Why does my toe keep swelling up?

July 10, 2021 7:34 AM

A few weeks ago, my toe suddenly swelled up for no reason that I can discern. A day or so later, the swelling was gone, but the whole thing was purple. It got better. Now it’s swollen again. Why? More riveting details inside.

A few weeks ago, the bottom of my big toe swelled up. I don’t recall anything that might have injured it. When I was barefoot, it felt like I was walking on a bubble, but I didn’t notice any discomfort when I had shoes on. The next day, the swollen bottom of the toe was looking a bit like a bruise. After a bike ride, I took my shoes off to find that my toe was no longer swollen or uncomfortable, but most of the toe (not just the bottom) was covered in deep purple discoloration. I had a physical scheduled already, so I mentioned it to my doctor during the appointment. She looked at the discoloration and didn’t have any concerns. The discoloration faded over the next few days.

I had chalked this up to a one-time problem, and I guessed it was caused by poor support in worn-out sneakers. I haven’t worn the sneakers since, but my toe started swelling again last night. Again, I don’t recall injuring it. Just like last time, it’s starting to look bruised now.

What might this be, and why might it keep happening?

posted by TEA to Health & Fitness (12 answers total)

Could be gout? My spouse had it for years with doctors failing to diagnose it, and it was awful. There are tests on uric acid levels that could confirm it.

To be fair, I don't think he's ever had discoloration, only swelling, so I don't know if that's a symptom.
posted by redlines at 8:16 AM on July 10, 2021 [8 favorites]

Nthing what redlines said; my hubby had horrible painful swelling in various toe joints and also had the purple discoloration. Covid toe was discounted; he had not had Covid and now we are fully vaccinated. Tests for gout kept giving mixed results but he finally received meds for gout and has not had another incident. Blessed relief!
posted by serendipityrules at 8:22 AM on July 10, 2021

Is it painful?
posted by ocherdraco at 8:50 AM on July 10, 2021

Is cold damage a possibility?
posted by momus_window at 9:52 AM on July 10, 2021

Response by poster: Thanks, everyone, for your help.

To answer the questions above:

ocherdraco, it only hurts when (1) it’s swollen and (2) I’m standing or walking when barefoot. When I put shoes on, it doesn’t bother me. Once the swelling goes down and the discoloration spreads, the pressure is relieved, and it doesn’t hurt.

momus_window, I haven’t had any exposure to cold.
posted by TEA at 10:58 AM on July 10, 2021

I've had toe gout flares in the past and most of them feel better when I wear shoes. They generally last longer than one day, though when I first started getting gout, some would be that short. I'd keep notes on how often and how long this happens and the next time you're getting a blood draw or seeing the doctor, ask to have your uric acid tested. For me, warm water soaks help but ice doesn't do much long term.
posted by soelo at 2:39 PM on July 10, 2021

Go see a podiatrist ASAP. Not emergency room or urgent care ASAP, more like "next week with PCP" ASAP.

Gout is a possibility, but usually those pain are so sharp and on the joint, rather than the toe itself. Drink a lot of water and take a lot of naproxen would help (I'd go double or triple the normal dose, just for a few days), or your doctor can prescribe something stronger like indomethacin. I would not self-diagnose ahead of time. Just have your PCP look at it.
posted by kschang at 3:47 PM on July 10, 2021

Did you have covid (even asymptomatic)?This sounds a lot like a common post-covid thing creatively named 'covid toes'.
posted by ananci at 5:31 PM on July 10, 2021 [1 favorite]

Also could be cellulitis - having experienced it twice on my feet - that is what happened - swelling and discolouration.
posted by Barbara Spitzer at 12:43 AM on July 12, 2021

I had that happen for the first time in graduate school and went in to the school's clinic about it, where I got patronized by a doctor who clearly thought I was making a big deal over nothing (the day previous the swelling had been huge! it had deflated by the appointment) explained it was merely a blood vessel breaking and "these things happen all the time" and offered me exactly zero help other than that. I discovered on my own, after it happened a few more time, that it was associated with a specific pair of shoes I owned, which didn't hurt at all, and when I quit wearing them, it quit happening.

I should note that this also occasionally happens in my fingers: a joint has a short, sharp pain and then I get a bruise and mild swelling at the spot. My current doctor isn't too worried. I have also had it happen twice in the past year that I got a short, sharp pain on the sole of my foot and a small swelling (skin too thick to see if it's a bruised or not) for a few days. I emailed my current doc, who isn't especially concerned but has requested I take photos of the swellings and send them on to her if it happens again.
posted by telophase at 8:52 AM on July 12, 2021

This happens to me more often (but still rarely) on my fingers, but it has definitely happened on my toes too. It's like a burning, itchy pain (not pain like an infection, more like a bad insect sting), then the swelling, then the creepy blue discoloration. I've always ignored it because it resolves in a few days (or occasionally reoccurs, but never for long enough for me to bother with the doctor). On further Google I came up with Achenbach's syndrome, which describes my problem pretty much exactly.
posted by zibra at 9:37 AM on July 12, 2021

Throwing in another possibility: people who are diabetic or pre-diabetic can also have issues with sores/swelling/pain in fingers and toes.
posted by Lafe at 1:17 PM on July 12, 2021