Do I have a Broken Joint in my Big Toe?

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A hurting big toe might seem a small thing compared to advanced forms of rheumatoid arthritis and other causes of joint pain. However, having a swollen big toe is one of the most annoying and bothersome types of joint pain, especially for active people who are always on the go!

a broken toe joint with doctor

 

The big toe is clinically named the “hallux”, and it has one of the most highly flexible joint articulations in the foot.

So, if you’ve suddenly started feeling pain in your big toe and wondered if you have a broken joint, we will give you the main reasons why your hallux is hurting, including a fractured articulation and various forms of arthritis.

Why is my big toe aching?

The leading causes of hallux pain are as follows:

  • Fractures and traumatic injuries: There are many types of fractures and traumatic events associated with joint pain in your big toe. Most of them are easily detected because joint pain starts after a traumatic event. However, there are also stress fractures, caused by repetitive movements for a prolonged time or an excessive load in cases of morbid obesity. Some instances might progress into a form of osteoarthritis, and in some cases, excessive healing of the bone might lead to bone spurs as a secondary cause of pain in the big toe.

 

  • Rheumatoid arthritis: The most common type of rheumatoid arthritis is located in the hands and the knees. However, in some cases, rheumatoid arthritis can affect various articulations of the foot, especially the big toe. In these cases, rheumatoid arthritis is caused by inflammation in the toe and may or may not be associated with injuries in this area. Symptoms include pain, stiffness, and swelling, but in advanced cases of rheumatoid arthritis the disease progresses to cause deformation in the articulation.

 

  • Osteoarthritis: It is a type of arthritis that is mainly triggered by wear and tear of the articulation. It is commonly associated with past trauma in the articulation of the big toe (a broken joint or a ligament sprain), but it is also prevalent in older and overweight people. When the cartilage wears down in osteoarthritis, it often causes popping sounds when moving the big toe.

 

  • Gout: It is an important cause of toe pain, especially in males. Gout is caused by an accumulation of uric acid crystals in the articulations of the foot. These crystals grow bigger and impair the normal function of the articulation, causing severe and sudden bursts of joint pain. These symptoms may be easily mistaken with traumatic pain as in a broken joint.

 

  • Hallux rigidus: It is also known as a stiff big toe. It is a medical condition that develops in adults aged 30 to 60 years old. Similar to arthritis, hallux rigidus is associated with swelling, an inability to bend the hallux, and severe pain that becomes worse after walking or moving the articulation.

 

Injuries to the Hallux (Big Toe)

with thanks www.ncbi.nlm.nih.gov

 

As you can see, each one of these causes should be properly evaluated before reaching a final diagnosis. Thus, if you’re in doubt, it is essential to ask your doctor about your symptoms in order to be properly guided according to your individual condition.



If the Toe bone re-heals, Can it become stronger?

You may have heard the old wives tale that when a bone re-heals it will make a stronger bond. This is simply not the case…..

If you have a broken articulation and give it enough time to recover, a healthy body will be able to recover the normal function of the articulation. However, in most cases there are consequences after having a broken bone. After re-healing, the affected bone turns out to be exactly the same as before or might also become more fragile, especially in older adults. This is why it is essential to pay attention and avoid any future traumatic event after you’ve had a fracture.

In some cases, the process of healing in your bones becomes excessive, but this is not good news and does not mean your bone becomes stronger after enduring a fracture. For example, another cause of prolonged joint pain in your big toe is a bone spur.

It is an overgrowth of bone tissue in the articulation of the big toe that results from traumatic injuries and osteoarthritis. In an attempt to repair the damage, the body adds excessive layers of bone, and instead of making the articulation stronger, it leads to chronic pain when bone spurs stick out and rub against the adjacent bone.

What can you do about it?

When hallux pain is associated with a traumatic event, and it becomes swollen and tender, a broken articulation in your big toe is a possibility we should evaluate with a health professional. However, some minor injuries might respond to home treatments and remedies. In any case, it is advisable to check and treat your Big Toe with appropriate resting, applying ice, and elevating the articulation.



Resting includes not walking and using crutches or special shoes to walk. When applying ice, we should be careful not to do it directly over the skin. Instead, you can place a piece of cloth or towel, or buy special ice packs meant to be used for this purpose. Elevating your toe reduces swelling by favoring circulation of blood back to the heart, and in most cases, it helps to reduce pain symptoms as well.

Another important measure you can use if you suspect a broken articulation in your big toe is buddy taping the affected toe. You can do this as a first-aid measure until medical help arrives. Materials for buddy taping include adhesive tape and a piece of gauze or cotton. The objective is to attach the affected articulation to the adjacent toe by taping them together, and it is the easiest way to splint a broken articulation in your big toe. The piece of gauze or cotton should be placed between the toes to prevent sores, and you should be careful not to tape your toes too tightly that your circulation might become compromised.

 

References:

Logterman, S. L., & Hunt, K. J. (2019). Hallux Rigidus. In Sports Injuries of the Foot and Ankle (pp. 259-264). Springer, Berlin, Heidelberg.

Qaseem, A., McLean, R. M., Starkey, M., & Forciea, M. A. (2017). Diagnosis of acute gout: a clinical practice guideline from the American College of Physicians. Annals of internal medicine166(1), 52-57.

Makhni, M. C., Makhni, E. C., Swart, E. F., & Day, C. S. (2017). Phalanx Fractures of the Foot. In Orthopedic Emergencies (pp. 379-381). Springer, Cham.

Welck, M. J., Hayes, T., Pastides, P., Khan, W., & Rudge, B. (2017). Stress fractures of the foot and ankle. Injury48(8), 1722-1726.

Stolt, M., Suhonen, R., & Leino-Kilpi, H. (2017). Foot health in patients with rheumatoid arthritis—a scoping review. Rheumatology international37(9), 1413-1422.

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