Every time you stand or walk, you’re putting pressure on your big toe joint. If the joint hurts, it may interfere with your comfort and mobility.

Big toe joint pain may develop gradually or suddenly, caused by any number of conditions. Podiatrists can diagnose the cause, then offer treatment.

“Seek a doctor if you’re having big toe joint pain, because there could be a variety of reasons causing it,” says foot and ankle surgeon Sara Mateen, D.P.M.

These conditions may cause big toe joint pain:

Arthritis

Arthritis of the big toe joint is often caused by age-related wear and tear. Sometimes, a structural abnormality or a traumatic injury is responsible for the pain.

“If there’s damage to the cartilage in the big toe joint, patients can develop arthritis in the joint,” Dr. Mateen says.

Many people manage arthritic big toe joint pain without surgery. 

“They can wear orthotics or accommodative shoe gear, take anti-inflammatory drugs or get a corticosteroid injection,” Dr. Mateen says. “Sometimes, physical therapy helps.”

Surgery may remove bone spurs, resurface cartilage or fuse bones at the affected joint.

Bunions 

A bunion is a painful, bony growth that develops at the big toe joint. It forms when the big toe gets pushed against the second toe.

“Commonly, it’s a genetic predisposition,” Dr. Mateen says, “but sometimes, improper shoe gear can lead to bunion deformity.”

Non-invasive treatments may decrease discomfort, but only surgery can remove a bunion.

“In terms of conservative, non-operative treatments, it would be accommodative shoe gear, orthotics, bunion splints or toe padding,” Dr. Mateen says.

Bunions worsen over time, so they should be removed when they become too painful. Minimally invasive surgery may be an option.

Gout

Gout is a type of arthritis that frequently affects the big toe joint. It causes significant pain, redness and swelling.

Gout is caused by high levels of uric acid. People who consume lots of red meat, seafood and alcohol may be at risk.

A podiatrist or primary-care physician can diagnose gout.

“We first rule out infection,” Dr. Mateen says. “We can then do a needle biopsy of the joint fluid and look at uric acid levels.”

Primary-care physicians provide long-term management of gout patients. The doctors may make dietary recommendations and prescribe medication.

“Gouty attacks will continue to happen if they’re not on proper medication,” Dr. Mateen says. “With medication, they’ll go away.”

Infections

Pain, redness and swelling isn’t always gout. Sometimes it’s a septic joint, an infection spread through the bloodstream.

“In immunocompromised patients like diabetics, if they have a wound in the area, it can lead to infection in the big toe joint,” Dr. Mateen says.

Patients may require antibiotics, plus a cleansing procedure.

“If it’s a septic joint, then they will have to be surgically washed out,” Dr. Mateen says. “It depends on the soft tissue around the big toe.”

Injuries

Sprains, strains and fractures often cause big toe joint pain.

“It’s common in athletes, but I also see it in older patients, if they stub their toe,” Dr. Mateen says. “In athletes, we call it turf toe, which can lead to major dislocation of the big toe joint.”

Sprains, strains and fractures are treated differently, but there are some similarities. Patients rest their injured foot and may need a boot or a surgical shoe.

Tendon Inflammation 

Overuse or injury of a big toe joint tendon may cause pain. However, it’s uncommon for only one tendon in the foot to be affected.

“In some rare cases, the tendons that cross over the big toe joint can cause discomfort,” Dr. Mateen says. “It’s a possibility after everything else is ruled out.”

Often, tendonitis is treated with rest, ice, compression, elevation and anti-inflammatory drugs. It’s rare for someone to need surgery.

Next Steps & Resources:

• Meet our source: Sara Mateen, D.P.M.
• To make an appointment with Dr. Mateen or a doctor near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.