Big Toe Pain

Dr. Corey Fox
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Director of Massapequa Podiatry Associates

Of all our toes, the big toe tends to find the largest share of trouble.

Sure, the smallest toe might occasionally collide with a coffee table leg, but the big toe is much further out on the front lines. There’s simply more of it to fall into misfortune! And not only is trauma a concern, but there are certain other conditions that tend to target your largest toe as well.

If you are having trouble with your big toe – or any of your toes, for that matter – never hesitate to contact us for expert evaluation, diagnosis, and treatment. We’re always here to help with issues involving pain, discomfort, and mobility.

Here are just a few potential causes of big toe pain, and how we can help you overcome them.

big toe pain

Bunion

A bunion is a bony protrusion that forms at the base of the big toe, typically accompanied by the gradual shifting of the toe toward the second and third toes. Pain is a common symptom – both in and near the bump itself, but also from the toes rubbing together.

Bunions are caused by an instability in the metatarsophalangeal (MTP) joint, located at the base of the toe where you see the bump. This instability causes the toe to gradually shift over time.

Conservative treatments can often be effective at addressing bunion pain, and can include padding, stretching, custom orthotics, and more accommodative footwear, among other options. In certain cases, however, bunion surgery might be the best or only way to significantly relieve symptoms.

Hallux Limitus

Hallux limitus also concerns the MTP joint at the base of the big toe. Unlike a bunion, however, the joint does not tend to shift. Instead, it becomes painful, stiff, and typically more difficult to bend over time.

Structural abnormalities, faulty biomechanics, and overuse are often responsible for hallux limitus. Left unaddressed, the condition can progress and become more difficult to treat. Arthritis may develop in the joint, and eventually the toe may barely be able to bend at all – a condition known as hallux rigidus. 

Conservative treatments for hallux limitus can include orthotics, shoe modifications, medications, and physical therapy. Surgery might be required in some severe cases.

Gout – Flares of Big Toe Pain

Gout is a form of arthritis in which excess uric acid forms crystals around a joint or surrounding tissue. Although this can feasibly happen in several joints, the joint of the big toe tends to be the most common location.

The most infamous symptom of gout is a sudden “flare” of pain that can occur in the joint. Pain tends to be intense, and the joint may become swollen and red. Symptoms tend to be most intense for a few hours after a flare, and may linger for days or weeks afterward.

Medication and dietary changes are typically the most effective way to treat gout and prevent future flares. In particular, it will be best to avoid foods high in purines, which the body breaks down into uric acid. Alcohols, red meats, and certain seafoods are among items that may need to be limited. Exercise and weight management are also important factors in limiting gout.

Sprains and Fractures

Trauma can of course lead to a big toe being in a lot of pain.

The big toe can become sprained, often referred to as “turf toe,” or fractures as a result of high impacts or sudden forces. 

If you do suspect a sprain or fracture in your toe, please do not delay in contacting us. It is a common thought that a broken toe cannot be treated, or doesn’t need a professional evaluation. While a fracture may heal on its own, ensuring that it does so properly can help prevent arthritis, chronic pain, and other complications in the future.

Sesamoiditis

There are two tiny bones right below the joint at the base of the big toe, known as sesamoids. They are not connected to anything else. Instead, they are embedded in the flexor tendon, and act as pulleys of sorts to help the toe in its movement. 

Sesamoiditis occurs when one or both bones become fractured or otherwise injured. This can cause both pain and difficulty bending the toe.

Rest and cushioning should provide enough opportunity for sesamoiditis to heal properly. Identifying and addressing the factors that led to excess stress being placed on the sesamoids can also help prevent the condition from happening again.

Do Not Wait to Treat Any Causes of Big Toe Pain

There are many ways that your big toe can be in pain, but all of them have at least one thing in common: waiting to effectively treat them does you no good. In fact, it can lead to even longer-lasting pain and further complications.

No matter what the situation is, we’ll always be happy to see you, get to the root of the problem, and recommend the best ways to help you find relief. Call us at (516) 541-9000 or fill out our online contact form.