Common foot complaints

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Big toe joint pain

Disorder
Big toe joint pain (most commonly hallux limitus / hallux rigidus)

Definition
There are many different causes of big toe joint pain. If the pain has developed over some years with increased joint stiffness or a grinding feeling, it is most likely arthritis (hallux limitus). However if the onset is more rapid, follows a trauma or is associated with inflammation about the joint, problems with other joints or changes in general health it is essential that you see a health care professional for advice. However as stated the most common cause of big toe joint pain is hallux limitus which is what will be discussed.

Incidence / Age
Incidence increases with age, rare in those under 20 years of age without a history of trauma or previous inflammatory joint disease. 

Symptoms / Signs
In hallux limitus (which is a form of osteoarthritis) common symptoms include pain in the great toe joint following increased levels of activity, which eases with rest. There may well be a limitation in motion within the big toe joint or when moved a grinding sensation is experienced (crepitus).

If there are inflammatory changes, pain in other joints or general health changes that occur at the same time as the big toe joint pain, the pain is less likely to be the result of osteoarthritis and more likely to be due to a systemic disease process or infection. Any of these signs and symptoms should prompt you to see a health care professional ASAP.

Self treatment
If you have pain in the big toe joint that lasts for more than 24 hours or recurs, it is best not to self treat, but to see a health care professional. However in the first instance you should rest your foot and take analgesics, as you would for a head ache. It is essential that the cause of the pain is established so the problem can be treated effectively.

Clinical and surgical treatments
If the big toe joint pain is the result of hallux limitus (osteoarthritis) the most effective treatment will depend on the severity of the degenerative change that has occurred within the joint.

If caught early enough, an orthotic can be used to help the joint function more effectively, as often it is abnormalities of function that predispose to degenerative change. However as the joint stiffens and degenerates treatment ranges from injection therapies, mobilisation of the joint, surgical realignment and decompression to total joint fusion or replacement. Great toe joints can now, if necessary, be replaced with an implant which reduces pain and allows a better range of movement than prior to operation.

Outcome / Prognosis
Diagnosis of the cause of big toe joint pain is the key. However it is fair to say that treatments are now available to address most of the common causes of big toe joint pain effectively, allowing those who suffer from such pain to return to there usually daily activities with no detriment. 

Recommended links
http://www.feetforlife.org

 

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Great Toe Pain - Common Foot Complaints - Birmingham Foot Clinic