As funny as Big Toe Joint Pain may sound it is actually a very painful condition for anyone who suffers from it. In fact, arthritis in the foot is most commonly found in the metatarsophalangeal joint which happens to be at the base of the Big Toe. The pain is most often associated with stiffness and as a result walking can become very difficult.

As with any joint, bones are covered with smooth cartilage. The cartilage can be disrupted through injury, excessive wear, or trauma. The result is often a rubbing of the bones and may cause bone spurs or other types of scar tissue to develop. The scar tissue can inhibit the Big Toe from bending naturally during walking and may even keep it from bending at all.

This condition is called Hallux rigidus and is common in adults as they enter middle age. No matter the cause, over time the results are much the same. The articular cartilage is damaged to the point that stress on the joint itself becomes a physical problem.

Those suffering from Big Toe Joint Paint may experience pain while active, while pushing off on the toes during walking, swelling, hard growths on the top of the foot, and complete stiffness in the Big Toe.


When caught early, the treatment for Hallux rigidus is quite easy. In its early stages sufferers may notice they are walking on the outside of the foot as they experience pain near the big toe. This alleviates the discomfort but is a sign there may be trouble ahead. A trip to the podiatrist is advised because if the joint pain and inflexibility continue to the point that a bone spur may develop on the top of the foot, the treatment can be more risky and the recovery painful and slow.

Podiatrists will perform a thorough exam of the the foot and look for signs of Hallux rigidus. X-rays are often used to try and locate the position and/or size of possible bone spurs and the amount of wear and tear in the joint itself. As a result a podiatrist can prescribe treatment.

In most cases, the usual anti-inflammatory medicines will reduce the swelling and help with the pain. Using ice and common sports remedies are also useful but cannot halt the progression of this condition. As with any foot condition wearing properly fitted shoes will drastically reduce the symptoms. The use of custom foot orthotics or arch supports will help support the foot and bring the entire foot into proper alignment therefore reducing excess pressure on the joint.

A bunion is a bony swelling at the base of the big toe. They occur when the big toe angles in towards the middle of the foot and the second toe, causing the base of the big toe joint to stick out from the side.

Wearing badly fitting shoes used to be thought to be a possible cause. However, there is a tribe in Africa who never wear shoes and who still get bunions! We now know that bunions are caused by poor foot function, usually as a result of excessive pronation (where your foot rolls inwards) and excessive motion. There may also be a genetic or hereditary tendency to have a weakness in this area – in some cases it is associated with joint problems such as arthritis.

Typically symptoms include inflammation and swelling at the base of the toe, tenderness in the affected area and if pain is severe, difficulty walking. Tight or badly fitting shoes tend to make symptoms worse and sometimes the foot may become so wide it can be difficult to find shoes that fit.
Treatment
for
Bunions
in
Adults

Once your Orthopaedic Podiatrist has examined your foot he will discuss with you the various treatment options available.

Long term treatment for bunions is usually in the form toe splints to wear at night and custom–made orthotic insoles and / or night splints. These will be tailored to fit your feet exactly to help align the toes and control overpronation and excessive movement in the foot.

Wearing good footwear will also help to ease any discomfort.

Surgery to straighten your big toe may be necessary if footwear and orthotics alone do not resolve the problem.

Hallux
Rigidus

Hallux rigidus is arthritis of the main joint of the big toe in the ball of the foot. Hallux is the name given to the big toe and rigidus means ‘stiffness’, hence ‘stiffness or arthritis of the big toe’. It is one of the most common causes of big toe pain in adults. In some people, only the upper part of the joint is affected; in others the whole joint is worn out.

As with most arthritic conditions Hallux rigidus is usually caused by wear and tear. The big toe bears the brunt of the stress generated by walking and running; experts estimate that with each step a force equal to twice your body weight passes through this very small joint.

Hallux rigidus can also be caused by poor foot function. Those with fallen arches or excessive pronation (rolling in) of the feet are particularly prone. If the foot pronates (flattens) excessively, extra pressure is placed on the big toe joint, resulting in hypermobility and excessive use.

Gout, which is sometimes referred to as ‘gouty arthritis’, can also cause arthritis of the big toe.

Problems caused by Hallux Rigidus include pain and stiffness in the big toe around the joint; a bony bump (called an ‘osteophyte’ or a ‘dorsal bunion’) may develop on top of the joint, your body’s natural response to the worn joint, which may rub on shoes. In some people this bump is their only problem.

Others may experience additional pain in the ball of their foot caused by walking on the side of their foot so as to avoiding putting pressure on their painful big toe.

Because of the painful big toe some people tend to walk on the side of the foot, which can produce additional pain in the ball of the foot.
Treatment
for
Hallux
Rigidus

Once your toe pain has been assessed by an Orthopaedic Podiatrist, he will determine the cause and discuss appropriate treatment options with you. He may also request an x-ray of your foot to gauge how advanced your condition is.

For long term improvement of Hallux rigidus custom-made orthotics, insoles that fit inside your shoes, can help to reduce discomfort, especially if symptoms are caused by poor foot function and overpronation.

