When pain in your big toe joint is making it tough to walk, you probably don’t need surgery to fix it! In fact, most people can find significant relief without ever going under the knife! Whether you’re dealing with arthritis, turf toe or hallux rigidus, this post will highlight proven non-surgical treatments that will get you back to your normal activities.
Causes of Big Toe Joint Pain ![feet with banadaged big toes]()
The big toe joint, technically called the first metatarsal phalangeal joint, is crucial for normal walking. Every time you take a step, the joint has to push upward to allow you to push off the ground. When it becomes stiff or painful, the joint affects your entire gait and can lead to problems throughout your body.
There are several different conditions that can cause big toe joint pain. These include:
Hallux rigidus, arthritis in the big toe.
The condition develops when cartilage in your big toe joint wears away, leading to bone-on-bone contact. The result is pain, stiffness and often formation of bone spurs. You may notice that your bone doesn’t bend up the way it used to, or develop a limp to avoid bending the joint. Progression typically follows a predictable pattern. It often starts with mild stiffness and occasional pain, particularly after activity. Over time, the joint becomes increasingly stiff and painful, and visible bumps may emerge due to bone spurs. In severe cases, the joint might be completely rigid.
Turf toe, a sprain of the ligaments around the joint.
First seen commonly in football players who played on artificial turf, this injury occurs when the big toe is forcefully bent upward beyond its normal range of motion, injuring the ligaments and joint capsule. It’s generally sustained during sports activities, but it can also be the result of stubbing your toe or other trauma. Symptoms include pain at the base of the big toe, swelling and difficulty pushing off when walking. Instead of developing gradually over time, turf toe typically has a sudden onset after an injury. Luckily, it responds well to conservative treatment when addressed properly.
Sesamoiditis...
Involving inflammation of the two small sesamoid bones located underneath the big toe joint. These bones are embedded in tendons to help the big toe function properly. When they become inflamed, usually due to repetitive stress or direct trauma, they can cause significant pain in the ball of your foot, beneath the big toe—people say it feels like you’re walking on a pebble. The pain is typically worse when pushing off on the big toe, and may be accompanied by swelling and bruising in the area.
Effective Non-Surgical Treatments to Relieve Big Toe Joint Pain
Regardless of the cause, there are several non-surgical treatment options we can use to relive pain in the big toe joint. The key is choosing the right combination of treatments for your specific situation.
First, you’ll want to modify your activities and footwear. Shoes play a crucial role in your big toe health, as pairs with a narrow toe box or high heel can compress the joint and worsen symptoms. Instead, look for shoes with a wide toe box that allow your toes to spread naturally. Good arch support and a slight heel elevation are also important features. If you have hallux rigidus, shoes with a rocker sole can be particularly helpful. These shoes have a curved sole that help you roll through your step without bending your toe as much.
Custom orthotics can be especially helpful for big toe joint pain, especially when the problem is related to abnormal foot mechanics. Orthotics work by controlling motion in your foot and redistributing pressure away from painful areas. For big toe joint problems, we often incorporate specific modifications like a Morton’s extension, which limits motion in the joint, or a dancer’s pad to redistribute pressure away from the sesamoid bones.
Physical therapy and specific exercises can help maintain joint mobility and strengthen the muscles around the big toe. Toe curls, marble pickups and gentle range of motion exercises can help keep the joint moving and reduce stiffness. Stretching the calf muscles is also important as tight calves can increase stress on the big toe joint.
Anti-inflammatory treatments can provide significant relief for many people with big toe joint pain. This includes both oral medications like ibuprofen or naproxen and topical treatments such as anti-inflammatory gels or Tolcylen transdermal CBD/CBG that we carry in the office. Ice therapy after activity can also reduce inflammation and pain.
For more persistent problems, injection therapy can be very effective. Corticosteroid injections provide significant pain relief and reduce the inflammation in the joint. Injections are performed in the office and can provide several months of relief.
Additional Ways to Relieve Big Toe Joint Pain
Advanced regenerative therapies such as platelet rich plasma (PRP) injections are showing promise for people with big toe joint conditions. PRP uses your body’s own natural healing factors to stimulate tissue repair and reduce inflammation. While more research is needed, early results are promising for some patients.
Taping techniques can provide immediate relief for certain causes of pain. Turf toe taping can be particularly effective for acute injuries or flare ups of certain conditions. We can teach you the right taping technique for your specific concern when we see you in the office.
If you have sesamoiditis, we can effectively use padding and offloading techniques. We can place special pads in your shoes to redistribute pressure away from the painful sesamoid bones.
Weight management can also help reduce big toe joint pain, as excessive weight increases stress on all the joints in your foot. Even a modest weight loss can significantly reduce joint stress and improve your symptoms.
Of course, activity modification doesn’t mean you have to give up all the activities you love—you just may need to change how you do them. For runners, you may need to switch to softer surfaces or temporarily reduce your mileage. Dancers may need to avoid moves that stress the big toe joint. But the most important move to make is to seek early intervention—by doing so, you can achieve long term relief from big toe joint pain without surgery. So contact our office today to reduce your risk for progression of your condition and lessen the chances of needing surgery.
