Osteochondral Lesion in big toe after injury, what steps do I take now?


Hello, very happy to be here!

In june of last year I was playing with my dog when I tried to kick a toy, missed, and kicked a base board. I knew something was off and went to the er immediately who x-rayed and found no fracture/break. I was told to stay off it and it would be fine.

5 months later I still had pain and swelling so I visited a orthopedic who took x-rays and found nothing wrong. She prescribed some steroid cream which helped with both pain and swelling and sent me on my way.

Fast forward to now and I still have slight pain and slight swelling. I visit another orthopedic who says it is likely arthritic and orders an MRI. The MRI came back as follows

”Mild degenerative changes first melatorsal-phalangeal joint with mild thinning and irregularity of the articular cartilage, small marginal osteophytes and mild subchondral bone marrow edema within the first metatarsal head. A small joint effusion is present. Unremarkable first metatarsal sesamoid bones.”

He recommends a steroid shot. I honestly am nervous of that after reading it can be degenerative/you end up needing more.

After this I visit a sports ortho who views the MRI and says just do nothing. no steroid shot, no PT, nothing. If it gets worse then maybe steroid shot but otherwise there’s no point in affecting your life yet.

Both orthopedics shrugged when I asked if this could get worse/what steps should I take to minimize pain/future problems. So, i come here with my mri and my toe and ask, what do I do now?


  • abletonfan5000

    should also mention I am 25 years and am looking to just keep as much of my current life as possible (hiking, walking, etc)

  • frogmorton
    frogmorton Member Posts: 29,640


    Sounds painful and of course at 25 you want to be walking and using that foot!

    If you're still in pain have you thought about seeing a podiatrist? Just thinking maybe they can help with suggestions for the most supportive footwear to minimise future damage and maximise your ability to use that foot??

    Others of course might have some better ideas.

    Sorry how rude of me! nice to meet you!