Shock-absorbing toe pads can help with pain in the ball of the foot and a silicone toe crest should help to minimize rubbing on the top of the toe.Equally, shoes that comfortably fit your feet, with a wider toe box and low heels, are also recommended.

If your toe is very painful your Orthopaedic Podiatrist may suggest a steroid injection, mixed with local anaesthetic, to help reduce inflammation inside the joint.

If none of the above helps, an operation may be necessary.

Sesamoiditis

The sesamoids are two pea-sized bones embedded within the soft tissue under the main joint of the big toe. They give the muscles in the foot extra leverage and power, absorb pressure under the foot during standing and walking and help to ease friction in the toe joint when the big toe moves.

Sesamoiditis refers to inflammation of the tissue surrounding the sesamoids bones, a condition which can be very painful. It is caused by doing the same type of toe movement over and over, which is why very active people, and runners and dancers especially, are particularly prone.

Sesamoiditis is also more likely to develop in those with high foot arches as this forces increased pressure on to the ball of the foot and may aggravate the sesamoid bones. As with any inflammation, the first sign of the condition is often pain, which is normally felt under the ball of the foot, around the joint of the big toe. Some swelling can also be expected but the affected area rarely appears red or bruised.
Treatment
for
Sesamoiditis

Once your foot has been assessed by an Orthopaedic Podiatrist, he will discuss appropriate treatment options with you.

Rest, with your foot elevated, will help to alleviate inflammation.

Ice therapy can also be applied to help reduce swelling, but never directly to the skin in case of ice burn occurring. Instead, wrap an ice pack in a cloth and apply to the affected area for up to ten minutes; this can also help to numb the pain.

Custom-made orthotic insoles that fit inside your shoes can help to correct Sesamoiditis due to high arches and poor foot function.

Gout

Gout is an inflammatory condition caused by a build-up of uric acid in the blood that leads to crystalline uric acid deposits in the joints. The big toe joint is most commonly affected.

Gout can occur in men and women but most commonly affects men over the age of 50.

Typically symptoms include sudden intense throbbing pain, often in the middle of the night, accompanied by redness and swelling. Attacks can last for up to five days at a time.

Due to its inflammatory nature, gout is often referred to as a form of arthritis or gouty arthritis. It is however, different from osteoarthritis.
Treatment
for
Gout

Correct diagnosis is extremely important. Your Orthopaedic Podiatrist will examine your foot and discuss with you your lifestyle and medical history prior to treating you for gout.

He may also request an x-ray of your foot to confirm diagnosis or to gauge how advanced the condition is. If you have suffered with gout for a long time, the x-ray may reveal deterioration of the joint.

A blood test, if taken, may also reveal elevated levels of uric acid in the blood.

To provide immediate relief of symptoms, your Orthopaedic Podiatrist will probably recommend a course of medication to your GP. The most common medication used is called Allopurinal.

For long term improvement of gout custom-made orthotics, cushioning insoles that fit inside your shoes, can help to reduce pain in the ball of the foot, as can protective shields and toe pads.

Dietary changes can also help. High-protein foods, such as cheese, oily fish, chicken, red meats, shellfish, lentils and alcohol, have all been linked to gout and should be avoided in excess. If you are overweight, losing weight will help.

Gout-friendly foods include cherries and pineapple, most berries, fruit and vegetables, brown rice and foods made from corn, rice, potato or buckwheat flours.

Acute attacks of gout are generally treated with a variety of prescription anti-inflammatory drugs. Ice or cooling lotions can also help during an acute phase.

Toe
Sprain

Toe sprains are normally caused by stubbing your toe when walking barefoot and stopping suddenly when running, causing your toe to jam into the end of your shoe.

Physically active people such as runners, footballers and dancers are most likely to suffer from this kind of injury.

Typically a sprained toe will be painful to move and swollen and bruised.
Treatments
for
Toe
Sprain

Your Orthopaedic Podiatrist will probably recommend resting the injured toe for at least 48 hours.

Elevate your foot to help reduce swelling and inflammation (a pillow is fine) and at regular intervals apply ice (wrapped in a towel) to the affected toe.

A compression bandage can also be used to help reduce swelling.

Corns
and
Calluses

A corn is a small area of skin, roughly round in shape, which has thickened due to pressure on it. There are two types of corn: hard corns usually occur on the top of the toe or on the outer side of the little toe and soft corns form in between the toes.

A callus is a larger, thickened area of skin, less-defined in shape that tends to form on the underside of the foot.

Both corns and calluses are caused by excessive pressure and friction (caused by rubbing) on the skin, most commonly as a result of poorly fitting shoes or excessive walking or running. They can become quite painful.
Treatment
for
Corns
and
Calluses

If you develop a painful corn or callus it is best to seek advice from an Orthopaedic Podiatrist.

If necessary he can pare (cut away or trim) the thickened area of skin and recommend correct footwear, insoles and gel pads to help prevent recurrences.

If there is a corn between the toes, a special sleeve worn around the toe may help to ease the pressure and toe splints (that keep the toes apart) should help corns between the toes to heal.


Big Toe Joint Pain

Big Toe Joint Pain

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