Big Toe Joint is Hurting – What Can Cause It?

Your big toe joint connects your toe to your foot, and it bears the brunt of the pressure from walking and running.  This joint is technically called the metatarsophalangeal (MTP) joint. It is a major part of the biomechanism that you use to push off on each step. Because it’s such a vital part of how you walk, any issues with it can be debilitating.

If your big toe joint is hurting, what can cause it? What can you do about it? There are many potential culprits for this condition. While there are some general solutions for the pain, you have to figure out the underlying cause before you can treat it effectively.

Causes

Injury

Injuring your toe is one of the most common causes for this kind of pain.

Turf toe is a widespread sports injury caused by excessive or repeated strain and impact on your toe joint. The tightness of your sports shoes, the hardness of the playing field’s surface, and the repetitive strain of running can all contribute to turf toe. It’s usually seen in athletes who exercise on a hard surface like AstroTurf, hence the name.

It is generally a sprain, which is when the ligaments in the joint become over-stretched or torn. Symptoms can include discoloration, swelling, and pain on the bottom of the toe joint. In order to treat it, you need to let the ligaments recover. Reduce stress on your MTP joint, and use a combination of elevation, ice, and rest to allow the ligaments to heal.

A stress fracture can also result from overuse of your toe, which can cause the entire toe to swell and hurt. This is easy to confuse with other forms of joint pain, and again it requires rest and recuperation in order to heal. In both cases, Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help with pain management while the injury heals.

Sesamoiditis

This condition results from overusing your toe, and it also is characterized by pain in the bottom of your toe joint, along with bruising, swelling, and loss of mobility. It is caused by inflammation in the sesamoid bones and their connective tendons, which sit below the MTP joint. The tendons support the movement of the joint, and so they can be damaged by overuse. The condition is most often seen in ballet dancers and runners.

Treatment focuses on reducing stress on the joint. Rest will allow it to heal, while special footwear and padding on the ball of your foot can be used when out and about to help reduce pressure on the joint. If you are over your recommended bodyweight, you may need to consider losing weight to reduce pressure on the joint.

Bunion

A bunion is a lump on the inside of the big toe joint. It is associated with a foot condition called hallux valgus, which causes the big toe to start pointing towards the smaller toes. It can be caused by rheumatoid arthritis, as well as by wearing shoes that are too tight at the front. The lump is actually the end of your toe bone poking in the wrong direction. The result is a pain in the joint, swelling, and a lack of mobility.

There are many ways to help treat a bunion, including:

  • Wear flat shoes that aren’t rigid and have space at the front to reduce pressure on the bunion.
  • Stretch the joint regularly to improve its mobility.
  • After exercise, apply an ice-pack wrapped in a cloth to the bunion for five minutes.
  • Losing weight can help by reducing pressure on the joint.
  • Cover the bunion with a bunion pad to reduce irritation and rubbing.
  • If it’s swollen and painful, NSAIDs can help manage the pain

Gout

Gout is a form of arthritis caused when high levels of uric acid build up in the bloodstream and then begin to crystallize in your joints. Uric acid is a waste product that is excreted in urine after passing through your bloodstream via the kidneys.

Gout normally starts with swelling and a sharp pain in the MTP joint. If left untreated, it can cause permanent joint damage, spread to other parts of your body, and can eventually result in lumps under the skin in the affected areas.

There are many ways to reduce your symptoms and to prevent a reoccurrence, such as:

  • Drink lots of water to help flush the uric acid from your system.
  • Elevate your foot.
  • Apply an ice-pack wrapped in a cloth for up to 20 minutes.
  • Keep your foot outside the bedcovers when you sleep to reduce pressure on it.
  • Lose weight if you are overweight or obese.
  • Avoid beverages and foods containing high-fructose corn syrup.
  • Increase your intake of vegetables and whole-grain foods.
  • Cut back on alcohol (especially beer), red meat, and seafood.

If the pain worsens, and you have a fever, then it is possible that you don’t have gout, but rather an infection in the joint. You should see a doctor immediately in this situation.

Osteoarthritis

Osteoarthritis is another form of arthritis that is caused by the cartilage in your joints wearing down. This can come from repeated wear and tear, as well as dislocation or a fracture. Eventually, the cartilage is eroded to such an extent that the bones in your toe and foot are directly rubbing against one another.

Typical symptoms include joint pain, inflammation, stiffness, and a grinding sensation. It can also result in a bony projection called a bone spur, which is similar to a bunion but occurs on the top of the joint rather than the inside of the foot.

It can be treated by physical therapy, anti-inflammatory medications such as NSAIDs, as well as wearing stiff-soled shoes, or shoes that specifically bend at the toes. In more severe cases, a steroid injection in the joint can reduce swelling and stiffness, and surgery may be required to remove the bone spurs.

Walk a Mile in These Shoes

When your big toe joint is hurting, what can cause it? The reasons include injury, chronic conditions, and general wear and tear. Most of the time, resting and painkillers, along with ice and elevation, can be enough for it to heal by itself. However, you may need to consider lifestyle changes such as wearing different footwear or losing weight, to help prevent your symptoms from reoccurring.

 

References

https://www.nhs.uk/conditions/foot-pain/toe-pain/
https://www.nhs.uk/conditions/bunions/
https://www.nhs.uk/conditions/gout/
https://www.nhs.uk/conditions/osteoarthritis/
https://www.kentcht.nhs.uk/wp-content/uploads/2016/12/Sesamoiditis-01003-v3.pdf

 

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