Introduction
Many people are affected by inflammation in various parts of the feet. The inflammation is particularly often localized on the big toe. There are various causes that can lead to such an inflammation.
Often it is nail bed inflammation (also called onychia or paronychia) that causes a painful inflammation of the big toe. Very often small injuries to the skin cause such an inflammation of the nail bed. The injury causes germs to migrate into the tissue, mostly the Staphylococcus aureus bacterium, which then cause an inflammation of the nail wall.
However, the germs can also penetrate deeper into the tissue, resulting in a panaritium, a purulent inflammation of the toe. This type of inflammation is usually treated with an incision. This means that the affected tissue is relieved through an incision and the inflamed tissue is treated.
Since such a panaritium on the big toe is often caused by an ingrown toenail, part of the nail root must usually be removed here as well. Inflammations of the big toe also occur in the context of metabolic diseases such as gout. Here a systemic therapy is required, since local measures alone cannot lead to the disappearance of the inflammation. The following article will now take a closer look at the causes, symptoms and treatment of inflammation in the big toe, covering as many questions as possible.
Causes of inflammation in the big toe
The causes of inflammation in the big toe are manifold. Often it is inflammation of the nail wall or nail bed, which can lead to painful swelling and redness of the toe. However, metabolic diseases such as hyperuricemia, colloquially known as gout, are also possible.
The following section provides an overview of various more or less common causes of inflammation of the big toe. These terms are usually used synonymously. However, the term nail bed inflammation is much more common in everyday language.
It can often be very difficult to distinguish the terms correctly. What they all have in common is that they are all inflammations of the fingers or toes.
- Onychie/Paronychie/Panaritium:
In onychia, it is mainly the nail bed that is inflamed.
A paronychia rather describes an inflammation of the nail fold (synonymously nail wall). A paronychia may also be accompanied by a purulent melting into the tissue. A panaritium, on the other hand, is a localized, purulent, melting inflammation of the fingers or toes.
Panaritium occurs less frequently on the toes than on the fingers. The inflammations are very similar in their clinical picture and ultimately differ in their extent and the severity of their symptoms and partly in their localization. Mostly they are caused by slight injuries, for example very fine cracks in the cuticle, through which skin germs such as Staphylococcus aureus, in particular, then enter the tissue and cause the inflammation.
In the case of the big toe, an ingrown toenail (Unguis incarnatus) is often also the cause of such an inflammation. A lack of foot hygiene or a fungal infection of the feet can also be the cause. Typically, these inflammations lead to swelling, redness and overheating of the big toes, which is accompanied by a characteristic pulsating pain.
In the case of advanced inflammation and systemic involvement, symptoms such as fever, chills and fatigue are also possible. Therapy depends on the severity of the inflammation and may involve local or systemic conservative approaches but may also require surgical intervention. Gout is a relapse of a disease of the protein metabolism, more precisely of the purine metabolism.
The underlying disease is called hyperuricemia. Excessive uric acid levels in the blood lead to deposits of uric acid crystals in various parts of the body. There are various forms and causes of hyperuricemia, but in 99% of cases there is a genetic disposition, in which the gout then manifests itself through malnutrition.
A diet low in meat is recommended, as well as a reduction in alcohol consumption. Moreover, being overweight favors gout, so it is especially important to normalize body weight in chronic gout. An acute attack of gout manifests itself in over 60% of cases as so-called Podagra.
This is an inflammation of the metatarsophalangeal joint of the big toe. Triggers are usually a diet rich in meat and fish, legumes or seafood. Also an alcoholic excess or fasting can lead to such an acute Podagra.This is characterized by sudden, very strong pain, as well as swelling and redness of the joint.
The examination of the toe is then usually felt to be so painful that it is not allowed. A fever also occurs occasionally. An acute attack of gout can last several hours and is treated with NSAIDs (e.g. Diclofenac) and glucocorticoids. Colchicine is also used as a reserve. It also helps to put the toe up and cool it down.
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