Thanks for the healing info, Sue, very helpful and am glad you are doing so well. TriGeek, my problem began precisely on the hiking trail--in the Shen. Park. Got sudden severe pain on top of toe, had to remove boot and walk barefoot a mile to car. Just like that it began and it's been pretty much the same since, except that the pain moved also to the ball of the foot, causing the one podiatrist to pursue a possible sesamoid problem. I have had constant slight puffiness on top of the big toe joint toward the second toe also. Have always felt that maybe the boot bending just over the joint and irritating it triggered my pain. None of the doctors seemed interested in the fact that it began suddenly, not chronically, but surely that must be a clue to something. I had both an MRI and bone scan. MRI finding ruled out sesamoid problem, said "arthropathy of first metatarsophalangeal joint. Spurring on first metatarsal head, findings likely related to osteoarthritis" Bone scan report says "findings may relate to osteoarthritis" Not very informative!
I think the diagnostic procedures and treatment alternatives for big toe probs are dismally archaic. I am going to get on the phone to NIH this week and see what I can find. Surely there must be ways to regenerate cartilage. And also to better target whether ligaments and tendons are involved. I feel as if the surgeons sort of go in there and see what they can see and then proceed to fix what they can--seems a bit chancey. I am still trying to work with stretching, gait improvement, and whatever I can find to avoid surgery, but am tending toward fusion if it comes to that.