Sharp Pain and Inability to Bend Little Toe: Possible Causes and Solutions

The little toe is experiencing sharp pain and cannot be bent?

Hello Doctor: I have SLE, and over the past 2-3 years, I have frequently experienced sharp pain in the little toe, specifically at the second joint (the one connecting to the foot).
Occasionally, the first joint also hurts.
The pain feels like a sharp prick, as if being stabbed by a needle.
The immunologist said it is not an attack from SLE.
Additionally, I am unable to bend my little toe and ring finger (on both feet) without using my hands to force them to bend; I cannot control the bending myself.
Could this be related? Do I need to get checked? Thank you!

LCH, 20~29 year old female. Ask Date: 2016/01/09

Dr. Shi Guozheng reply Orthopedics

Foot pain is often related to footwear.
If it is not influenced by systemic lupus erythematosus (SLE) and medication treatment has been ineffective, it may be necessary to see a physician.

Reply Date: 2016/01/09

More Info

Hello,
Thank you for sharing your concerns regarding the sharp pain and inability to bend your little toe. Given your history of systemic lupus erythematosus (SLE), it's understandable that you are worried about the implications of these symptoms.

The sharp, stabbing pain you describe in the second joint of your little toe could be attributed to several potential causes. While your immunologist has indicated that this pain is not a direct result of SLE, it is essential to consider other possibilities. One potential cause could be a condition known as "Morton's neuroma," which is a thickening of the tissue around a nerve leading to the toes. This can cause sharp pain, tingling, or numbness in the affected toe. Another possibility is a form of arthritis, such as osteoarthritis or psoriatic arthritis, which can affect the joints and lead to pain and stiffness.

The inability to bend your little toe and ring finger could suggest a condition known as "trigger finger" or a more generalized issue with tendon or nerve function. In some cases, conditions like Dupuytren's contracture can cause the fingers to bend inward due to thickening of the tissue beneath the skin. This could also be related to your SLE, as autoimmune conditions can sometimes lead to changes in connective tissue.

Given these symptoms, it would be prudent to seek further evaluation. A visit to a rheumatologist or a neurologist may be beneficial. They can perform a thorough examination and may recommend imaging studies, such as X-rays or MRIs, to assess the joints and surrounding tissues. Additionally, nerve conduction studies could help determine if there is any nerve involvement contributing to your symptoms.

In the meantime, managing your symptoms may involve conservative measures. Over-the-counter pain relievers, such as NSAIDs, can help alleviate pain and inflammation. Physical therapy may also be beneficial, focusing on exercises to improve flexibility and strength in your toes and fingers. If you find that certain footwear exacerbates your symptoms, consider wearing shoes that provide adequate support and room for your toes.

It's essential to monitor your symptoms closely. If you notice any changes, such as increased pain, swelling, or changes in color in your toes, seek medical attention promptly. Early intervention can help prevent further complications and improve your quality of life.

In summary, while your SLE may not be directly causing these symptoms, it is crucial to investigate further to determine the underlying cause. A comprehensive evaluation will help guide appropriate treatment and management strategies. Please take care, and I wish you the best in finding relief from your symptoms.

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