Do You Have Big Toe Pain? How A Chiropodist Can Help

What might be causing pain in your big toe? The most common causes of moderate to severe big toe pain include:

  1. Bunion
  2. Hallux Limitus and Hallux Rigidus
  3. Sesamoiditis
  4. Turf Toe
  5. Arthritis – causes big toe joint pain
  6. Gout – causes big toe joint pain

Other causes of big toe pain are ingrown toenailscorns and calluses, cuts, scrapes or bruises and blisters.

We do a thorough assessment of your feet to see what might be causing your big toe pain. We’ll look at how you stand and walk, check the range of motion in your joints, and see how your shoes fit. 

I’ll ask questions about your medical history, medications you’re on, or any surgeries you’ve had.

Does the pain in your big toe:

      • Slow you down?
      • Make it difficult to move around?
      • Limit your activities?
      • Reduce the types of shoes you can wear?
      • Create additional knee, hip or back pain?

Here are some of the most common problems that occur in your big toe.
You can also skip ahead for help on how we treat big toe pain.

1. Bunion

A common problem involving the big toe is the formation of bunions. A bunion is a large bump on the big toe joint. It is the most common cause of forefoot deformity, with an estimated prevalence of 23% to 35%. It is medically known as hallux valgus.

Bunions cause a shift in the position of the big toe, causing it to drift toward the other toes over time. The usual result of this is a widened forefoot and a red, irritated bump on the side of the big toe joint.

The redness and irritation are typically a direct result of footwear which puts undue stress on the soft tissues in this area. It also can cause symptoms on the inner edge of the foot, the sole and the small toes. Learn more about bunions.

At Custom Foot Clinic & Orthotic Centre, we provide non-surgical care of bunions to eliminate symptoms and halt or decrease the progression of the deformity of the big toe.

We make effective orthotics and orthopaedic shoes to rebalance diagonal directional forces, as well as use splints of different types to reshape the joints gently. We use physical or medication therapies to help ease pain and inflammation.

Make an appointment to get your bunion assessed and to see how we can help and if you are a candidate for treatment.

Bunion Treatment

References:
1. The Treatment of Hallux Valgus, Dtsch Arztebl Int. 2012 Dec; 109(49): 857–868.
2. Bunion, https://en.wikipedia.org/w/index.php?title=Bunion&oldid=912707988 (last visited Aug. 31, 2019).

2. Hallux Limitus and Hallux Rigidus

Hallux Limitus is a condition that limits the joint range of motion at the big toe joint, causing big toe pain.

In order for the feet to efficiently distribute pressure as we walk, a certain degree of flexibility is needed at the big toe joint. When the big toe joint locks up during gait, arthritis can develop in that joint, further limiting the range of motion.

Hallux Limitus may result in a bunion or a bump on the top side of the big toe joint. Typically Hallux Limitus makes it painful to walk with every step, and people often try to “alter their step” to take the pressure off of the big toe joint, but this often results in extra stress, pain and inflammation to other areas of the foot.

When the big toe joint becomes very stiff overall and is significantly limited in motion during walking, this is known as Hallux Rigidus and is another cause of big toe pain.

After a thorough assessment of your big toe, we might recommend anti-inflammatory medication or physical therapy to mobilize functional motion loss of the big toe joint. Custom orthotics may also help increase the big toe range of motion.

Make an appointment to get your big toe assessed for Hallux Limitus or Hallux Rigidus and to see what type of treatment you are a candidate for.

References:
1. Key Insights On Treating Hallux Limitus, Podiatry Today,
March 03, 2007, Volume 20 – Issue 3 – March 2007
2. Conservative Care Recommendations For The Stages Of Hallux Limitus/Rigidus, Podiatry Today, November 17, 2017, Volume 30 – Issue 12 – December 2017

3. Sesamoiditis

The sesamoid bones are two small bones that sit below the big toe joint and are embedded within a tendon. The sesamoid bones can be subject to pain and inflammation from acute or chronic trauma. 

The two major causes of sesamoiditis are chronic overload from long-standing overpronation and a sudden overextension injury during sport activities.

Occasionally significant physical stress can cause fracture of these tiny bones.  Sesamoiditis is often linked to activities that involve balancing on toes or jumping, such as ballet, volleyball, or basketball.

Make an appointment to get your sore toe assessed so we can help you start moving better.

Sesamoiditis Treatment

References:
1. Painful sesamoid of the great toe, . 2014 Apr 18; 5(2): 146–150.
2. Sesamoiditis: What you need to know, Medical News Today,
Last reviewed Fri 21 July 2017 By Rachel Nall, RN, BSN, CCRN

4. Turf Toe

Turf toe is a common sports-related injury, and like sesamoiditis, is characterized by pain on the bottom of the big toe joint.

The pain stems from a sprain, which is an injury or tear of a ligament. This most commonly happens when the toe joint becomes hyper-extended or bent back with excess force.

Quick movements which change position, such as in soccer or football, are often the culprits.

The name turf toe comes from the link between this injury and sports played on artificial turfs, such as football and soccer. The conditions of the hard turf, athletic shoes, and stress on the toe from running may all contribute to this injury.  

