What to Know About Managing Big Toe Pain and Stiffness

Big toe arthritis is a common and often painful condition that can make walking, standing, or even fitting into shoes difficult. As the cartilage in the big toe joint wears down, it leads to stiffness, swelling, and decreased mobility. Knowing the causes, symptoms, and available treatments can help you manage big toe arthritis and protect your long-term mobility.

What is Big Toe Arthritis?

Big toe arthritis, medically known as hallux rigidus, is arthritis in the first metatarsophalangeal (MTP) joint. This is the joint where the big toe meets the foot, and it plays a critical role in walking and pushing off during movement.

In hallux rigidus, the protective cartilage that cushions the joint gradually wears away. As this happens, bone rubs against bone, leading to inflammation, stiffness, and pain. Over time, the joint may become rigid or develop bone spurs that make movement even more difficult.

Causes of Big Toe Arthritis

The most common causes of big toe arthritis include:

• Osteoarthritis (wear and tear) – Degenerative arthritis that worsens with age and repeated use. Often begins in people over 40.
• Previous trauma – A fracture, sprain, or repeated stress to the big toe joint can damage cartilage and lead to arthritis.
• Foot structure issues – Flat feet, bunions, or abnormal walking patterns may increase stress on the big toe joint.
• Inflammatory arthritis – Conditions like rheumatoid arthritis or psoriatic arthritis can affect the MTP joint.
• Gout – A type of arthritis caused by uric acid crystal buildup, often beginning in the big toe.

Knowing the root cause of your big toe arthritis will guide treatment and prevent future flare-ups.

Symptoms of Big Toe Arthritis

Big toe arthritis often develops slowly. Common symptoms include:

• Pain and stiffness in the big toe, especially during walking or standing
• Difficulty bending the toe upward
• Swelling and tenderness around the joint
• A bump or bone spur on top of the toe
• A grinding or clicking sensation in the joint
• Pain when wearing tight or hard-soled shoes

Over time, the toe may lose most of its motion, making daily activities more difficult.

Diagnosing Big Toe Arthritis

At Vale Foot and Ankle, diagnosis begins with a full evaluation. This typically includes:

• Physical exam – To check the range of motion, swelling, and tenderness in the big toe joint
• X-rays – To look for joint space narrowing, bone spurs, or degenerative changes
• Ultrasound or MRI – If soft tissue issues or early-stage arthritis are suspected

We also consider your activity level and lifestyle when forming a treatment plan.

Treatment for Big Toe Arthritis

Treatment depends on the severity of your condition and your lifestyle goals. At Vale Foot and Ankle, we offer both non-surgical and surgical options for big toe arthritis.

Non-Surgical Treatments

Most early to moderate cases of big toe arthritis can be managed conservatively:

• Activity modification: Reduce activities that stress the joint
• Footwear changes: Stiff-soled shoes or rocker-bottom soles can reduce motion and pain
• Custom orthotics: Inserts that support the arch and limit big toe movement
• Anti-inflammatory medications: Oral or topical to reduce pain and swelling
• Steroid injections: Targeted relief of joint inflammation during flare-ups
• Physical therapy: To maintain joint flexibility and reduce stiffness
• Stem cell injections: Use regenerative cells to help repair damaged joint tissue, reduce inflammation, and support long-term healing

These can provide meaningful relief and delay the need for surgery.

Surgical Treatment Options

When pain persists despite conservative treatment, surgery may be recommended. Surgical options for big toe arthritis include:

• Cheilectomy: Removal of bone spurs and damaged tissue to restore motion
• Fusion (Arthrodesis): Fusing the bones of the joint to eliminate pain, often used for severe arthritis
• Joint replacement (Arthroplasty): In selected cases, the damaged joint may be replaced to preserve motion
• Osteotomy: Realigning the bones to reduce pressure on the joint

At Vale Foot and Ankle, our surgeons will evaluate which procedure is best for your specific condition and lifestyle needs.

Living with Big Toe Arthritis

With the right treatment plan, many patients experience significant improvement in function and pain. Staying active is important, but knowing your limits and taking care of your feet can slow down the progression of arthritis. Here are some tips to help manage big toe arthritis:

• Wear supportive, loose shoes
• Avoid activities that make symptoms worse
• Stretch the toe and calf
• Use ice or heat during flare-ups
• Watch for increasing stiffness or swelling

Big Toe Arthritis Treatment in CT

Big toe arthritis can impact your ability to walk, independence, and overall well-being, but you don’t have to live with foot pain. At Vale Foot and Ankle, we treat big toe arthritis with non-surgical and surgical options.
If you’re experiencing stiffness or pain in your big toe, contact us today and schedule an appointment. Our foot and ankle experts will work with you to create a plan to get you back to comfort and mobility.