Toe and foot pain are no joke — they can be very uncomfortable and affect your everyday activities. Gout and turf toe are two conditions that can cause pain and swelling of your big toe and its joints, reducing mobility. Although some of the symptoms may initially show up in the same ways, the underlying causes and treatments are different.
Knowing more about these conditions can help you know the difference between them and lead you to get the best treatment for your pain.
Gout is a general term that describes many different conditions. These conditions are caused by a buildup of uric acid. If your body is not excreting the uric acid, urate crystals form in your body’s tissues, typically around joints. This buildup of crystals causes a type of painful arthritis.
Certain conditions like blood and metabolism disorders or dehydration can cause your body to make too much uric acid. Additionally, kidney or thyroid conditions can make it harder for your body to remove excess uric acid. If your diet is high in purines, the breakdown of these natural chemical components of DNA and RNA can cause a buildup of uric acid.
Gout can be caused by:
- uncontrolled diabetes
- high blood pressure
- use of diuretics
- lymphoma or leukemia
- hemolytic anemia
- chemotherapy or radiation treatments
Depending on the stage and severity of your gout, it may be treated in different ways. Treatment can include:
- medication, both over-the-counter and prescription
- lifestyle changes like reducing alcohol consumption and losing excess weight
- eating a nutritious diet
Turf toe, or hyperextension, is when you bend your big toe too far toward the top of your foot. It can cause a sprain of your toe or your ligaments surrounding it. Turf toe is a kind of metatarsophalangeal joint sprain, which means that at least one of your joints connecting your toe to the rest of your foot is injured.
Turf toe can happen during any sport or activity when your forefoot is on the ground with your heel up, and then you are pushed into a position of hyperextension of your toe. It most often occurs among football players on artificial grass. This is because the turf is harder and not as shock absorbent. Turf shoes also often have less protection in the forefoot because they tend to be more flexible.
Treatment for turf toe depends on the severity of the injury, which ranges from grade 1 to 3:
- Grade 1. Treatment for grade 1 turf toe involves the RICE (rest, ice, compression, elevation) method, which can be done at home, along with taking nonsteroidal anti-inflammatory drugs (NSAIDs). You can return to sports once you can tolerate this level of activity.
- Grade 2. Grade 2 treatment focuses on improving your symptoms, which may include wearing a walking boot and partial weight-bearing. An MRI may be done to get a better idea of the extent of your injury.
- Grade 3. Grade 3 injuries may require 8 or more weeks of recovery and immobilization, and sometimes even surgery.
At first glance, gout and turf toe don’t seem like they would have much in common, but there are several similarities between the two. They can include:
- joint pain or stiffness
- being unable to move your toe typically
- redness, discoloration, or swelling around your toe and joint
Pain with both may be somewhat relieved by NSAIDs. While gout can be acute, it can also become chronic if not treated and lead to joint damage. If turf toe is not treated, this can also cause lasting damage to your joints.
In gout, the damage to your joint is from internal mechanisms, meaning the uric acid buildup and urate crystals. With turf toe, the injury to your joint is from an outside force that bent the foot in a certain way.
The symptoms of gout are due to the uric acid crystals forming on your joints or around your soft tissue, making it hard to move joints and causing pain. In turf toe, the symptoms are from the hyperextension of your toe and surrounding joints and ligaments.
Gout can be managed with diet, medications, and lifestyle changes. None of these treatment strategies overlap with those for turf toe. Treatment for turf toe depends on the injury and accompanying symptoms — medication is solely used to relieve the pain.
If you are predisposed to gout or have multiple risk factors, joint injury may trigger a gout attack. Even stubbing your toe can cause a gout attack if there are enough uric acid crystals in your cartilage already.
If you have gout, it’s important to take precautions for your feet and joints when you exercise. Continuing to manage your condition over time is important.
Gout and turf toe can both cause similar symptoms like joint pain and stiffness, as well as pain with walking. With turf toe, there will generally be an event that causes the injury because of hyperextension — it doesn’t just happen out of nowhere. A gout attack, however, can develop without warning.
Although the two have very different causes and treatments, it’s important that both are accurately diagnosed to get appropriate treatment. Without treatment, both conditions have may potentially worsen and significantly impact your joint health and mobility.