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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 6006
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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I have two very painful big toes, Quite a time the pain is

Customer Question

I have two very painful big toes
JA: How long have you had the pain? What seems to make the pain better or worse?
Customer: Quite a long time the pain is only better when i am off my feet
JA: Anything else in your medical history you think the doctor should know?
Customer: I am 78 and suffer with Arthritous in my ankles, the main pain is in my right toe
Submitted: 5 months ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 5 months ago.

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. Can i ask do you have any swelling, redness or tenderness in the toes? Any color changes at all? Apart from arthritis do you have any other medical conditions like diabetes?

Expert:  Dr. Muneeb Ali replied 5 months ago.

Since you seem to be offline, ill leave a response here which we can discuss later on

Well this can be due to a number of conditions, the first one which comes to mind is that you could have gout which is a condition in which you can have uric acid deposited into the joints of the big toe. This would be diagnosed on a clinical examination along with a uric acid level. The treatment would be based around NSAIDs or even uric acid lowering drugs.

Another cause of this could be due to peripheral arterial disease which is a condition in which there is narrowing of the arteries of the lower limbs., This can lead to pain, swelling, color changes in the feet,numbness etc. The diagnosis is made with the help of a simple doppler ultrasound and then treated with medications like plavix or cilastozol. In severe cases stents may be used.

Another cause of this could be a condition in which there is damage to the nerves themselves such as peripheral neuropathy. In the early stages of neuropathy only a few toes would be involved. This would need a EMG/NCS to be done and then treated with specialized medications like lyrica or neurontin.

Lastly this could also be arthritis which could be one of the causes here and a xray of the feet would be required to diagnose the condition. I would suggest that you talk to your doctor regarding these possibilities and at the same time start using OTC motrin or aleve

Do you have any more questions?

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Customer: replied 5 months ago.
I know that i do not have gout
under each big toe there is a redness which gives pain when walking.
My right ankle is slightly swollen at the joint.
I have had the Doppler test and all was well.
Also 4 years ago i had two operations on my back, i now have 12 nuts and bolts, the bottom of the back can become painful during the day which i believe may be due to some of the pain.
What are your thoughts.
John
Expert:  Dr. Muneeb Ali replied 5 months ago.

Have you had any xrays of the foot done as of yet? What about a NCS?

Customer: replied 5 months ago.
1 cannot afford to pay that much as i have a wife in aged care and need all my money for her she has Altzhiemers and it is a very expensive to cope with.
I also thought that a $5 was asked for and not $48.
John
Expert:  Dr. Muneeb Ali replied 5 months ago.

We the doctors just work for the site and DONT control the payments AT ALL, you can contact customer services for payment issues and they will be willing to give you a refund if you want.