Big Toe Joint Arthritis


"I love my toes again.”

-Dina W.

What is big toe joint arthritis?

The big toe joint, also known as the metatarsophalangeal joint, is located at the base of the big toe and is the most common site of arthritis in the foot. Big toe joint arthritis is characterized by an erosion of cartilage, which results in pain and stiffness in the toe joint. Since this joint moves every time you take a step, the condition can make walking very difficult.


What causes big toe joint arthritis?

Arthritis of the big toe joint, also known as stiff big toe or hallux rigidus, is caused when the cartilage covering the ends of the bones in the big toe joint (metatarsophalangeal joint) are worn down. As a result, the bones in the joint begin rubbing together, causing stiffness and pain.

Hallux rigidus is usually due to having a different foot anatomy that places increased pressure on the big toe, but it may also be caused by an injury to the big toe that damages the cartilage.


What are the symptoms of big toe joint arthritis?

big toe joint arthritis painIf you have big toe joint arthritis, you will likely experience:

  • Stiffness and pain in the big toe joint
  • Difficulty moving the big toe up and down
  • Inflammation and swelling around the joint
  • Pain that worsens with an increase in activity

Some patients may also develop a bump on top of the foot at the base of the big toe that can indicate the presence of a bone spur (extra bone growth).


What are the risk factors for big toe joint arthritis?

There are several factors that can increase your risk for big toe joint arthritis:

  • Age – most cases of big toe joint arthritis develop between the ages of 30 and 60
  • Occupation – jobs that place significant stress on the big toe, including those which require periods spent squatting or stooping, put you at a higher risk for developing the condition
  • Foot anatomy – certain structural abnormalities such as flat foot or excessive pronation of the foot (where feet roll inwards) can make you more prone to developing hallux rigidus
  • Big toe injuries – significant or repeated injuries to the big toe including stubbing the toe can damage the joint’s cartilage and make arthritis more likely
  • Inflammatory diseases – certain inflammatory diseases, such as rheumatoid arthritis and gout, can cause big toe joint arthritis


What are the treatment options for big toe joint arthritis?

If you are experiencing stiffness or pain in the big toe joint, call our office at 212‑434‑4920 or fill out the schedule appointment form on this page so Stuart Katchis, M.D. can evaluate and diagnose your condition. Big toe joint arthritis is a progressive condition that gets worse over time and treatment outcomes are significantly improved if medical evaluation is sought when symptoms first start.

In many cases, symptoms of big toe joint arthritis can be successfully treated or managed long-term with nonsurgical methods.


Nonsurgical Treatment

Nonsurgical treatment options may involve:

Applying ice

Applying ice to the affected area will help reduce pain and inflammation.

Taking anti-inflammatory medications

Taking over-the-counter anti-inflammatory medications can considerably reduce pain. If necessary, Dr. Katchis may prescribe a stronger medication to lessen your discomfort.

Altering footwear

Tight shoes and high heels that place pressure on the big toe should be avoided and traded out for shoes with a wide toe box and stiff, supportive soles. Shoes with a “rocker” design on the bottom may also be recommended.

Using orthotics

Inserts placed in the shoes can help relieve pain and swelling by repositioning the foot and reducing pressure on the big toe.

Getting cortisone injections

Cortisone shots injected into the affected area may significantly reduce pain and discomfort.

Shock wave therapy

Sound wave therapy may be implemented to temporarily reduce pain and stiffness.

Surgical Treatment

Surgery may be recommended if nonsurgical treatments will not prove effective for relieving pain, particularly in cases of more severe big toe joint arthritis where the condition has progressed and bone spurs have developed. The type of surgical procedure recommended by Stuart Katchis, M.D. will depend upon each patient’s unique situation.


Surgical treatments include:


A common type of surgery when big toe arthritis is less severe, this procedure involves Dr. Katchis removing the bone spurs and a portion of the foot bone to give the big toe more room to bend. The surgery provides most patients with great results and long-term relief from the condition.


A procedure utilized when the condition is severe, the surgery involves Dr. Katchis fusing together the bones of the big toe joint and removing the damaged cartilage around them. Special devices may be inserted to keep the bones in place while they heal together. After healing, the big toe won’t be able to be bent, but pain is completely eliminated.

What does the recovery process entail?

Surgical treatment for big toe joint arthritis (hallux rigidus) involves several weeks or months of recovery depending on the type of surgery performed. With any type of surgery for this condition, it may require you to wear a firm and flat postoperative shoe to protect your foot while the bones heal.

Whether you undergo nonsurgical or surgical treatment for arthritis of the big toe joint, Stuart Katchis, M.D. will provide recommendations for long-term measures designed to keep your symptoms from flaring up, such as footwear modifications and wearing orthotics. Footwear that eliminates the need for the toe to bend, such as shoes with “rocker” soles, may help considerably.

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