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

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What is osteoarthritis?

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, known as the first metatarsophalangeal joint, is a common site of OA.

What are the symptoms of OA in the toe?

Even in the early stages, arthritis in the toe can cause tenderness, achiness, and joint pain. You may also feel achiness or pain in other toes or the arch of your foot as you walk. Over time, you may even develop a burning sensation. An arthritic toe may ache 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.

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 each other. Your body will attempt to repair this by growing more bone. This creates 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. This is known as a bunion.

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 hammertoes, which are toes that are bent downward.

Causes of osteoarthritis

Your risk of OA increases as you age. This is mostly due to wear and tear. Your body becomes less able to heal damaged cartilage as you 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 occur due to a toe injury or deformity of the foot. Stiffness in the big toe generally begins between the ages of 30 and 60.

Home treatments

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. These lifestyle modifications may help you feel better, but they don’t stop the progression of OA.

Osteoarthritis treatments

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

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.

Your doctor can inject steroids directly into your joint. They can repeat this procedure if necessary. If OTC medications aren’t effective, your doctor may prescribe other medications.


In more severe cases, doctors can surgically remove damaged cartilage and fix the joint in a permanent position, which is called a fusion or arthrodesis. They can do this using a plate and screws, or wires. Some patients may benefit from joint replacement surgery, which is called an arthroplasty. Surgical options will depend on your activity level and whether your activities require motion of the metatarsophalangeal joint. Ask your doctor if you’re a good candidate for surgery if nonsurgical treatment doesn’t help.

Can you prevent osteoarthritis?

Follow these tips to help prevent OA:

Maintain a healthy weight

Maintaining a healthy weight can help prevent your joints from experiencing extra stress. The Arthritis Foundation says that for every 1 pound you gain, your knees have to support 4 extra pounds of stress. Over time, this extra stress will lead to the breakdown of your joints.

Maintain healthy blood sugar levels

People with type 2 diabetes are twice as likely to have arthritis. Recent research shows that high blood sugar can help the formation of molecules that cause cartilage to stiffen. People with diabetes also experience inflammation that can cause a loss of cartilage.

Stay in shape

Regular exercise helps to strengthen the muscles that support your joints. It also keeps your joints limber. Getting 30 minutes of physical activity five times per week can help prevent OA.

Take care of any injuries

You’re more likely to develop arthritis in joints that you’ve injured. Wear protective gear when you’re playing sports. Practice good lifting techniques when you’re carrying heavy objects.

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