The big toe is important for functions such as stability and walking so pain in the big toe can be quite unpleasant. The first metatarsophalangeal joint is the main joint that connects the big toe to the forefoot. So what is causing the pain?

Hallux Valgus

A common condition in the general population, also known as bunion deformity. This involves the big toe gradually moving towards the lesser toes with an enlargement of the tissue surrounding the big toe joint. Most bunions are caused by foot biomechanics, footwear and hereditary factors. They can result in symptoms such as widening of the forefoot, an irritated, red and sometimes swollen bump on the side of the joint.

Turf Toe

This is a common sports injury to the plantar plate and sesamoid when the big toe is forced upwards. The typical mechanism of injury is an athlete jamming their foot against a hard surface or pushing off the big toe with cutting/running and is usually seen in sports such as football and soccer.

Gout

This is a metabolic condition that can affect any joint but mostly occurs in the big toe joint. Gout involves a build up of uric acid in a person’s system which forms crystals that gets deposited into a joint. Symptoms of gout attacks may include: red, hot and an intense level of pain at the joint.

Sesamoiditis

The sesamoid bones are two tiny bones located under big toe joint. They lie within a tendon that flexes the big toe down. These bones are prone to trauma in activities that involve balancing on toes or jumping. Trauma can cause pain, inflammation and sometimes fracture.

Arthritis

Arthritis in the big toe joint is also referred as hallux limitus or ‘stiff toe’, where the mobility of the big toe is affected. It can be caused by overuse of the joint or injury to the joint, thereby damaging the joint surfaces and the nearby soft tissue. Symptoms of hallux limitus can include pain with walking and stiffness, especially during cold or damp weather, swelling and inflammation around the big toe joint.

 

If you are experiencing any of these problems, an assessment by a podiatrist is recommended to see what can be done!

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