Osteoarthritis of the Big Toe: Symptoms, Causes, and Treatments

Written by Ann Pietrangelo | Published on March 12, 2014
Medically Reviewed by George T. Krucik, MD, MBA on March 12, 2014

Osteoarthritis Overview

Osteoarthritis (OA) is the most common type of arthritis, and it can affect joints anywhere in the body. When cartilage in the joints wears down, bones become exposed and rub against each other. This causes swelling and pain in the joint and can limit your range of motion.

OA generally starts slowly, but worsens over time. The base of the big toe (first metatarsophalangeal joint) is a common site of OA.

Read on to learn more about symptoms and treatment for OA of the big toe.

Symptoms: Aches, Pains, and Stiffness

Even early on, arthritis in the toe can cause tenderness, achiness, and joint pain. You may also feel achiness or pain in other toes or in the arch of your foot as you walk. Over time, you may even develop a burning sensation. An arthritic toe may be achy after long periods of sitting, or when you first wake up in the morning.

Overgrowth of the big toe bone can make it difficult or even impossible to bend your toe. This results in a stiff toe, also called hallux rigidus.

Symptoms: Changing Appearance

Arthritis causes inflammation, so you’ll probably notice some swelling around the joint of your toe. Damaged cartilage causes bones to rub against together. In time, this can cause bony protrusions called bone spurs.

You may be unaware of bone spurs until you develop a visible bump or callus on your toe. As the big toe changes, it can start to push against the other toes, causing the joint at the base of the big toe to become enlarged (bunion).

Symptoms: Difficulty Walking

Walking can be a problem if you can’t bend your big toe. If you don’t already have bunions, the imbalance in the way you walk can make them more likely to develop. As you walk, bunions push against your shoes, causing your big toe to push against your other toes. This makes walking painful. Over time, bunions can lead to corns, calluses, and hammer toes (toes that are bent downwards).

Causes of Osteoarthritis

The risk of OA increases as you age, due mostly to wear and tear. Our bodies become less able to heal damaged cartilage as we grow older. You’re more likely to develop OA if you have a family history of it, or if you’re obese.

Hallux rigidus also may be the result of a toe injury or deformity of the foot. Stiffness in the big toe generally begins between the ages of 30 and 60.

Self-Help Measures

Over-the-counter (OTC) pain relievers and anti-inflammatories can help lessen pain and swelling. Placing ice packs on the toe can offer temporary relief.

Choosing the right footwear can make a big difference. High heels, tight shoes, and pointy-toed shoes can encourage the formation of bunions. You may also benefit from inserts or arch supports.Always allow plenty of room for your big toe.

Extra weight adds stress to the bones of your feet, so pay attention to your diet and get regular exercise. While these lifestyle modifications may help you feel better, they unfortunately don’t stop the progression of OA.

Treatment

Your doctor will probably take an X-ray of your foot to look for bone spurs and assess degeneration of the joint. They may recommend custom-made insoles or shoes that have stiff soles and a rocker bottom.

Your doctor or physical therapist can show you how to perform stretches and exercises for your feet. In some cases, a splint or brace may be helpful. A walking cane can help you feel more stable.

Steroids can be injected directly into the joint, a procedure that can be repeated, if necessary. If OTC medications aren’t effective, other prescription medication may be recommended. 

Surgery

In more severe cases, damaged cartilage is removed surgically and the joint is fixed in a permanent position with pins. Some patients may benefit from joint replacement surgery. Surgical options will depend on the severity of your condition. Ask your doctor if you’re a good candidate for surgery if non-surgical treatment doesn’t help.

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