Table of ContentsView AllTable of ContentsSigns and SymptomsCauses and DiagnosisNonsurgical TreatmentSurgical TreatmentPrevention and OutlookFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Signs and Symptoms
Causes and Diagnosis
Nonsurgical Treatment
Surgical Treatment
Prevention and Outlook
Frequently Asked Questions
Our feet provide support and strength to our legs and play a crucial role in movement and function. Without healthy foot joints, muscles, and tendons, the entire foundation of our legs becomes compromised.
This article discusses symptom management and treatment options for osteoarthritis of the big toe.
Peter Dazeley / Getty Images
It’s estimated that nearly 40% of people in the United States have some issue with their feet.
One of the most common ailments affecting the foot is the development of osteoarthritis of the firstmetatarsophalangeal(MTP) joint, where the big toe connects with the rest of the foot. This is often referred to ashallux rigidus.
Osteoarthritis of the big toe can range from mild to severe and can cause symptoms such as:
Osteoarthritis progression of the first MTP can also lead to the development of abunion, also known ashallux valgus. This deformity causes a bony overgrowth on the side of the big toe. Often, the toe will start to turn toward the other toes, as opposed to being straight.
However, the most common cause of big toe pain is in fact osteoarthritis. OA, often referred to as wear-and-tear arthritis, can develop after injury or lifelong activity. In osteoarthritis, the healthy joint space begins to narrow, and the cartilage which cushions both bony ends of a joint starts to wear down.
Causes and Risk Factors of Osteoarthritis
Supportive Shoes and Orthotics
Shoe modifications and orthotics (custom-made shoe inserts) designed to limit MTP motion can be used to treat hallux rigidus.Wider toe boxes in shoes or rocker-bottomed shoes can help alleviate pressure from the big toe when walking and improve symptoms.
Apodiatrist(foot doctor) may be able to customize orthotic shoes to an individual based on their personal needs.
Weight Loss
Because the feet and legs quite literally support a person’s entire body weight, weight loss is an effective way to take extra pressure off of joints of the lower extremities.
Dietary modifications coupled with regular aerobic exercise is the most effective way to sustain long-term weight loss. While there are many diets, theMediterranean diet, which emphasizes fruits, vegetables, healthy fats, whole grains, and less meat and dairy, andanti-inflammatory dietsmay be most helpful to people with OA.
8 Foods to Avoid With Osteoarthritis
Big Toe Exercises
One of the biggest challenges of OA when it occurs anywhere in the body is that the pain and discomfort usually end up limiting a person’s range of motion, the measurement of movement of a joint.
However, the truth is that continued movement and exercise can actually help maintain near normal range of motion. Chronic stretching and exercise, when done properly, can help improve symptoms as well.
Big Toe ExercisesBig toe exercises can either be done at-home on your own or at a facility with the help of a physical therapist. Some recommended toe exercises to maintain or improve joint mobility and flexibility include:Toe pullsToe curlsMarble pickupResisted toe flexionLearn more about these toe exercises and morehere.
Big toe exercises can either be done at-home on your own or at a facility with the help of a physical therapist. Some recommended toe exercises to maintain or improve joint mobility and flexibility include:Toe pullsToe curlsMarble pickupResisted toe flexionLearn more about these toe exercises and morehere.
Big toe exercises can either be done at-home on your own or at a facility with the help of a physical therapist. Some recommended toe exercises to maintain or improve joint mobility and flexibility include:
Learn more about these toe exercises and morehere.
Medication
Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen), can be used to help alleviate the discomfort, pain, and stiffness associated with OA of the big toe.
NSAIDs can also reduce inflammation within the first MTP joint, further improving symptoms.
Steroid Injections
If the first MTP joint is swollen and red, anintra-articular (into the joint space) cortisone injectionmay provide some relief in symptoms.Corticosteroidsinjected directly into the joint space will work to decrease the inflammation present, thus reducing swelling, redness, and associated pain.
Injections can be performed at the office of a podiatrist,orthopedist(specialist in the musculoskeletal system, including joints and bones) orrheumatologist(specialist in arthritis and other musculoskeletal conditions).
Cheilectomy
For people with milder hallux rigidus (grades 1 or 2), a minimally invasive procedure known as acheilectomycan be performed to relieve symptoms. The procedure involves the removal ofdorsal osteophytes(bone spurson the top part of the metatarsal head).
