Big Toe Joint Pain and What To Do About It

There are several possible causes for pain in the big toe joint. Two of the most common causes are hallux valgus (bunions) or hallux limitus/rigidus (sti big toe).

Hallux Valgus or a bunion is bump on the side of the big toe joint.

1. What causes bunions?
   1. Genetics can predispose someone to develop a bunion. Bunions are most commonly caused by genetics either

      in people who have a family history of bunions, flat feet or hyper-mobility.

   2. Abnormal biomechanics can place improper stress on the joint leading to bunion formation.
   3. Females are more prone to developing bunions largely due to the prevalence of wearing higher-heeled or

      tighter-toed shoes. In addition, certain hormones can contribute to increased foot instability.

   4. Arthritis whether it be rheumatoid arthritis or osteoarthritis has been seen in patients who go on to develop

      bunions.

   5. Improper shoes like high heels or narrow-toed shoes are more likely to cause bunions as well.
2. What should I do about my bunion?
   1. If you’re not having any pain, then nothing needs to be done for your bunion! Bunions should only be treated if

      they become painful.

   2. If you are having a painful bunion, proper shoe gear like wearing shoes with a wider toe shoe box is highly

      beneficial.

   3. Stretching and strengthening key muscle groups that contribute to bunions is highly recommended.
   4. Orthotics provide support to the arch of the foot especially when the cause of the bunion is a collapsing arch.

      In addition, Correct toes, which are a device that functions to help maintain the anatomic structure of the

      forefoot, can also be of benefit.

   5. If all conservative options fail then surgery may be needed to properly treat and restore the proper

      biomechanics to the foot and big toe joint.

Halliux Limitus/Rigidus is defined as limited or no motion at the big toe joint.

a. What causes Hallux limitus/rigidus?

1. Osteoarthritis is a condition caused by the wear of the cartilage of a joint. Over time, the cartilage in the big toe joint wears down, which leads to pain, stiffness, and limited motion.
2. Bone spurs can form around the joint in response to arthritis or injury. These bone spurs can restrict motion and cause the joint to become sti.
3. Previous injury or trauma like a sprain, fracture, or dislocation, can damage the cartilage, ligaments, or bones, leading to stiffness and pain. Repetitive trauma like running or jumping can also contribute to big toe stiffness.
4. Abnormal foot mechanics and walking patterns can place extra strain on the big toe joint.
5. Inflammatory arthritis like Rheumatoid or Psoriatic arthritis can affect the big toe joint, leading to swelling,

   pain, and reduced motion in the joint.

b. What should I do about my stiff big toe?

1. One of the main ways to decrease pain and stiffness in the big toe joint is to try and decrease motion going through the joint. The best way to do that is to wear stiffer-soled shoes or to consider incorporating a carbon fiber foot plate under the insole of your shoe. Additionally, rocker bottom shoes can help decrease motion through the joint.
2. NSAIDs can help decrease inflammation. Topical analgesics like Voltaren or capsaicin can provide temporary pain relief.
3. Stretching and strengthening your Achilles tendon. Stretching the big toe joint itself can help improve motion at the joint.
4. If all conservative options fail then surgery may be needed to remove spurs from the joint or fuse the joint altogether.

While bunions and hallux limitus/rigidus are two of the more common causes of big toe joint pain, there are other causes like gout or turf toe that can be contributing to your big toe hurting. This is why it is important to see a foot and ankle specialist who can help pinpoint and diagnose the cause of your pain in order to properly treat and help prevent further damage.

Come see us at District Foot & Ankle so you can get back to being a better you today!