Ask the Doctors: Indications and Treatment of Big Toe Pain


Two men wearing white lab coats in an office setting.Michael Kelly, DPM, D. ABFAS, FACFAS, and Beau Vesely, DPM, FACFAS, are podiatrists certified by the American Board of Foot and Ankle Surgery and together lead St. Joseph’s Hospital’s foot and ankle podiatry practice.

Why did you choose to be a podiatrist?

Dr. Kelly: I was born with flat feet and had significant pain in my feet as a child. In eighth grade, I had operations on both feet with great success. That experience led me to decide to become a podiatrist so I could help others who were suffering from painful deformities.

Dr. Vesely: I chose podiatry after shadowing many different specialties. I immediately noted how important feet are for our overall health. Foot problems can be the first sign of serious systemic disease. I also thought podiatry was unique in that patients often walked out of the office with immediate pain relief.

What are the most common causes of big toe pain?

Dr. Kelly: Pain in the big toe, or the first metatarsophalangeal joint, can be caused by a number of factors, including bunions, arthritis, ingrown toenails, diabetes, gout or sesamoiditis, which affects the two tiny bones located under the big toe that are part of the big toe joint. To treat these sources of big toe pain, we have to diagnose the exact cause and prescribe treatment plans accordingly, sometimes with medications and in many cases with surgery.

Dr. Vesely: Sometimes big toe pain is caused by ill-fitting shoes, too tight or too loose, affecting the big toe area or not having the proper arch support in footwear. This goes for everyday shoes and athletic footwear alike. At St. Joseph’s we treat a wide variety of patients, including children, who often suffer injuries from sports and recreational activities, or even congenital birth deformities that may require reconstruction of the foot or ankle.

How do you diagnose the cause of a patient’s big toe pain?

Dr. Kelly: Our first or subsequent consultation(s) with a patient is very important to help determine the cause of pain. Often times we ask patients to have an X-ray of their foot before their appointment, so we can review it and discuss our findings and recommendations. A medical history, physical examination and imaging studies all help contribute to a proper diagnosis.

Dr. Vesely: We also look closely at the patient’s medical history. Did they have an injury or experience trauma of the area? How long they have been in pain? Was it gradual or sudden? Big toe pain can be very debilitating, and we want to get to the root of the problem as quickly as possible and prescribe a solution that will get them back on their feet!

Why would a patient choose St. Joseph’s Hospital to treat their podiatry needs?

Dr. Kelly: We offer a comprehensive range of treatment solutions and specialize in both conservative and surgical options. There is no “one size fits all” approach; each patient is evaluated and treated for their specific needs and personal lifestyle.

Dr. Vesely: We specialize in foot and ankle care for all ages. Each patient we treat can be assured of a very personalized approach to their podiatry needs, knowing that we will be them every step of the way.

Click here to learn more about Dr. Kelly and here to learn more about Dr. Vesely. To find out more about St. Joseph Podiatry, please click here.

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