People don't realize the importance of your toes until one of them starts to hurt, especially if it's the big toe. It does more work that you may realize and bears about half your weight each time you take a step. They may be small, but having big toe pain sure isn't. It can cause problems standing, walking and even maintaining balance. Our big toe provides thrust when we take each step so when it's hurting, it can really slow you down. Here are some of the most common reasons your big toe might be hurting.
A pretty common culprit of big toe pain is arthritis and the most common place to get arthritis in the foot is at the base of the big toe in the metatarsophalangeal joint. With arthritis, the cartilage that lines this joint gets damaged and osteophytes (small lumps of bone) form, this results in stiffening of the big toe which ends up becoming very painful and may even cause your toe to become misshapen. It's important to get a diagnosis so you have treatment options including rest, icing, compression, steroid shots, and long-term medications. Comfortable, supportive shoes with a wide toe box can also be very relieving.
Hallux rigidus means "stiff big toe." It can be due to arthritis, overuse or injury. If it's not treated, the toe may become frozen, meaning the joint is so rigid it makes it hard to walk or stand for long periods of time. Once diagnosed, your podiatrist will discuss both surgical and non-surgical treatment options. Non-operative treatment for Hallux Rigidus is typically attempted prior to surgical treatments. These treatments include physical therapy, intra-articular injections, shoe modification (wide toe box, supportive) and rest.
Most people usually know they have a bunion because of its appearance. However, in the beginning stages, you may start to have big toe pain as the bunion gradually forms over time as the big toe shifts position, with the top of the toe turning inwards and the bottom of the toe pushes outwards, forming a lump. Bunion pain is typically located around the joint or within the joint and may also travel into the arch of the foot. Most bunions happen to women due to wearing ill fitting shoes even though they can be related to genetics as well. Podiatrists will recommend a supportive shoe with a wide toe box and orthotics to ease the discomfort of a bunion, however, surgery is usually required for complete recovery.
An ingrown toenail usually leads to redness, swelling, tenderness to the touch and sometimes infection which can cause pain into the big toe joint and sometimes the entire foot. The big toe is the most common place for an ingrown nail. Ingrown toenails occur when the edges or corners of the toenail grow into the skin on the side of the nail. Sometimes an ingrown toenail is the result of improper nail trimming, but it can also be caused by anatomy, genetics or wearing shoes that are too small. Home treatments like soaking your foot in warm, soapy water will help, but if you've developed an infection, your podiatrist might prescribe an antibiotic.
Turf toe, a sprain of the big toe joint, is common with athletes and usually happens from playing on artificial turf causing hyperextension of the toe. The pain is felt on the bottom of the big toe which is also inflamed and tender to the touch. This injury results from excessive upward bending of the big toe. Conservative treatments include the RICE method - rest, ice, compression, and elevation - and NSAIDs, or nonsteroidal anti-inflammatory drugs. In some severe cases, surgery can repair tissue and restore mobility.
Gout is a form of arthritis resulting from high levels of uric acid in the body that creates crystals that settle in the big toe joint causing intense pain, redness and soreness. Gout is very painful and the big toe is a likely place for a gout attack. If you have high levels of uric acid, sharp crystals can form in your body and jab the joint. Once appropriately diagnosed, if you have a flare up, rest and elevate your foot. Limit foods that are high in uric acid, such as meats, seafood and alcohol. There are effective medications to prevent and treat gout, and symptoms usually go away in a few days. Because our feet are constantly exposed to injury by walking, running, or other athletic activity, toe pain is fairly common. If you are suffering with tenderness or pain at or around your big toe joint, it is important to see a podiatrist to ensure that your big toe pain is diagnosed correctly so effective treatment can be provided. Early diagnosis and treatment can make a world of difference in alleviating the symptoms through simple, conservative treatment.
Dr. Jeffrey S. Hurless
DPM, FACFAS Board Certified Foot & Ankle Surgeon/Podiatrist
Medical Director, HealthyFeetStore.com