Big Toe, Big Problem: Why a Stiff Big Toe May Be More Serious Than You Think

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Big Toe, Big Problem: Why a Stiff Big Toe May Be More Serious Than You Think

Whether it's your little toe or your big toe, even a seemingly minor toe injury can be a big problem. Mobility becomes uncomfortable, as your gait becomes a limp or even a shuffle. Even something as innocent as a stiff big toe can be concerning and may warrant a consultation with a podiatrist.


Nobody is recommending urgent medical care if you discover that your big toe is newly stiff. You may recall a direct cause (injuring your toe via impact with a hard object), so the stiffness is hardly a mystery. You may have injured your toe in another way, or you may have simply slept on it at an awkward angle. Such injuries generally subside without much intervention. Over-the-counter pain relievers and resting the affected joint are all you need. When your big toe stiffens further to the point of being immobilised, you may have a more serious issue.


A stiff big toe perhaps sounds more impactful when you use its medical name—hallux rigidus. Although this condition can be exacerbated by injury, it's more likely to have been developing for some time despite the apparent sudden onset of symptoms. The condition doesn't technically even affect the toe itself, but you're experiencing a painful stiffening and inflammation of the toe's largest joint: its metatarsophalangeal joint (MTP). The arthritic pain can make walking difficult, or even impossible.


Essentially the cartilage which prevents unnatural friction of your MTP joint has worn away. The resulting friction of the unprotected joint has resulted in stiffness and painful inflammation (the primary symptoms of your hallux rigidus). The condition is caused by progressive wear and tear, perhaps due to minor misalignment of the MTP joint during motion. Previous injuries can exacerbate the condition. 


Although your first port of call might be your GP, they may immediately refer you to a podiatrist for dedicated treatment. The goal of this treatment is to restore the joint's full range of motion. This is not as simple as simply resting the foot, although rest will relieve the inflammation of your MTP joint and its surrounding structures. Your toe stiffness and pain can rapidly return without addressing the underlying cause of your hallux rigidus. 


Treatment involves prescription orthotics. Your podiatrist can arrange customised carbon fibre inserts for your shoes to regulate the direction in which your MTP joint can move. Extreme cases may require completely customised shoes, with metal support plates built into their soles. A series of corticosteroid injections will help to eliminate swelling (and pain), with your shoe inserts now preventing further irregular motion of the joint. 

A painfully stiff big toe that appears to be getting worse is something that requires investigation.

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