Why Does My Big Toe Joint Hurt?

Antonio Ruffoblog

The 1st metatarsophalangeal joint (1st MPJ), commonly referred to as the big toe joint, often experiences acute and chronic pain in the foot.

This is often attributed to its role as a weight-bearing joint, subject to significant stress and repetitive movement, leading to various foot pathologies that we will discuss below.



  • Degeneration of protective cartilage and nearby structures in the big toe joint leads to stiffness and limited range of motion.
  • Loss of protective cartilage can cause pain and difficulty with activities like walking, running, and sports.
  • Treatment approaches, depending on severity, may include:
    • Physical therapy targeting the affected joint
    • Recommendations for footwear modifications
    • Orthotic therapy to support the joint
    • Foot mobilization techniques aimed at reducing degeneration in the joint
    • Laser or shockwave therapy to induce healing at the joint

Turf Toe

  • Sprain of the ligaments around your big toe joint
  • It typically arises from acute hyperextension of the big toe, such as forcefully pushing off during activities like running or dancing
  • The term "turf toe" stems from its common occurrence among athletes playing on artificial surfaces
  • Symptoms often encompass pain, swelling, limited range of motion, and occasionally bruising at the big toe joint
  • Treatment initially involves confirming the diagnosis, followed by a period of rest and immobilization. Subsequently, physical therapy is initiated, along with strategies to prevent recurrence and protect the joint

Bunion Pain

  • Hallux valgus, commonly known as a bunion, is a condition that affects the alignment of the big toe and the joint at its base
  • A noticeable and often painful bump forms on the inner side of the big toe joint
  • This misalignment and bump can cause discomfort, pain, and difficulty with narrow footwear
  • Treatment strategies may include: Identifying the root cause of the bunion, making adjustments to footwear, using orthotic devices, engaging in physical therapy to protect the joint and maintain its strength


        • Sesamoiditis: This foot condition triggers inflammation and irritation of the sesamoid bones, two small, pea-shaped bones situated beneath the big toe joint.
        • The sesamoid bones serve as pulleys, offering leverage and easing pressure on the tendons
        • Undue stress, such as poor foot biomechanics, or repetitive activities can induce inflammation and discomfort in this region.
        • Treatment methods might entail rest or modifying activities for a certain period, adjusting footwear or using orthotic devices to remove stress from the area and engaging in physical therapy to fortify surrounding muscles and alleviate stress on the sesamoid bones.


              • Gout is a type of inflammatory arthritis characterised by the accumulation of uric acid crystals in the joint
              • Gout attacks cause sudden and intense episodes of pain, redness, and inflammation, often affecting the big toe joint
              • It typically starts with elevated uric acid levels in the blood, which can stem from genetics, diet, or underlying medical issues like diabetes
              • Treatment options encompass short-term and long-term medications, lifestyle adjustments, footwear modifications and potentially using orthotic devices, depending on the extent of damage to the big toe joint to protect the area

                    The best time to see your Podiatrist is in the early development of symptoms. Take your first step back to pain free and book in for an appointment with one of our experienced Podiatrists today!

                    Useful Links

                    Read more about other types of toe and forefoot pain and how we use our biomechanical assessments to diagnose your condition