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Big Toe Pain

Big Toe Pain


Pain in the big toe can be many things. However, a very frequent cause of big toe pain is a restriction of upward motion of the first toe joint in walking. Your big toe joint will feel sore in shoes, sometimes without shoes and mostly painful when you are walking or running.


The pain can come on immediately upon weight bearing activities or afterwards there may be a dull, aching or sharp pain in the joint. Sometimes there is swelling or redness of the joint and in some patients’,  there isn’t.


The medical term is hallux limitus and it can be caused by


  • injury
  • biomechanical factors
  • genetics
  • autoimmune disease or systemic arthritis




Often you will have pain in both big toes at the same time. If you are seeing a bump on the top of the joint its most likely a pain that will get worse as it progresses – increasing joint stiffness and increased pain is the usual course.


Once the problem becomes more involved, gait compensations can occur.







  • The first issue we will look at is changing your foot wear to something more supportive for your foot. A stiffer soled shoe is important to help reduce tension in the joint. A deeper toe box with an adjustable strap or lace across the midfoot will reduce any friction on the joint.


  • If your foot and ankle have restrictions we will aim to reduce these restrictions with foot and ankle mobilisations


  • A home exercise program to strengthen and improve the range of motion of your foot and ankle


  • Foot orthotics to reduce the internal compression in the big toe joint thereby improve pain and mobility


  • Shockwave treatment for cartilage repair and reduction of pain of the big toe joint


  • Steroid injection


Other causes of big toe pain are

  • Nerve entrapment
  • Ingrown nail
  • Tendinopathy
  • Infection
  • Sesamoiditis (small circular bones under the big toe joint)
  • Restricted blood supply
  • Muscle cramps
  • OCD (piece of bone or cartilage that has broken off and is in the joint)


The type of treatment you will be advised on depends on your age, activity levels and how restricted the big toe joint has become. The main aim of treatment is to reduce the pain and improve your quality of life so you can enjoy your favourite activities again.


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