Big toe joint pain is a common problem that can happen with anybody for several reasons. The big toe is attached to the foot by the metatarsophalangeal (MTP) joint. Given that we are always using our feet to move, walk, run, dance, and engage in activities we tend to put a lot of pressure on this joint that supports the body and allows the toe to bend up and down. The big toe joint pain can be incredibly difficult and even cause problems with walking and moving.

Although not all kinds of pain are serious and some of them can even resolve on their own, others may need medical attention and adequate treatment.

What causes big toe joint pain?

• Bunion: A bunion is a bump formed on the MTP joint of the big toe. Often mistaken for a bony growth, it is actually a deformity resulting in the shift of the entire big toe and drifting toward the other toes. This condition is also known as a “Hallux Valgus” deformity.

  Bunion causes serious swelling, pain, irritation and even restricted flexibility. It can be due to too much pressure on the joint, arthritis, it can be a hereditary bone structure (flat feet) and it happens more specifically to people who wear tight shoes around the toes.




• Fracture: You probably have already at least once in your life kicked your toe against a table or a chair, let a heavy object fall on your foot or even tripped while walking. Fractures can also occur from sports activities that can be stressful on the toes such as running and football.

  When a fracture happens, it results in swelling, numbness, and intense pain. You can even notice a discoloration around it. Sometimes, surgery may not be necessary if the fracture is minor but in other cases such as dislocated bones, it will need surgery. In both cases you need to seek medical attention and the decision will be given to the doctor whether to proceed with surgery or not.

  Fractures are diagnosed with an x-ray to get a view of the bone and determine its seriousness. A fracture will affect walking and wearing shoes for several weeks during the healing period. You may even need crutches.

• Turf Toe: Turf toe is a common sports injury. It can result from any sport such as football, soccer, dancing, running, basketball etc. Unlike fractures that affect the bones, turf toe is an injury of the soft tissue or a tear of the ligaments at the base of the big toe joint where the pain will be localized.

  It happens when a person hyperextends the toe or flexes it in an excessive way during an activity resulting in the injury of this one. Symptoms include pain, swelling and discoloration of the toe.

  Turf toe can be from an immediate force or a growing pain from several repetitive injuries. Some of them can heal at home with icing, elevation and resting, even crutches are needed at times, while others need to be consulted by a medical specialist.

• Ingrown toenail: Ingrown toenail happens when a person cuts their nail too short or in a weird curve. The nail grows into the sides of the skin causing the painful sensation. Tight shoes are the primary cause of ingrown nails and can even make the situation worse.

  Some people are just born with a tendency to have ingrown toenails, but it is also caused by some injuries or poor hygiene. When you have an ingrown toenail, your toe becomes tender, sore, swollen, and can even have pus oozing from it in case of an infection.

• Sesamoiditis: Sesamoiditis is an inflammation of the two small bones underneath the big toe joint called sesamoid bones. Being attached to tendons, the sesamoids bones help to flex and move the big toe.

  The sesamoiditis is the result of the overuse or the injury either acute or chronic of the big toe. The most common people who have sesamoiditis are ballet dancers and runners. Sesamoiditis results in pain, bruising, swelling and trouble moving the big toe.

  A fracture of the sesamoid bones can also occur and will require either a cast or crutches in order to relieve any weight bearing on it. Even surgery is necessary sometimes.

• Osteoarthritis Arthritis: Osteoarthritis is the degeneration of the articular cartilage which results in the rubbing of the bones against each other. It can be the result of a trauma, a dislocation of the big toe or can even develop from foot structure problems.

  This causes pain and swelling to the toe which leads to difficulty walking. A condition called “Hallux Rigidus” can result from osteoarthritis and limits the range of motion of the big toe. It usually worsens over time.

• Gout: Uric acid passes through the kidneys and is then removed from the body in the urine. In some cases, this uric acid builds up and forms crystals which lend in the joints. When this happens on the big toe it is called “Podagra”.

  Gout is very painful and causes hypersensitivity of the toe along with hotness and redness. The pain can start any time even at night.

  Left untreated, it can happen several times, which leads to joint damage and can even form lumps under the skin.

Some less common reasons to big toe joint pain are:

• Raynaud’s disease: a disease that narrows the arteries, limiting blood flow to the fingers and toes.

• Morton’s neuroma: a condition that affects the foot procuring the sensation of constantly standing on a small rock under your foot.

• Rheumatoid arthritis: a less common type of arthritis that results in the deformity of the foot and toes.

Diagnosis

To diagnose the reason behind the big toe joint pain, the doctor needs to do a physical exam along with questions about medication history, symptoms the patient is experiencing and everyday activities. He will need to test the flexibility of the toe (bend it up and down), the areas that are tender, sore, or inflamed.

He will also look for bone spurs which are bony growths. In some cases, an x-ray is needed to take a better look at the bone or even a blood test (e.g., to see the level of uric acid in the blood in order to diagnose gout).

How to treat big toe joint pain?

The treatment of big toe joint pain will depend on the diagnosis and the reason behind the pain.

Anti-inflammatory drugs (NSAIDS) can be prescribed most of the time to help ease the pain and reduce the swelling. In some cases, inflammation will be treated with corticosteroids.

When the pain is due to an injury, it is best to stop the activity that led to the injury during the healing time and rest as much as needed.

Sometimes your doctor may ask you to lose weight in order to relieve pressure on the toe.

You may need to wear only large shoes that have extra space for your big toe, orthopedic shoes, shoe inserts, shoes with stiff sole or that can bend on the big toe joint depending on the diagnosis to help with the movement without causing too much pressure or irritating the joint.

You can try cutting your toenails in a straight way to prevent them from growing into the skin. Soaking your feet in warm water a few times per day can also be helpful. If you notice pus or redness you need to contact your doctor.

Physical therapy is beneficial in some cases of gout along with specific medication treating the level of uric acid in the blood and also in some cases of arthritis.

RICE therapy (rest, icing, compressing, and elevating the foot) is applicable especially in toe injuries such as sprains and turf toes.

Surgery can sometimes be mandatory for fractures and can even be done to remove bunions, repair joint damage or remove bone spurs.

When to see a doctor?

You always have to pay attention to your big toe pain. Even though not all cases are serious and some of them will get better over time such as sprain that may only need rest, other cases need medical attention especially if the pain doesn’t go away after 3 days, get worse over time, or even interfere with your life.

Do not wait to call your doctor if the pain is intense, sudden or without a known reason.

Prevention

You can’t prevent all of these conditions from happening. However, there are a few things that you can do to keep some risk factors away:

Maintaining a healthy weight, follow a normal diet that gives your body its full necessities (if your doctor doesn’t tell you to lose weight there is no need for it).

Do not wear tight shoes especially around the toes. This can avoid many reasons leading to big toe joint pain.

Engage in regular physical activities to keep the body moving without pressuring too much the joint.

---

If you or anyone you know is suffering from joint pain in your feet, call us today on (469) 562 4188 to book an appointment with our expert doctors.