Gout would hurt all the time, not just when you flex.
The surgeon didn’t mention my friend’s microfractures right away so they may be difficult to spot unless they are looking for them. If you had that, your foot would swell and not just the toe. I wonder if you could have a small bone chip in that toe joint. You never realize how much you use your feet until you get some mysterious pain in one.
I sometimes have plantar fasciitis in the other foot and the toe in the hurt foot feels similar to that. When I hurt the foot the entire arch of the bottom of the foot swelled. After the swelling was gone the heel hurt so I think I hurt the plantar fascia ligament when it twisted. That would explain why when I twist the foot to get a regular shoe on or flex it too much, it hurts behind the toe. That ligament attaches to the big joint behind the toe.
My daughter has been nagging me to get a second opinion by seeing her foot doctor so I agreed to do that. If he can’t get it fixed I’ll be going to an orthopedist. I put a slip on shoe on this morning and turned my toe down instead of up and it didn’t hurt so I’ll try that a time or too and see how it works. By doing that it doesn’t pull on that big tendon.