Ask the Podiatrist: What is this Pain in My Big Toe When Walking

A question we as foot doctors get often concerns pain in the big toe.  Big toe pain can be from a number of things, but there are a few 'usual suspects' that we diagnose most frequently.  Below, we're explain the difference between the more common reasons for big toe pain.


Big Toe Pain From Arthritis

A pretty common culprit of big toe pain is arthritis.  The most common place to get arthritis in the foot is at the base of the big toe in the metatarsophalangeal joint (MTPJ). The big toe is continually bending up and down as we walk making it prone to wear and tear. With arthritis, the cartilage that lines the MTPJ gets damages and osteophytes (small lumps of bone) form. This results in stiffening of the big toe, known as hallux rigidus. Common symptoms include big toe joint pain, especially during the push-off phase of walking, inflammation and stiffness limiting how much the big toe can bend up. A bunion may develop on the toe. Toe arthritis may be linked with foot injuries or episodes of gout, but often develops with no obvious cause. Treatment consists of pain relief, ice, steroid injections and orthotics such as a rocker bar which fit on the sole of your shoe so you don’t have to bend the toe up when walking. If symptoms get progressively worse, surgery may be required to either trim some of the bone, fuse the joint or replace it altogether with a prosthesis.


Big Toe Pain & Bunions

Bunions, also known as hallux valgus, are a common cause of big toe joint pain.  Gradually over time, the big toe shifts position with the top of the toe turning inwards, whilst the bottom of the toe starts to push outwards, forming a lump.  Bunions most commonly affect females and are often due to wearing ill-fitting shoes that squash the toes or genetic causes, or as mentioned above can be related to arthritis. If you have bunions, they're at least likely to be contributing to your toe pain!

Treatment options include stretching exercises, wearing toe spaces such as the yoga toe to stretch the toes apart, pain relief and in severe cases, surgery.  Visit our bunion surgeon & bunion surgery section to find out more about causes, symptoms, treatment and prevention.


Big Toe Pain & Gout

Gout is a common cause of big toe joint pain.  The classic symptoms are sudden, very intense pain, inflammation, redness, heat and tenderness.  Gout most commonly affects the big toe, known as podagra, but can affect any of the other toes. 

It is caused by high levels of uric acid in the body, produced as the body breaks down purines, a substance found in certain food and drink.  This leads to the formation of urate crystals which can collect in the toe joint and cause inflammation. Get in to see us quickly- the pain will be intense and you'll be glad to have a podiatrist on your side!

Big Toe Pain in Athletes

Athletes, especially those who play football and soccer, often get pain in their big toe.  This can be cause by turf toe, from hyperextending the toe, or tennis toe, from repeatedly bashing the toe into the front of your shoe (like during running and quickly stopping/changing direction while runnning). Both of these require rest and care to get your feet in the game again.


Ready to discover the root cause of your toe pain?  Schedule an appointment at our office!  We'd love to see you!

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