Common Causes of Big Toe Joint Pain

Antonio Ruffoblog

The big toe joint, also known as the 1st metatarsophalangeal joint (1st MPJ) is a common location for both acute and chronic pain in the foot.

This is due to it being a weightbearing joint that can easily get put through excessive stress and repetitive motion which can result in multiple different pathologies.



  • This involves the degeneration of the protective cartilage and surrounding structures at your big toe joint, leading to stiffness and limited range of motion in the joint
  • The loss of protective cartilage can lead to pain and difficulty with activities such as walking, running and playing sport
  • Depending on the severity, treatment may involve physical therapy at the joint, footwear modifications/advice, orthotic therapy and foot mobilisations to reduce the degeneration occurring at the joint

Turf Toe

  • This is a sprain of the ligaments around your big toe joint
  • It typically occurs due to an acute hyperextension of the big toe (e.g. running from a standing start and pushing off your big toe excessively) or from repetitive pushing off the big toe in activities such dancing and sprinting
  • The name "turf toe" originated from the fact it often affects athletes who play on artificial surfaces
  • The symptoms often include pain, swelling, limited range of motion and sometimes bruising at the big toe joint
  • Treatment initially will include confirming the diagnosis and a period of rest and immobilisation before commencing physical therapy and establishing ways of protecting the toe to stop it happening again for you

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 visible and often painful bump is present on the inside of the big toe joint
  • This bump and misalignment can cause discomfort, pain and difficulty with footwear in particular with narrow shoes
  • Treatment can include diagnosing the cause of your bunion, footwear modifications, orthotic devices and physical therapy to reduce the continued misalignment of the joint


        • Sesamoiditis is a common foot condition that causes inflammation and irritation of the sesamoid bones, which are two small, pea-shaped bones located beneath the big toe joint
        • The sesamoid bones act as pulleys, providing leverage and relieving pressure on the tendons
        • However, excessive stress (e.g. poor foot biomechanics) or overuse/repetitive activities can lead to inflammation and pain in this area
        • Treatment may involve a period of rest/activity modification, footwear modifications or orthotics and physical therapy to help strengthen the surrounding muscles and reduce 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 will lead to sudden and severe episodes of pain, redness and inflammation which commonly occurs in the big toe joint
              • It begins with high uric acid levels in the blood and this can be due to genetics, diet or other medical conditions such as diabetes
              • Treatment includes short-term and long-term medications, lifestyle modifications, footwear modifications and possibly orthotics depending on the damage that has occurred at the big toe joint.

                    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