Left big toe pain w toe-off

[Eggs_selent]

My left big toe gives a shooting pain with the toe-off movement. It has been feeling this way since June of 2010 and there was no trauma that I know of, but I did wear a pair of shoes that was tight over the metatarsal-phalangeal joint.  I have tried stretches, tucking the big toe under and pressing my big toe down lifting my heel with some relief.

I recently saw a podiatrist who crafted a shoe insert for me to try with the theory that I have high arches, tight Achilles tendon and very flexible joints, jamming my metatarsal into the ground causing the pain. He said that I do not have any bunions.  No x-rays were taken. The inserts feel comfortable, but the pain is still present with a toe-off.  I feel that the pain is more in the metatarsal-phalangeal joint or in the proximal phalange.  Also , my left foot is half a size larger than my right foot and the top of my left big toe presses against the top of many of my shoes including my tennis shoes, which worsens the pain.

If anyone has any alternative theories, I would love to hear them!

Thank you very much.

[Eggs_selent]

Thank you so much for your response. Your post was very helpful. I think this sounds right and I will look into meeting with an orthopedic foot specialist.

I found some joint exercises online to help with hallux rigidus that have been making a difference.  

[DrMickeyZ]

You should be seen by an orthopedic foot specialist.  This sounds a lot like hallux rigidus, which is a form of arthritis of the great toe.  It can be alleviated with the proper orthotics (usually a very stiff insert for the sole of the affected foot and a wide toe box).  Sometimes, surgery is necessary.  The pressure on the top of the foot is extremely common in this problem, and it usually winds up forming a "bump".  However, there is none of the second toe deformity seen with bunions.

An X-ray is necessary for diagnosis.