Pain in the 1st metatarsophalangeal joint (1st MPJ), commonly known as the big toe joint, is a frequent issue due to its role as a weight-bearing joint. It endures constant stress and repetitive movement, making it prone to various conditions that cause pain, stiffness, and reduced mobility.
Let’s explore some of the most common causes of big toe joint pain and their treatment options.
Osteoarthritis (Big Toe Arthritis)
Cause:
Degeneration of the cartilage in the big toe joint leads to stiffness, pain, and a limited range of motion. This can make walking, running, and sports difficult.
Treatment:
✔ Physical therapy to improve joint function
✔ Footwear modifications for better support
✔ Orthotic therapy to reduce joint stress
✔ Foot mobilisation techniques to maintain movement
✔ Laser or shockwave therapy to promote healing
Turf Toe (Ligament/Tendon Sprain)
Cause:
A sprain of the ligaments around the big toe joint, often caused by hyperextension when pushing off forcefully, such as in running, football, or dancing. Common among athletes playing on artificial turf.
Symptoms:
✔ Pain, swelling, and limited movement
✔ Bruising around the big toe joint
✔ Acute trauma to the joint with activity
Treatment:
✔ Rest & immobilisation to allow healing and reduce damage
✔ Physical therapy to restore mobility and prevent recurrence
✔ Protective footwear or orthotics to reduce stress on the joint
✔ Laser therapy to promote healing
Bunion Pain (Hallux Valgus)
Cause:
A bunion is a misalignment of the big toe, creating a painful bump on the inner side of the joint. It often worsens with narrow footwear.
Treatment:
✔ Identifying the root cause of the bunion (e.g. the biomechanics of how you walk, genetics or a mixture of both)
✔ Footwear adjustments to reduce pressure on the big toe
✔ Orthotics to improve alignment and muscular activity around the joint
✔ Physical therapy to strengthen the joint and maintain mobility
Sesamoiditis (Sesamoid Bone Inflammation)
Cause:
Inflammation of the sesamoid bones, two small bones under the big toe joint that act as pulleys to reduce tendon stress. Poor foot mechanics or repetitive impact activities can cause irritation.
Treatment:
✔ Rest & activity modification initially to reduce pain/inflammation
✔ Footwear adjustments to reduce pressure through the sesamoid bones
✔ Orthotics for better foot mechanics to relieve stress on the sesamoid bones
✔ Physical therapy to strengthen surrounding muscles and reduce tension
✔ Laser therapy to stimulate healing and reduce inflammation
Gout
Cause:
Gout is caused by uric acid crystal buildup in the joint, leading to sudden, intense pain, redness, and inflammation. It often strikes at night, waking sufferers with severe discomfort in the big toe joint. The condition can stem from diet, genetics, or medical conditions like diabetes.
Treatment:
✔ Medications to manage inflammation and uric acid levels
✔ Lifestyle adjustments, including dietary changes
✔ Footwear modifications & orthotics to support the joint and reduce stress through the affected 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