Big Toe Joint Aches and Pains - What you need to know:

Often times patients will present with what they consider to be a "Bunion" in their big toe joint, and they attribute this to their pain. Many times, this is false. A bunion is an actual deviation or dislocation of the big toe joint, whereas the painful prominence which are often gradually increasing in size after many years removed from an injury can be related or directly attributed to progressive "bump" production which has the general buzzword "Arthritis".

Arthritis is actually a misnomer, because many times the inflammation of the joint is only noted initially in the disease process and over time the cartilage wears away forming spurs and bone prominence which leads to the pain and inability to move the joint fluidly. This is actually an "arthrosis" which is the end result of the condition. Arthritis is not usually visualized directly on a radiograph but arthrosis is easily visualized.

A clinician will find effusions whenever arthritis is active. This is the "Swelling" that patients often note is painful and warrants medical attention. This is often including joint space widening in the case of inflammatory arthritis but narrowing over time with osteoarthritis, and reduction of ability to move the joint without pain and with eventual grinding.

Patients will often times not recall the traumatic event which sparks the progressive wear down of this area on their foot, but many times this is not necessary. Patients will also note that the "bunion" is growing and is usually located on top and side of the joint. This is not a bunion, as these tend to only be located on the side of the joint and not at all on top.

What do you need to know to determine what to do next??

1) If the pain is at the end of the day you should see a foot and ankle specialist.

2) If the motion of the joint is limited or not similar to your other foot, you need to see the specialist.

3) If you have been given 2 or more cortisone injections in the same joint, you need to see a specialist.


There is a common theme here. A foot and ankle specialist is paramount to help a patient achieve a good result in treating first toe joint arthrosis. Often times, this is progressive and may limit treatment options depending on the stage of the pathology. There is no actual cure for any form of arthritis, but there are means to treat and accommodate the condition in order to reduce pain and limitation with walking.  We are adept in treating all forms of arthritis, from the initial swelling stage, to the end stage limited motion in the toe joint.  There are many times several good options depending on the stage of the disease process, and we will be able to give you a definitive solution in many cases.

Dr TIMM.