The procedure is considered joint sparing, because it maintains the range of motion of the joint. It’s important to note that this procedure is considered a pain-relieving procedure, as it does not significantly improve the overall range of motion of the joint.
Causes and Treatment of Bone Spurs in Feet
Arthrodesis
Arthrodesisof the first MTP is currently considered the gold standard of treatment for severe osteoarthritis.
Arthrodesis consists of fusing the bones that make up the MTP joint, essentially eliminating the joint itself. This is an effective pain-eliminating and deformity-correcting procedure, however, it comes at the cost of loss of range of motion. With the joint being fused, a person who has undergone this procedure will longer be able to bend or extend their big toe.
Arthroplasty
Arthroplastyis a surgical procedure that aims to restore the function of the toe joint.
Unlike some other surgical options, arthroplasty decreases the amount of pain a person experiences without losing any range of motion. In some cases, arthroplasty may actually increase a person’s range of motion of the big toes.
This surgery has evolved throughout history from the use of silicone implants to metal implants to synthetic cartilage implants.
Synthetic Cartilage Implant
Most recently, synthetic cartilage implants have been introduced as a potential treatment option for OA of the first MTP.
A synthetic implant is placed at the head of the first metatarsal, restoring a smooth joint surface.
Long-term studies are underway, but initial results are promising.Since only a small amount of bone is removed in order for the implant to be placed, near normal length of the toe itself is maintained, which is not always the case with other surgical options.
While there is no way to prevent osteoarthritis from developing, several things can be done to delay the onset or slow the progression. These include:
Treating hallux rigidus is more effective if started when symptoms are mild. For people with severe symptoms and longstanding OA of the big toe, nonsurgical options may not be enough to provide adequate relief. More complex and sometimes limited surgical options may be needed.
Summary
Osteoarthritis of the big toe, also known as hallux rigidus, can cause pain, stiffness, and loss of joint mobility. Prognosis is good if symptoms are treated early.
There are numerous nonsurgical and surgical treatment options for hallux rigidus. Nonsurgical options include wearing supportive shoes and orthotics, big toe exercises, weight loss, steroidal medications, and NSAIDs. If necessary, surgical procedures like cheilectomy, arthrodesis, arthroplasty, and synthetic cartilage implants can be considered.
A Word From Verywell
If you are experiencing arthritic pain of the big toe, consult an orthopedic or arthritis specialist to discuss a diagnosis. Though symptoms may be minor, they can lead to severe pain and limited mobility. Several surgical and nonsurgical treatment options are available to provide symptom relief.
Frequently Asked QuestionsSigns of arthritis in the toes include pain when walking, joint stiffness, and sometimes swelling of the joints.Learn MoreWhat Is Arthritis in the Toes?Walking with proper footwear or orthotic inserts is good for osteoarthritis of the big toe. Walking can aid in weight loss, which takes some of the strain off joints and keeps joints mobile. However, walking without proper footwear may lead to more damage to the foot joints, so be sure to consult with a podiatrist or orthopedic specialist for recommendations.Massage may provide some relief in arthritic pain, particularly if there is strain to some of the supporting muscles, tendons, or ligaments of the feet.Trauma, repetitive motions, and excessive walking with improper footwear are a few circumstances that may trigger flare-ups (times when symptoms increase) of big toe arthritis.Learn MoreHow to Manage Arthritis Flare-Ups
Signs of arthritis in the toes include pain when walking, joint stiffness, and sometimes swelling of the joints.Learn MoreWhat Is Arthritis in the Toes?
Signs of arthritis in the toes include pain when walking, joint stiffness, and sometimes swelling of the joints.
Learn MoreWhat Is Arthritis in the Toes?
Walking with proper footwear or orthotic inserts is good for osteoarthritis of the big toe. Walking can aid in weight loss, which takes some of the strain off joints and keeps joints mobile. However, walking without proper footwear may lead to more damage to the foot joints, so be sure to consult with a podiatrist or orthopedic specialist for recommendations.
Massage may provide some relief in arthritic pain, particularly if there is strain to some of the supporting muscles, tendons, or ligaments of the feet.
Trauma, repetitive motions, and excessive walking with improper footwear are a few circumstances that may trigger flare-ups (times when symptoms increase) of big toe arthritis.Learn MoreHow to Manage Arthritis Flare-Ups
Trauma, repetitive motions, and excessive walking with improper footwear are a few circumstances that may trigger flare-ups (times when symptoms increase) of big toe arthritis.
