Pain that is centered around the big toe joint is a very common problem that we see. There are several common causes of this, and the good news is, they are very treatable to help with the pain if you are suffering from this.
The most common reason we see pain around the big toe joint is a bump that forms on the big toe joint called a bunion. These do typically get worse over the years, but we do see them develop even in children. They make shoe fitting difficult, and they pinched a nerve around the side of the big toe joint that causes pain. If wearing wider shoes and padding over the area does not help, there are several different types of surgical procedures that can help correct the deformity and alleviate the pain.
The next most common reason we see pain within the big toe joint region is from arthritis. This can be caused after trauma or from things like rheumatoid arthritis, but the most common reason we see this develop is osteoarthritis which is simply from wear and tear use over the years. If the arthritis is caught early enough, anti-inflammatories, shoe modifications, and orthotics can be helpful. If it has progressed further, things like cortisone injections or surgery to remove bone spurs can be helpful. In the end stage development of arthritis surgical procedures such as joint fusions or joint replacements can be helpful to alleviate pain.
Another common reason we see pain around the big toe joint is from a gout flare. Gout occurs when uric acid builds up in the body and this can happen as patients get older due to decreased kidney function. This typically presents as a red, hot, swollen and painful joint, and it can also be related to a high purine diet, although this is not always the case. Diet modification can be helpful for this, but in the acute flare setting either using medications such as colchicine and indomethacin or cortisone injections are typically the most helpful. If the flares continue to be problematic and occur, allopurinol and other medications can be helpful to lower uric acid in the body and prevent flares from recurring. It is important to treat this and get it under control, because if you let flares continue to happen over the years, arthritis will eventually develop within the joint.
One other common reason to get pain around the big toe joint is sesamoiditis. Sesamoiditis occurs when 2 bones which sit underneath the big toe joint become inflamed. These bones are normal, and almost all patients have 2 sesamoid bones, but it is pretty common to either have them become inflamed and painful, or for patients to develop fracturing within 1 of these bones. Rocker-bottom type tennis shoes and orthotics can be helpful to offload this area and sometimes immobilization in a Cam walker boot is necessary. If it becomes a more chronic problem there are surgical options for this as well.
If you are suffering from any foot and ankle pain, call your expert Colorado Springs podiatrists and foot and ankle surgeons today at Foot and Ankle Institute of Colorado at 719-488-4664!
