Why Does My Big Toe Hurt?

James W. Rust
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Something I often see as a podiatrist in Ormond Beach are toe injuries in athletes.  For being such small digits, toes can really affect an athlete’s ability to play.  In the news recently many athletes have been suffering from toe injuries, including Pierre Garcon (Washington Redskins) and Bart Scott (New York Jets).  A common condition affecting toes of athletes and nonathletes alike is hallux limitus.  Hallux is the medical term for the first or big toe.  Hallux limitusis a disorder characterized by progressive limited or loss of motion, particularly upward motion of the big toe.  Without the necessary range of motion of the big toe, propulsion forward during walking is difficult so the foot will have to propel itself forward with other mechanisms.  The condition is progressive and in time the cartilage covering the joint will degenerate leading to arthritis of the first toe joint.

Since hallux limitus is progressive symptoms vary depending on the degree of severity.  People with hallux limitus may experience pain particularly when walking.  Activity may become more difficult.  There also may be tension and swelling around the big toe.  Over time, there may be bony growth that develops on top of the big toe joint.  Degeneration of the cartilage will lead to arthritis like symptoms.

Hallux limitus can be caused by a number of factors including genetics and trauma.  A long first metatarsal or a short second metatarsal can be biomechanical causes.  Hallux limitus can also be due to overuse.

As far as treatment, conservative treatment includes accommodating shoes that may have a wider and deeper toebox.  As well, orthotics can be custom manufactured with modifications like a Morton’s extension.  Steroid injections and NSAID’s can be used for pain relief.  If conservative treatment is not sufficient then surgery would be suffering with a toe injury, it is important that you get it checked as quickly as possible. Contact Atlantic Foot & Ankle Associates for an immediate evaluation. 

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