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Pain in the big toe!

Big toe pain

Pain at the joint of the big toe is a very common complaint that can be quite painful and debilitating. The first metatarsophalangeal joint (MTPJ) is the joint that connects your big toe with your first metatarsal. The reason this joint is a common area for pathology is because this joint endures significant weight bearing stress whenever we walk, run or jump. Listed below are some of the possible causes of 1st MTPJ pain.


A bunion or hallux valgus deformity is due to a change in the 1st MTPJ whereby the 1st toe angles laterally, or towards the lesser toes. This deformity results in a prominent 1st metatarsal head which can cause pain and reduced range of motion. As HAV is a progressive condition, the 1st toe may increasingly deviate, often overlapping lesser toes.


The most common forms of arthritis that affect the big toe joint are osteoarthritis and rheumatoid arthritis. These conditions both cause damage to joints, often resulting in pain, stiffness, swelling and reports of a grinding sensation.


Gout can affect any joint in the body, however the big toe joint is the most commonly affected. It is the result of a build up of uric acid which forms tiny crystals in the joints. Uric acid is normally found in the blood, however an excess amount of this can occur due to the body not being able to excrete it quickly enough or because there is too much being produced. Gout is a type of arthritis that causes inflammation, with symptoms including red, hot, swollen and painful joints.


Beneath the big toe joint there are two small bones embedded in a tendon that runs to the end of the toe, known as sesamoids. These sesamoids provide a smooth surface over which the tendons slide, and help to increase muscle force as well as assisting in weight bearing and helping to elevate the bones in the big toe. Sesamoiditis is when the tendons surrounding the sesamoids become inflamed, and presents as pain under the big toe particularly with bending and straightening the joint.


Synovitis is inflammation of the synovial membrane that lines joints. Synovitis is commonly associated with diseases such as arthritis and gout, however can also be the result of overuse or trauma. Symptoms include swelling, redness and pain with motion of the joint.

Turf toe

Turf toe is a common sports related injury, and is a sprain of the ligaments that cross the big toe joint. The injury is the result of an excessive force being placed upon the joint while hyperextending, such as pushing off from the big toe when sprinting. The injury is particularly common in sports which are played on an artificial turf as this is a harder surface than grass and does not have much give when forces are placed upon it. Turf toe can be categorised into three grades depending on the severity, ranging from stretching of the soft tissue to partial tearing and even dislocation of the MTPJ.

If you are experiencing pain, or other sports related injuries please don’t hesitate to contact the clinic to book an appointment online, or over the phone with one of our specially trained physiotherapists or podiatrists in Kew or Oakleigh. You can book an appointment online with one of our podiatrists in Kew, podiatrists in Oakleigh or physiotherapists in Kew at or call us on (03) 9853 7836.

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