What is Big Toe Arthritis?

Big toe arthritis occurs in the joint between the foot and the big toe (1st metatarsophalageal joint) and is known as hallux rigidus. It is commonly mistaken for a bunion (hallux valgus) as there is often a lump. Less commonly the joint closest to the nail (interphalangeal joint) is arthritic. The cause is unknown but may be the result of acute trauma or repetitive microtrauma to the joint. Anatomic variations of first metatarsal may play a role.

What are the Symptoms?

Arthritis is associated with pain and stiffness. The symptoms may come on gradually over months or years. In the big toe, pain may occur initially on the top of the joint but eventually is felt globally. It can be worse with push-off when walking or running. Pain is worse with activity but as the disease progresses can be present constantly. In women, stiffness can make it difficult to wear heels. These symptoms may affect your ability to walk, run, negotiate stairs and do your normal daily activities. Spur formation and swelling may make it difficult to wear shoes and cause numbness of the toe. In some cases pain may be felt under the ball further across the foot (transfer metatarsalgia) due to the abnormal functioning of the big toe.

What is the Treatment?

Non-surgical treatment in the early stages involves stiff soled shoes with wide and deep toe boxes.

Failing this, people usually benefit from surgical intervention to remove the spurs on the top of the joint in the early stages. In more advanced cases many types of joint replacement have been used over the years with varying success but fusion (1st metatarsophalangeal joint fusion) remains the gold standard.