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To you, it’s the big toe. But in anatomy, it’s known as the hallux, and it’s a common source of foot pain for many people.

When most of us think of big toe pain, we probably think of bunions, those unsightly lumps that appear along the side of the big toe when the toe joint is pushed outward from its normal alignment.

But bunions are just one problem that causes pain in the big toe. At Next Step Orthopedics, Dominique Nickson, MD, and his team treat various foot pain issues, including two other causes of big toe pain, hallux varus, and hallux rigidus.

Big toe anatomy

The big toe has two joints: one close to the tip of the toe near the nail bed and one nearer to the main part of your foot (the metatarsophalangeal joint or MTP joint). This second joint joins the bones of your big toe to one of the middle bones of your foot (called the first metatarsal).

Most big toe problems occur at the MTP joint, where the toe meets the foot. That’s because this joint is subjected to a lot of pressure when walking. It’s also where a lot of flexing occurs every time you push off when you take a step.

Located on the outside of your foot, the big toe joint is also subjected to pressure from the sides of your shoes. Footwear is a common cause of bunions, and it can also increase painful symptoms associated with hallux varus and hallux rigidus.

Hallux varus: Symptoms and treatments

Hallux varus is a condition where the big toe curves away from the rest of your foot. This condition occurs most commonly after bunions surgery, but it can also be caused by an injury or an underlying inflammatory disease, like rheumatoid arthritis. Less often, hallux varus can be present at birth.

The most common symptoms of hallux varus include:

  • Joint stiffness and decreased mobility
  • Weakness around the toe joint
  • Pain when walking or when standing for long periods
  • Swelling around the joint
  • Ingrown toenails
  • Problems finding footwear that fits

When the curvature is mild, conservative treatments can be very effective. That includes treatments like:

  • Therapeutic exercise
  • Splinting or taping the toe
  • Medicine to reduce pain and inflammation
  • Wearing shoes with wide toe areas

If these treatments don’t correct the deformity over time, Dr. Mickson may recommend surgery to reposition the toe and restore normal function and range of motion.

Hallux rigidus: Symptoms and treatments

Hallux rigidus is a painful condition caused by arthritis. As its name implies, hallux rigidus causes the big toe to become stiff and inflexible. Like many types of arthritis, hallux rigidus is more common with age, affecting about 1 out of every 40 people over 50, according to the American Orthopaedic Foot & Ankle Society.

In addition to painful stiffness around the toe joint, hallux rigidus can cause symptoms like:

  • Pain when walking or putting pressure on the toe
  • Painful bump or lump on the joint
  • Problems flexing or moving the joint
  • Pain when resting (in more severe cases)

Hallux rigidus symptoms can often be relieved with conservative treatment options aimed at reducing pain and inflammation. These options might include:

  • Using ice or heat on the joint
  • Medications to reduce pain and swelling
  • Using prescription orthotics to support the joint
  • Joint injections to reduce inflammation

If these options don’t provide adequate relief for pain and stiffness, surgery might be considered to repair the joint, remove painful bone spurs, or immobilize (fuse) the joint.

Big toe pain can interfere with the activities you enjoy, and if you ignore your symptoms, they’re likely to get a lot worse. Dr. Nickson and his team are skilled in treating various foot pain issues, including problems involving the big toe. To learn how he can help you, call us at (972) 547-0047 or book an appointment online.

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