Aching and throbbing in your big toe can affect your balance and stop you from participating in physical activity. Various types of arthritis, including gout, are common sources of pain in the big toe. Understanding this condition, and how to treat it, may help you avoid further injury and allow you to resume activity.
The joint in your big toe is the metatarsophalangeal, or MTP joint. It is the most common site of arthritis in the foot. This joint bends each time you take a step, and if it stiffens, your toe may ache and throb. Articular cartilage is located at the end of each bone in your toe, and if this cartilage gets worn down, the bones of your toe rub together. This rubbing may result in bone overgrowth, or bone spurs, preventing the toe from bending while walking. When this rubbing causes stiffness in the big toe, arthritis called hallux rigidus occurs. The condition causes joint pain during activity, especially when you push off on the toes. Signs of hallux rigidus include joint swelling, development of a bump on top of the foot, stiffness and an inability to bend the big toe.
Gout is another form of arthritis that may cause throbbing or aching in your big toe. It is due to a buildup of uric acid in the body. Purines are substances found inside of all body tissues, dried beans, peas, anchovies and liver. Uric acid is a byproduct when purines are broken down. Uric acid buildup causes uric acid crystals to settle in the joint of the big toe. Other symptoms of gout can include lumps of uric acid forming under the skin and stones of uric acid in the kidneys.
Medication and Home Treatments
Reducing the swelling caused by arthritis in your toe may ease throbbing and aching. This may be accomplished with the use of over-the-counter anti-inflammatory or pain relieving medications. Prescription medications that treat arthritis in the big toe include nonsteroidal anti-inflammatory drugs, NSAIDs, corticosteroids and colchicine. Taking colchicine or NSAIDs daily may be recommended to avoid arthritis flare-ups and to lower uric acid levels in the blood. Applying ice packs to your big toe may also help control swelling. Avoid wearing high heel shoes or shoes that place pressure on you toe. Shoes that have a rocker or roller bottom can reduce the need for the big toe to bend.
Hallux rigidus can be treated with surgical procedures. A cheilectomy is a treatment option when damage to the big toe joint is mild or moderate. This procedure involves removal of bone spurs and a portion of the foot bone, giving more room for the toe to bend. Postoperative swelling of the toe and operative site may last for several months and long-term relief usually follows. A procedure called arthrodesis fuses bones together and is for patients with severe cartilage damage. Removal of damaged cartilage occurs and the joint is permanently positioned with screws, pins or a plate. This procedure results in the bones fusing together and the big toe no longer bending.