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
- 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
- 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.