your physician if s/he shares my view and suggests these tests.

Hope I have answered your query.

Take care

Regards,
Dr Suresh Heijebu, General & Family Physician
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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What Causes Intermittent Sharp Pain In The Knuckles?

Brief Answer: Possible Gouty arthritis Detailed Answer: Hello, As per your symptoms, the possibility of Rheumatoid arthritis is unlikely. The worsening of symptoms with alcohol intake may point towards underlying Gouty arthritis. Gouty arthritis episode is usually sudden in onset and associated with the involvement of big toe. To confirm the diagnosis, it's advisable to consider the estimation of serum Uric acid levels and 24 Urinary Uric acid levels. Further management if any is largely based on test results. Meanwhile, pain-killers (eg. Acetaminophen/Tylenol) during the course of pain episodes will be very handy. Please check with your physician if s/he shares my view and suggests these tests. Hope I have answered your query. Take care Regards, Dr Suresh Heijebu, General & Family Physician