Big toe joint

Hi,

I've had tenderness under my big toe joint now for over 3 months after tripping up and landing hard on my right foot - i stopped running for 2 months and just swam and cycled - but I still get the tenderness when bearing weight. It eases off after a few days but i'm always conscious that it's there...(tenderness). I ran the other day and the next day it was more tender. I went for an xray 3 weeks after the initial incident and it came back clear and was told it was a bone bruise. Do you think this is likely or something else? I've been to physio and docs - not helped and just keep mentioning that it could be metarsalagia and i'm being referred to another physio in a few weeks time...i've just got this feeling that it's more than metarsalagia and that it's sesamoiditis instead....why hasn't anybody even mentioned this to me yet?

Hope somebody can give some advice. I've read on the web that you can get jshaped cushion pads - what are these and how do you place these under the toe joint?

Thank you

There's several things it could be:

~ Gout - though this might have shown on an xray but you'd need a blood test to confirm. Gout is generally treated with things like allopurinol.
~ arthritis - again, xray would have shown but early stages might be missed. Depends who ordered and read them. Treatment can include surgery to fuse the joint or even an artificial, silicone joint
~ soft tissue inflammation - from the fat pad down to where the tendon inserts into the bone. Very common, actually. They are generally self-limiting, meaning they will settle over time but it persistent an injection of cortisone can hurry the healing on
~ some trauma - what your chap described as a 'bone bruise'! Again will settle in time but an injection can help hurry it along.
~ callosities or corn which can easily be dealt with by a chiropodist.

Metatarsalgia does not manifest in the great toe, more usually on the metatarsal heads of the smaller toes. It is caused by poor or extreme weight bearing on those m/t heads, often from over-use of high heels or too much walking or the presence of callouses.