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Joint pain in the big toe is a common complaint during old age. People playing contact sports like rugby and football often experience big toe joint pain and swelling. Lack of rest or overuse of the feet are some of the common reasons behind big toe pain when walking. However, such a type of pain is not a cause of worry and goes away without any treatment.
Causes
Hallux Rigidus: Also, referred to as arthritis of the big toe, this condition is typically seen in the joint located in the ball of the foot. There are two joints found at the base of the toe and arthritis affects the larger joint. This joint connects the foot bone with the bone of the big toe. Besides, restricting the normal movement of the big toe, radiating pain from the affected toe is also experienced while walking or standing. This condition occurs in older people and is the result of wear and tear of joints.
Our joints are exposed to varying pressure during our day-to-day activities. Over time, this can have a negative impact on the joint strength. Joints are points, where two bones meet. At the end of each bone there is a covering of tough elastic tissue, known as cartilage. It prevents friction between bones. In arthritis, the cartilage gets eroded, leading to inflammation of the joints. When arthritis affects the big toe, it brings joint stiffness. The patient's inability to move the toe is distinctly visible. Swelling on the top of the big toe joint in the form of bony bump is also seen due to the development of hallux rigidus.
Bunions: Protrusion of a bony structure near the side of the big toe, is referred to as bunions. The enlargement of the bony structure that make the big toe inclined, is the result of inflammation of the bursa (a fluid filled sac that prevents rubbing between the bone and the tendons). A bump like appearance near the large toe joint is seen in people suffering from bunions. The skin around the bumpy area appears red and can cause considerably difficulty while moving the toe.
Injury: Injury to the big toe joint can also cause swelling and pain, thus limiting toe motion. Damage to the big toe joint predisposes a person to toe arthritis. Injury may damage the structure of the toe bone, which may lead to hallux rigidus. Sports like football, where in kicking the ball puts tremendous pressure on the foot, can bring joint problems in the big toe.
Gout: People suffering from gout often experience joint pain that in most cases affects the big toe. Gout is the result of too much uric acid in the bloodstream. This excess uric acid gets deposited in the joints, making them red and inflamed. The initial symptoms of gout are often noticed on the big toe and over time the joints of the knees, heels and wrists may also become inflamed. Too much intake of foods rich in purines (organic compounds that later metabolize into uric acid) is the primary contributory factor in the development of gout. Other factors that may trigger recurring gout attack are high blood pressure, physical injury and frequent use of diuretics.
Bone Marrow Edema: This condition usually resulting from an injury is typically marked by accumulation of fluid in the bone. When it affects the big toe bone, the abnormal build up of fluid causes noticeable swelling and excruciating pain. Apart from sports injury, medical conditions like rheumatoid arthritis and osteoarthritis can cause fluid to gather in the bone. Although there are different treatment methods, the condition heals slowly and so the person may take more than a year to resume his normal activities.
Treatment
Different treatment options exist to overcome this discomfort associated with big toe joint. Application of ice cubes on the affected part of the body can help to alleviate pain. Other treatment methods are given below:
Heat Therapy: A conservative form of treatment involves putting the affected area in a tub containing moderately hot water. This procedure can also help to relieve the pain associated with big toe joint.
Medications: Medicines that act as pain relievers for toe joint problems are ibuprofen. This is an anti-inflammatory drug that can work miracles to decrease the pain substantially.
Corticosteroids: When big toe pain does not respond to ibuprofen, corticosteroids injections may be administered to reduce the pain.
Buy Proper Footwear: Wearing the right shoes is necessary to manage the pain effectively. Shoes that have a small toe box will only contribute in worsening the pain. Purchasing shoes with a wide toe box, would certainly be a comfortable option. Shoes having thin soles can also worsen the pain. Thick soled shoes can help to reduce the strain on the big toe, while walking. Insertion of orthotic arch support is another shoe modification that can be helpful to decrease the discomfort.
Surgery: In case of bunions, surgical procedure involves, realigning or removing the affected bone structure. This may help to resolve the issue. For hallux rigidus, it all depends on the severity of the arthritis. A surgical procedure known as cheilectomy is commonly used in which the protruding bump is cut to restore movement of the big toe. In severe cases, few more bone cuts (osteotomy) are made to improve movement.
Gout sufferers are advised to make some dietary changes such as minimizing consumption of protein rich foods as they are high in purines. These simple modifications in the diet can go a long way in managing gout effectively. On the whole, treating the underlying cause of big toe pain at the right time is the key to normalize the function of the big toe. Taking necessary precautions such as staying away from ill-fitting shoes is a pre-requisite to alleviate the discomfort.