Turf toe and gout are painful conditions. They can cause pain and swelling of the big toe and make walking difficult. While the two conditions cause similar symptoms, they have different causes and treatments.
This article covers turf toe and gout’s differences, including symptoms, causes, diagnosis, and treatment.
What Is Gout?
Gout is a painful form of inflammatory arthritis. It typically affects one joint at a time—usually the big toe. Gout can affect other joints, including the fingers, elbows, ankles, and knees.
The cause of gout is too much uric acid in the blood, which can be deposited as urate crystals at the site of a minor to moderate injury. This causes an extremely painful gout attack.
There are times when gout symptoms get worse. These periods are called flares or gout attacks. Other times, people with gout experience remission—periods of no symptoms or pain.
Repeated gout attacks can lead to chronic gout, sometimes called gouty arthritis. The crystals form tophi (masses of white growths of urate crystals) and destroy the cartilage of the joints.
The main symptom of gout in the toe is sudden, severe pain in the affected toe. Other symptoms include:
- Warmth and tenderness of the toe
- Swelling in and around the affected joint
- Red, shiny skin over the affected toe
- Itchy, peeling skin when the swelling improves
- Intense pain that makes movement difficult (10 on a pain scale of 10 maximum)
- Pain can be relieved by nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) or Aleve (naproxen), but not Tylenol (acetaminophen)
Gout attacks often occur at night and can wake you up from sleep. A cardinal sign of gout is that you can’t sleep with bedsheets covering the affected toe.
These attacks can last an average of five to 10 days. It is possible to experience gout attacks every few months or even every few years. Even so, it is difficult to predict how often attacks will occur and when they might happen.
There is no cure for gout, but the condition is manageable and treatable. It is treated with medication and self-management approaches.
What Is Turf Toe?
Turf toe, sometimes called metatarsophalangeal (MTP) joint sprain, is an injury of the big toe. This injury occurs when the big toe is bent too far or forcefully. A turf toe injury often leads to soft tissue and ligament stretching or tearing.
Turf toe is a common injury among athletes who compete on artificial turf (grass) surfaces. The damage can also occur from wearing flexible, light shoes while walking and performing other physical activities on any surface, including natural grass.
Symptoms of turf toe can range from mild to severe. You may hear a pop if a sudden injury causes the turf toe. In this case, the pain will be felt right away. If your turf toe injury is related to repetitive movements, the pain may gradually worsen with time.
Additional symptoms of turf toe include:
- Pain and tenderness that is either constant or occurs when there is pressure on the toeSwelling and bruising at the base of the toe and top of the footLimited range of motion in which the movement of the toe and bending is more difficult A joint that feels loose, such as MTP joint being out of place or feeling unstableStiffness in the big toe
A turf toe injury can improve with at-home therapies, including rest, ice, and pain relievers like Advil and Tylenol. A healthcare provider may recommend other therapies to allow healing, such as strapping the toe and offloading weight from your toe, wearing a controlled ankle motion (CAM) walking boot, and orthotics (prescription shoe inserts).
Turf toe injuries that don’t heal correctly will need surgery to treat. According to a 2018 report, only 2% of turf toe injuries require surgical intervention.
What Is the Difference?
Turf toe and gout share some symptoms. Common symptoms of the two conditions are:
- Toe pain and stiffnessRange of motion problems Redness, swelling, and discoloration of the toe and surrounding areas
Turf toe tends to be an acute condition (severe and sudden in onset) that improves with time. Gout can be acute but can become chronic if not properly treated. Both conditions can lead to joint damage without medical intervention.
The cause of gout is a uric acid buildup in the body, leading to urate crystals forming in the joints. With turf toe, the injury results from an outside force overextending the toe’s ability to bend, damaging the toe’s joints, ligaments, and tendons.
Pain and swelling from turf toe and gout can be relieved with NSAIDs, ice, and rest. Dietary changes can improve gout since gout attacks can be triggered by eating high-purine foods that increase uric acid levels in the body. Your healthcare provider may also prescribe treatments to reduce gout attacks and uric acid levels.
Can Turf Toe Trigger Gout?
