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Hallux Limitus (Big Toe Joint Pain)

25
Jun
Big Toe Joint Pain (Hallux Limitus/Rigidus)
Big Toe Joint Pain (Hallux Limitus/Rigidus)
  • Stuart
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  • arthritis . Big toe joint pain . bunion . hallux limitus . hallux rigidus . hallux valgus .

Hallux limitus is a common cause of pain in the big toe joint.
(hallux meaning big toe & limitus meaning limited movement)

The big toe joint also is known as the 1st Metatarso-phalangeal joint (1st MTP joint) is made up from the long 1st metatarsal bone and the big toe known as the proximal phalanx of the hallux.  On the underside of the big toe joint, there are 2 small oval bones known as the sesamoids. (see here for a link to injury to the sesamoids)

The pain experienced from the big toe in hallux limitus is from a lack of movement from the joint, or forced movement to the joint or a mechanical jamming of the joint.

As the condition progresses, degeneration within the joint is seen with an increase of bony growth on the top of the joint known as an osteophyte.  In combination with this, the big toe often starts to turn upwards to help the big toe joint at the pushing off phase. Over longer periods of time, there is a reduction of the joint space and loss of cartilage from the ends of the bones which make up the joint.

Causes:

Injury to the big toe joint is common, usually dropping something heavy onto the joint or low-grade repetitive injury such as kicking objects such as martial arts. Genetics plays a role, as we inherit the shape of our feet. Long or short 1st metatarsals causes a mechanical change therefore leading to jamming of the big toe joint.

Footwear plays an important role, an unsupportive and non-cushioning shoe or high heels overload the big toe joint. Shoes are designed to bend at the level of the big toe joint. If a shoe is toe short or long this can affect the foot function when walking.

Being overweight is known to cause greater forces through the joint.

Findings:

Symptoms are described by patients as an aching type pain within the joint with stiffness. Pain is present when walking over cobbled ground or the bumps at the street crossings. Exercise that involves using the joint. Wearing heeled or un-supportive shoes are painful.

Diagnosis is based on clinical assessment and history. Imaging the area such as x-ray is helpful to assess the joint in different views.

Different Causes of symptoms:

Bunion (hallux valgus), Gout

Home Treatments:

Treatment is to reduce the stress and load going through the joint.

  • Rest from high impact activity or activity that causes the big toe joint to flex.
  • Wearing supportive good fitting shoes, avoiding high heels.
  • Ice pack for 10mins at the end of the day.
Clinical Treatments:
  • Clinical Assessment including assessment of your biomechanics.
  • Footwear Modification.
  • Orthoses or Insoles to reduce the load away from the joint.
  • Example of an orthosis

    In patients who experience ongoing symptoms referral for an injection or surgical assessment.

    To find a Podiatrist in your area, here is a link for the College of Podiatry

    Click Here to make Appointment

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