If you are experiencing pain in your big toe and have no existing medical conditions, you should consider seeking medical attention from a chiropodist foot specialist.

In almost all cases, diagnosing and treating an underlying condition or injury in its early stages can reduce your chances of progression leading to more debilitating long term complications.

Make an appointment to get your big toe assessed so we can help you feel better.

References:
1. What is turf toe and how do you treat it?, Reviewed by William Morrison, MD, Last reviewed Mon 22 October 2018
2. How to Treat Turf Toe Injuries, Volume 21 – Issue 9 – September 2008

5. Arthritis

The most common form of arthritis that affects the big toe joint is osteoarthritis, caused by wear-and-tear — with typical symptoms of joint pain and stiffness.

Osteoarthritis at the big toe joint may be caused by problems with foot structure and functioning (such as hallux limitus), resulting in excess wear-and-tear.

Trauma such as a fracture or dislocation of the big toe can also result in osteoarthritis. Other, less common types of arthritis that affect the big toe include rheumatoid arthritis and psoriatic arthritis.

Although there is no known cure for osteoarthritis, there are many ways we can help you ease the pressure on the affected joints and therefore reduce the pain and inconvenience.

Physical therapies, anti-inflammatory medication and custom orthotics can help redistribute the pressure as you walk. We can also advise you on the best type of shoes to wear for your exact problem.  

Make an appointment to get your big toe assessed and to see what type of treatment will help you move and feel better.  

References:
1. Interventions for treating osteoarthritis of the big toe joint, Cochrane Review, 8 September 2010
2. Osteoarthritis, The College of Podiatry, UK 

6. Gout

Gout is a metabolic condition associated with excess uric acid in the bloodstream that can affect the big toe joint. When uric acid forms crystals can deposit into joints—such as the big toe joint—an attack of acute gouty arthritis can occur.

Symptoms of gouty arthritis include a red, hot, and intensely painful joint. It is very sore to walk on and can last hours to days at a time. If gout attacks go untreated and occur repeatedly for a number of years, joint damage may occur.

Medications in combination with a healthy diet can help to control gout. If we assess your toe and suspect this might be the cause, we will refer you to your primary care physician. If you are unsure, please make an appointment for an assessment.

Gout Diagram

References:
1. Gout, Arthritis Society, Canada
2. What is Gout?, Arthritis Foundation, USA 

How We Treat Big Toe Pain

We perform a thorough assessment to determine the best treatment plan. It will depend on the cause and severity of your big toe pain. For example, if you suffer from gout you may need to make dietary changes or take gout medication.

If you have a bunion, you may need non-surgical treatment to offload and stabilize the joint and prevent progression of the deformity.

You may benefit from wider orthopaedic shoes or orthotics to control joint function.

Or you may benefit from over-the-counter anti-inflammatories or the RICE (Rest, Ice, Compression, Elevation) method may also help. This treatment is commonly used to relieve pain from acute injuries.

For moderate to severe pain, non-surgical methods prescribed are:

  • Prescription-strength anti-inflammatories
  • Medication
  • Stretching exercises performed routinely
  • Prescription pain medication
  • Corticosteroid injections
  • Physical therapy (such as laser or ultrasound therapy)

Not ready to book an appointment? Here are some tips to help you manage your big toe pain:

  • Wear shoes that fit you properly; offer support, balance, and stability; and have wide toe boxes.
  • Exercise your feet, ankles, and lower legs regularly to keep your muscles strong.
  • Seek medical and nutritional advice if you suffer from gout.
  • Drink plenty of fluids, especially during athletic activities.

If you find your own strategies to relieve your big toe pain aren’t working or you need professional guidance please ask me a question or book an appointment for a full assessment.

It is a good idea to see a chiropdodist foot specialist regularly especially if you spend a lot of time on your feet or have diabetes. Often the earlier your foot problem is assessed, the faster you will respond to treatment, and can get feeling better!

I am a registered chiropodist and foot care specialist and have been helping patients for over 20 years.

Are you uncertain about whether you should choose a chiropodist vs. podiatrist? Chiropodists and podiatrists provide the same care. There are 600 registered chiropodists in Ontario and only 60 podiatrists. The College of Chiropodists of Ontario stopped using the name podiatrist in Ontario in 1993, over 26 years ago — but the name is still used in other provinces in Canada, also USA and UK.

Chiropodists today must complete 7 years of post-secondary education. We do complete case management of foot problems, assessing and treating the entire foot and its complications.

Chiropodist Podiatry Foot Specialist Trina Scarrow Treating Feet

Chiropodist Trina Scarrow, BSc, DCh treating a patient with foot pain — for proper foot functioning and overall well-being.

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Are you ready to get your feet taken care of by an experienced foot care specialist and a professional chiropodist? I have two locations in Guelph and Milton.

I provide full biomechanical exams and gait analysis — I will be able to help address your foot discomfort by foot care treatment, custom orthotics and orthopaedic shoes, surgery, medication, laser or physical therapy.

Chiropodists and podiatrists are the only regulated health professions who have the ability to prescribe and provide custom orthotics as defined in the Regulated Health Profession Act of Ontario.

I want to help get your feet functioning better so you can feel better.