Gout is linked to specific risk factors, including being male, having a body mass index (BMI) of 30 or more, metabolic syndrome (a group of conditions that can lead to heart disease or diabetes), decreased kidney function, genetics, and family history. Gout attacks are triggered by stress, eating purine-rich foods, medications, physical trauma, and other events.
Stubbing your toe can cause a gout attack if uric acid crystals are in the nearby joint lining. A turf toe injury might trigger a gout attack of the big toe, but it is not the cause of gout.
If you have gout, it is vital to protect your feet, especially when exercising or working outside. Continuous, long-term management of gout is also crucial for preventing gout flares and joint damage.
Diagnosis
To diagnose turf toe, a healthcare provider will examine your toe to determine the extent of the injury. They will ask about your symptoms and test your range of motion. They might request imaging if the injury looks severe or if a fracture or more serious injury is suspected.
A diagnosis of gout is typically based on symptoms and medical history, a physical examination of affected joints, lab work, and imaging. Blood work for gout measures uric acid levels in the body (although this reading can be falsely low). Imaging can rule out other causes of symptoms or look for uric crystals in the joints and surrounding tissues.
A joint aspiration test may be done if the diagnosis is unclear or there is a possibility that the symptoms are due to infection. With this test, a sample of joint fluid is taken from the affected area of gout and examined under a microscope to look for urate crystals, bacteria, and any other abnormalities.
Treatment
Turf toe is treated with rest, elevating the affected foot, ice, and nonprescription pain relievers. Your healthcare provider might recommend physical therapy exercises and stretching to help accelerate healing. They might also recommend taping your big toe to your nearby toes to restrict motion while the toe heals.
Turf toe rarely requires surgery to repair tears, fractures, or joint damage.
Gout treatment focuses on reducing pain and symptoms during a gout attack and preventing future attacks. Medications that improve symptoms during a gout attack include NSAIDs, injected corticosteroids, oral steroids (prednisone), and Colcrys (colchicine).
Medicines that can lower uric acid levels in the body include the oral medication Zyloprim (allopurinol), Probalan (probenecid), or Uloric (febuxostat). Gout is also managed with diet, weight loss, and physical therapy.
Summary
Turf toe and gout both affect the big toe. They can cause similar symptoms, including joint pain and stiffness. Turf toe usually is due to an injury that overextends the toe. Gout occurs because there is too much uric acid in the body. Gout attacks can occur without any warning.
Both turf toe and gout need a proper diagnosis so treatment can start. Without treatment, these conditions can worsen and affect your joint health.
A Word From Verywell
Any number of conditions can lead to toe pain. Some cause mild discomfort, whereas others are so debilitating that you cannot put even light pressure on the toe or the foot.
Conditions that cause toe pain include inflammatory arthritis, toe injuries, bunions, calluses, infections, and nail conditions. If you are experiencing toe pain or toe pain with swelling, tenderness, redness, and warmth, call your healthcare provider right away to determine the source.
Frequently Asked Questions
- Where is the pain located with turf toe?
- Turf toe pain affects the area around the big toe and the joint that goes up to the foot toward the ankle. You may feel pain immediately, especially if the toe is bent suddenly and quickly.
- Learn More:
- 5 Common Causes of Pain in the Big Toe Joint
- Can turf toe trigger gout?
- A mild toe injury can cause a gout attack if uric acid crystals are in the nearby joint lining. A turf toe injury can trigger a gout attack of the big toe, but it is not the cause of gout.
- Learn More:
- How to Treat a Gout Flare-Up
- What is the fastest way to cure turf toe?
- It might take up to a month to heal from turf toe. Taping the big toe to the nearby toes to restrict movement can stabilize the joint and reduce the risk of further tears or damage to the joint.Afterard, you might need physical therapy to help regain the affected joint’s strength and range of motion.
- Learn More:
- Understanding If You Need Physical Therapy
Turf toe pain affects the area around the big toe and the joint that goes up to the foot toward the ankle. You may feel pain immediately, especially if the toe is bent suddenly and quickly.
A mild toe injury can cause a gout attack if uric acid crystals are in the nearby joint lining. A turf toe injury can trigger a gout attack of the big toe, but it is not the cause of gout.
It might take up to a month to heal from turf toe. Taping the big toe to the nearby toes to restrict movement can stabilize the joint and reduce the risk of further tears or damage to the joint.
