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5 Common Big Toe Problems

5 Common Big Toe Problems Stephen Pinney, MD There are a number of problems that can affect the great toe –also known as the Hallux. Here are five common problems:   Bunion Bunions, also known as hallux valgus (big toe angled to the outside) are the most common great toe problem.  Many bunions are painless, but some are associated with pain over the prominence on the inside of the big toe –especially if tight constrictive shoes are worn. Bunions often run in families and are more common in women than in men. Pain in the forefoot and flatfeet may also be seen in patients with bunions. For more info on bunions checkout here.   Great Toe Arthritis Arthritis of the big toe develops over time in certain individuals in a condition called hallux rigidus (Big toe stiffness).  The cartilage of the big toe joint wears away due to the way the joint is loaded.  This leads to pain, swelling, and stiffness in the big toe joint.  This condition is often seen on both feet –although one side is usually more painful than the other.  For more info on great toe arthritis checkout here.   Ingrown Toenails In some individual one or both sides of the toenail of the big toe will “grown into” the skin and soft-tissue beside the toenail.  This causes the soft-tissue to become inflamed and even locally infected leading to pain and swelling. An unusually shaped (ex excessively curved) toenail is a risk factor for developing an ingrown toenail. For more info on ingrown toenails checkout checkout checkout here.   Gout Gout is one of the oldest known medical conditions. It commonly affects the great toe.  “Gout attacks” are very painful and cause swelling and redness of the big toe (also known as Podagra).  Uric acid is a chemical that is found in the blood.  When the levels of uric acid get too high it can crystalize in the joint lining (commonly in the big toe). The body responds to these crystals with an intense inflammatory reaction leading to marked big toe pain.  For more info on gout checkout here.   Turf Toe An acute injury where the big toe is jammed upwards often produces a “turf toe.” The injury causes a partial or complete tearing of the strong lining (plantar plate) stabilizing the base (near the sole of the foot) of the big toe joint. Turf toe injuries are commonly seen in any sport (ex. football) or activity where the big toe may be jammed upwards in a forcible manner. For more information on turf toe injuries checkout here.    

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5 things you probably didn’t know about bunions

5 things you probably didn’t know about bunions   The term “bunion” is derived from the Latin word for turnip. The medical term for bunions is Hallux (big toe) Valgus (pointing away from the midline). Tight shoes do NOT cause bunions. Rather, you can usually blame your parents. More than 80% of patient with bunions have a first-degree family member with a bunion. However, if you have a bunion and wear constrictive shoes it will cause pain –so comfortable shoes are still very important! There’s very little correlation between the size of a bunion and how painful it is. It is natural to think that a big bunion = lots of pain, and a small bunion = very little pain.  However, that is not the case. Small bunions can be very painful, and many large bunions cause no symptoms at all. The vast majority of bunions can be treated effectively without surgery. Only a small percentage of patients with bunions will need surgery. Most bunions can be managed effectively without surgery. Simple non-surgical treatments like wearing a shoe with more width and a softer upper can be very effective at decreasing or eliminating bunion symptoms. Bunion surgery is not a cosmetic procedure. Bunions that are not painful should not be operated on. The recovery from surgery is considerable and “there is no operation that has ever been invented that can’t conceivably have a complication.” These are two of the reasons why performing cosmetic bunion surgery (surgery in the absence of significant symptoms of discomfort) has been identified by the “Choose Wisely” campaign as an unnecessary procedure. For more information on bunions check out the FootEducation bunion page!   Stephen Pinney MD Editor-in-Chief FootEducation.com  

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