The Difference Between Turf Toe and Gout

By Terez Malka, MD
Medically reviewed
December 7, 2021

Turf toe and gout are both painful conditions that can affect the big toe.

Even though the symptoms may be similar, there are distinct differences between the two conditions. 

Gout is a very common condition that occurs due to the buildup of uric acid in the joints.

Pain may be felt at the base of the big toe and also sometimes arms, elbows, fingers, and knees. 

Turf toe is an external injury caused by playing sports on artificial turf.

The term turf toe is a common term associated with hyperextension of the big toe.

Hyperextension is the forceful over-bending of the big toe towards the top of the foot, which causes a tear in the surrounding ligaments of the big toe.

If you’re currently stuck in front of the TV icing your foot, then you should know the similarities and differences between the two conditions so you know how to treat your pain.

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What is Gout?

Gout flare-ups can interrupt even the best-laid plans.

When uric acid cannot properly pass through the body, crystals accumulate in the big toe and other joint tissue.

Uric acid usually dissolves in your blood and is cleared through your kidneys before passing out of your body in your urine.

If your body produces too much uric acid or your kidneys cannot properly excrete it, then you can contract gout. 

If you have gout, you’ll feel pain at the base of your big toe.

When urate crystals build up in the joints, you’ll feel uncomfortable swelling and pain, and the joint will often look red and feel warm.

There may also be discomfort in other areas of the body like the hands, feet, knees, elbows, wrists, and ankles, but the toe is the most common joint to be affected

Gout flare-ups can last anywhere from 3-10 days.

Stress, eating certain foods, and even living in cold weather can cause flare-ups. 

Causes of Gout

The consumption of fatty foods and certain processed meats can cause an excess build-up of uric acid.

In addition, drinking an excess of beer or other alcohol, as well as soda (or consuming foods high in sugar) have been found to be correlated with cases of gout. 

Common medical conditions like diabetes, obesity, kidney disease, high blood pressure, thyroid conditions, and congestive heart failure can all cause gout.

Dehydration and metabolic disorders can create an excess of uric acid, as well.

Treatment of Gout 

Unfortunately, there is no cure for gout, but it can be treated with medication and lifestyle changes.

Don’t let gout go untreated, since it can develop into chronic arthritis or “tophi” bumps.

Tophi are hard bumps found underneath the skin.

Pain can be managed through nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and indomethacin (Indocin).

Some home remedies may to be helpful.

Ingesting ginger, magnesium, water with lemon, apple cider vinegar, and celery are all suggested to treat or prevent gout flares, but none have been proven to be effective.

Certain lifestyle changes, including limiting how much alcohol you drink, reducing processed meats, and high-fat foods, can reduce the amount of gout attacks. 

There are other prescription treatments such as an anti-inflammatory steroid and a medicine called colchicine, that are often prescribed to treat gout flares.

Some patients with many gout flares may take a preventative medication or follow a specific diet recommended by their doctor.

In rare cases, your health care provider may recommend surgery for gout, but it is usually only to remove nodules or tophi in the joints.

What is Turf Toe? 

Turf toe is the quickest way for a star player to be benched.

It’s a painful sprain or ligament rupture in the area of the metatarsophalangeal joint (where your toe connects to your foot) of the big toe, quickly followed by swelling, redness, and painful discomfort in the injured area. 

Turf toe is also referred to as a stiff big toe or hallux rigidus.

Football players, gymnasts, martial artists, or any athlete playing on synthetic floors or grass can get turf toe.

Cause of Turf Toe

Turf toe is a sports injury that can sideline even the best athletes.

Turf is harder than natural grass and doesn’t absorb shock.

When players push off into quick sprints or put sudden force on the big toe, hyperextension can occur.

Athletes will feel a painful pop at the moment of injury. 

It is a sprain of the ligaments within the big toe area.

Bending the big toe too far back or too quickly can tear tissues or ligaments.

Sports athletes with repetitive injuries are more susceptible to turf toe.

While playing on turf, wearing proper, sturdy shoes can help absorb shock.

Treatment of Turf Toe

Athletes will feel acute pain before swelling, limited range of motion, bruising, and redness in the injured area.

In most cases, turf toe is treated with the RICE method (rest, ice, compression, elevation) and with nonsteroidal anti-inflammatory drugs (NSAIDs). 

In severe cases, a doctor might recommend a walking boot.

An MRI may be needed to determine the severity of the condition if it is not improving over time.

The most extreme cases require surgery and up to eight weeks of recovery time.

After injury, immediately consult a doctor or sports medicine specialist to evaluate your injury and determine a care plan..

To keep you playing through the whole game, athletes should properly warm up.

Wearing the correct athletic shoes and taking care of old injuries is a must.

Be sure to treat the injury so it does not develop into chronic big toe pain.

How Gout and Turf Toe Are Similar

Even though the causes of the two conditions are very different, the symptoms feel strikingly similar.

Take both conditions seriously and receive a proper evaluation from your primary care provider or a sports medicine specialist. 

Both conditions create limited mobility, intense joint pain, redness, or discoloration around the injured area.

Gout or turf toe are both felt in the big toe and can be quite painful.

Pain management medication such as NSAIDs like ibuprofen (Advil, Motrin) or naproxen (Aleve) can lessen the pain and swelling of both gout and turf toe. 

It’s important to talk to a doctor if you think you have gout or turf toe.

Both conditions can worsen over time if not properly addressed.

Gout can become chronic arthritis, and turf toe can cause lasting damage to your joints.

How Gout and Turf Toe Are Different 

Gout and turf toe can feel very similar, but they are caused by two completely different events. 

Gout is an internal issue due to the build-up of uric acid.

Extra uric acid stems from an unhealthy diet or preexisting medical conditions like diabetes or kidney disease. 

An external sports injury causes the hyperextension of the big toe, known as turf toe. It is not related to an internal condition. 

Gout is treated by a change of diet and with both over-the-counter and prescription medications. 

Turf toe is treated as a sports injury, and diet changes have no effect. 

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When to See a Doctor

Gout flare-ups or turf toe can throw a monkey wrench into your whole day.

Don’t hesitate to discuss these symptoms with your doctor or provider.

In most cases of gout, no imaging is required, and your provider can diagnose you with just an exam. 

For an acute injury like turf toe, an X-ray may be needed right away and an MRI may be ordered for pain that does not improve or gets worse over time.

For gout, you may be referred to a rheumatologist to help with joint pain, or your primary care doctor may be able to help you mange this condition.

For turf toe, if the toe looks dislocated or the pain is severe, then please go see a provider immediately.

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Frequently Asked Questions

Can turf toe cause a gout flare-up?
Even though the two conditions are not connected, a sports injury like turf toe can cause a gout flare-up if there’s already a build-up of uric acid.
What other ailments can be mistaken for gout?
Gout can sometimes be mistaken for other joint conditions like carpal tunnel syndrome, rheumatoid arthritis, osteoarthritis, pseudogout, or a joint infection.
What should you do if you think you're having a gout flare-up?
If you are having a gout flare you should take an anti-inflammatory medication like ibuprofen (Motrin, Advil) or naproxen (Aleve). Using ice and elevating the painful area can also offer relief. Make sure to avoid alcohol and drink lots of fluids to hydrate your body. Most importantly, if the pain is severe, call your doctor or provider, as they can offer prescription medications to help manage your symptoms.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.