Osteoarthritis of the Big Toe

While the big toe seems like a trivial part of the body that we take for granted often, it actually plays a major role in maintaining our balance. Thanks to the support offered by our big toes, we can walk, run and exercise. Our big toes help us travel the world and do the things we love. Without them, we would feel unbalanced and have a much poorer posture.

So, when we encounter pain in our big toe, or in any of our toes for that matter, we can automatically feel off balance and unable to do the daily things that once seemed simple, such as jogging.

Toe joint arthritis is one of the most common and painful arthritic big toe conditions that can affect younger or older people alike.  

Arthritic toe joint

The big toe is comprised of the metatarsophalangeal (MTP) joint – an important intersection that unites the metatarsal bone (in the foot) with the primary bone of the big toe. During walking, the joint bends and actually supports up to 50% of our body weight. That’s a lot of pressure for such a small body part! When the cartilage of the joint gets worn out, the joint becomes inflamed since there is no cushioning to protect it. This can cause stiffness (also called hallux rigidus) as well as pain. An arthritic toe joint can be a hereditary condition, or it can happen from an acute injury where the cartilage tears. 

Most common symptoms:

  • Pain in the toe or foot when walking – or in more serious cases, when the foot is at rest.
  • Stiffness and loss of mobility in the toe.
  • Small bumps that form by the toe joint.
  • Swelling, redness and inflammation. 

If you suspect you have hallux rigidus or big toe joint arthritis, your podiatrist will first examine your toe and possibly take x-rays to rule out other problems and to also get an idea of the scope of the problem. 

Treatment options: 

Managing symptoms: If your symptoms are not severe enough to keep you off your feet, you can manage the pain, redness and swelling with icing the toe or immersing your foot in ice cold water for as long as is tolerable, and then alternating to warmer water. Do this a few times to temporarily relieve symptoms. Taking ibuprofen can also help with the inflammation. However, what’s most important is not over-stressing the toe through exercise and wearing comfortable shoes that will help with the healing process. 

Shoe accessories: Shoe inserts can help not only with the pain and stiffness of big toe arthritis, but also slowly correct any deformities. Talk to your podiatrist about what shoes are best for your toe in this situation. In most cases, the recommendation is to wear shoes with a wider toe box. So, no heels or pointy shoes for the ladies! Also, shoes with a more rigid sole may be prescribed so that the toe joint does not bend as much.  

Surgery: The word everyone dreads. Surgery to correct hallux rigidus is typically a last resort option, but many people do it if the condition interferes with basic walking functions and daily activities. It’s an option considered when all other homeopathic solutions have failed to relieve painful symptoms. Today, there are a few different types of surgeries available depending on the severity of the joint issue and individual lifestyles. If you’re a nurse, for example, the nature of your job may not allow you to wait out the pain to see if the problem subsides on its own. In this case, a procedure where the joints of the toe are fused (joint fusion) by screws or other materials to help with the mobility of the joint.

As always, if your feet are hurting for any reason, make sure to call our Evanston office – Evanston Podiatric Surgeons at 847-475-9030, or Downtown Chicago office –Mag Mile Foot and Ankle Institute at 312-236-3507. Our care options for foot injuries and pain include some of the most cutting-edge procedures and technologies available!

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