Learn MoreHow to Manage Arthritis Flare-Ups
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ho B, Baumhauer J.Hallux rigidus.EFORT Open Rev. 2017;2(1):13-20. doi:10.1302/2058-5241.2.160031Hunter DJ, McDougall JJ, Keefe FJ.The symptoms of osteoarthritis and the genesis of pain.Rheumatic Disease Clinics of North America. 2008;34(3):623-643. doi:10.1016/j.rdc.2008.05.004Centers for Disease Control and Prevention.Osteoarthritis.Arthritis Foundation.Mediterranean diet for osteoarthritis.Koutsouradis P, Savvidou OD, Stamatis ED.Arthrodesis of the first metatarsophalangeal joint: The “when and how”.World J Orthop. 2021;12(7):485-494. doi:10.5312/wjo.v12.i7.485Johns Hopkins Medicine.Arthroplasty.Smyth NA, Murawski CD, Hannon CP, Kaplan JR, Aiyer AA.The use of a synthetic cartilage implant for hallux rigidus: a systematic review.Foot & Ankle Specialist. 2021;14(4):366-371. doi:10.1177/1938640020937160
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ho B, Baumhauer J.Hallux rigidus.EFORT Open Rev. 2017;2(1):13-20. doi:10.1302/2058-5241.2.160031Hunter DJ, McDougall JJ, Keefe FJ.The symptoms of osteoarthritis and the genesis of pain.Rheumatic Disease Clinics of North America. 2008;34(3):623-643. doi:10.1016/j.rdc.2008.05.004Centers for Disease Control and Prevention.Osteoarthritis.Arthritis Foundation.Mediterranean diet for osteoarthritis.Koutsouradis P, Savvidou OD, Stamatis ED.Arthrodesis of the first metatarsophalangeal joint: The “when and how”.World J Orthop. 2021;12(7):485-494. doi:10.5312/wjo.v12.i7.485Johns Hopkins Medicine.Arthroplasty.Smyth NA, Murawski CD, Hannon CP, Kaplan JR, Aiyer AA.The use of a synthetic cartilage implant for hallux rigidus: a systematic review.Foot & Ankle Specialist. 2021;14(4):366-371. doi:10.1177/1938640020937160
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ho B, Baumhauer J.Hallux rigidus.EFORT Open Rev. 2017;2(1):13-20. doi:10.1302/2058-5241.2.160031Hunter DJ, McDougall JJ, Keefe FJ.The symptoms of osteoarthritis and the genesis of pain.Rheumatic Disease Clinics of North America. 2008;34(3):623-643. doi:10.1016/j.rdc.2008.05.004Centers for Disease Control and Prevention.Osteoarthritis.Arthritis Foundation.Mediterranean diet for osteoarthritis.Koutsouradis P, Savvidou OD, Stamatis ED.Arthrodesis of the first metatarsophalangeal joint: The “when and how”.World J Orthop. 2021;12(7):485-494. doi:10.5312/wjo.v12.i7.485Johns Hopkins Medicine.Arthroplasty.Smyth NA, Murawski CD, Hannon CP, Kaplan JR, Aiyer AA.The use of a synthetic cartilage implant for hallux rigidus: a systematic review.Foot & Ankle Specialist. 2021;14(4):366-371. doi:10.1177/1938640020937160
Ho B, Baumhauer J.Hallux rigidus.EFORT Open Rev. 2017;2(1):13-20. doi:10.1302/2058-5241.2.160031
Hunter DJ, McDougall JJ, Keefe FJ.The symptoms of osteoarthritis and the genesis of pain.Rheumatic Disease Clinics of North America. 2008;34(3):623-643. doi:10.1016/j.rdc.2008.05.004
Centers for Disease Control and Prevention.Osteoarthritis.
Arthritis Foundation.Mediterranean diet for osteoarthritis.
Koutsouradis P, Savvidou OD, Stamatis ED.Arthrodesis of the first metatarsophalangeal joint: The “when and how”.World J Orthop. 2021;12(7):485-494. doi:10.5312/wjo.v12.i7.485
Johns Hopkins Medicine.Arthroplasty.
Smyth NA, Murawski CD, Hannon CP, Kaplan JR, Aiyer AA.The use of a synthetic cartilage implant for hallux rigidus: a systematic review.Foot & Ankle Specialist. 2021;14(4):366-371. doi:10.1177/1938640020937160
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