Causes of big toe pain: What is hallux limitus?

Hallux limitus is a condition which causes big toe pain and characterized by diminished range of movement and pain or discomfort at the big toe. After some time, the reduced range of motion can lead to the development of arthritis of the big toe joint. The diminished range of motion that leads to hallux limitus is a prevalent occurrence but not usually recognized until there is big toe pain.

Indications of hallux limitus

  • Big toe pain that can be aggravated by physical activity or walking
  • Bony enlargement or lump in the top part of the big toe joint
  • Diminished range of motion of the big toe joint such as difficulty in flexing the big toe at 65 degrees upwards while in standing position
  • Development of bone spurs and narrowing of the joint space at the big toe joint which is usually seen in an X-ray
  • Out-toeing or walking similar to a duck
  • Presence of a callus on the side of the big toe
    Hallux limitus

    Big toe pain that can be aggravated by physical activity or walking

What are the possible causes?

Hallux limitus is often triggered by abnormalities in the foot structure. A raised first metatarsal bone such as among with flat feet can disrupt with normal range of movement of the big toe. An unusual length of the first or second metatarsal bone can also lead to hallux limitus.

A good example of an abnormal metatarsal length is Morton’s toe. This is characterized as having a second toe that is evidently longer than the big toe. This foot is more susceptible to develop big toe pain.

Other causes of hallux limitus include the following:

  • Constant disturbance to the big toe joint such as in turf toe which is an overuse injury among those who engage in sports
  • Acute trauma to the big toe joint
  • Inflammatory issues such as gout, rheumatoid arthritis or psoriatic arthritis

The diminished range of motion linked with hallux limitus can progress to full loss of motion.

Management

Once a diagnosis of hallux limitus is given by the doctor, the condition can be managed with the following treatment measures:

  • RICE method (rest, ice, compression, elevation) of the affected limb
  • Proper stretching of the big toe
  • Applying over-the-counter pads that are added to the interior of the shoes used by the individual
  • Orthotics or arch supports with specialized modifications that work by relieving the stress from the big toe.
  • Special styles of shoes such as those that have stiff or rigid soles or have rocker soles. These styles reduce movement of the big toe joint.
  • Surgery is usually considered if the conservative measures could not alleviate the symptoms especially the big toe pain. In most cases, surgery involves either restoration of the range of motion to a certain degree or fusion of the joint completely to prevent any movement.

Always bear in mind that with every step of the foot, there is a certain degree of the flexibility of the big toe joint needed. This will allow the foot to properly absorb and transfer the body weight as the feet strikes the ground. Once the flexibility of the foot is compromised, the other joints in the body can feel the effects.

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