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Pain top of foot Near Big Toe

Getting Pain top of foot near big toe?Top of Foot Near Big Toe Anatomy

If you are suffering pain top of foot near big toe, then you may be having to deal with something fairly serious.

The various reasons for pain near the big toe are:

  • extensor hallucis longus tendonitis/osis
  • hallux limitus
  • hallux rigidus

Extensor Hallucis Longus Tendonitis or tendonosis can cause pain top of foot near big toe.

This condition usually arises from an over activation of the extensor tendon that runs down the top of foot and attaches into the big toe.

The tendon can partially tear or damage due to excessive forces involved in the first metatarsal phalangeal joint aka big toe joint.

These forces can be either due to a stretching or pulling type force.

For example, when the toe is  down and therefore pull on the tendon around the top of the joint, leading to tearing and inflammation – ultimately resulting in pain along the top part of the big toe joint.Alternatively if the tendon is activated enough i.e. lifting the big toe, then it is certainly possible to fatigue and tear the tendon. That is the more common reason we see pain in this area.In terms of treating that condition it really depends on the cause.
If however the tendon is chronically fatigued and repeatedly damaged due to poor biomechanics, such as over pronation, one should address the aggravating movements with appropriate footwear and or orthotics.That is, if it is an acute damage such as stubbing the toe and damaging the tendon, one needs to rest and treat the foot accordingly with ice and reducing movement to allow the tissue to heal adequately.

Pain top of foot near big toe because of Hallux Limitus

This condition involves the normally smooth and freely movable up and down motion of the big toe joint, otherwise known as the first metatarso-phalangeal joint becoming limited, as the name suggests.

This renders the supportive tissues (tendon, ligaments, capsule, muscles etc) vulnerable to taking the relatively speaking now abnormally high stresses or strain and therefore causing pain top of foot near big toe.

Another way to think of it is if you strapped one of your finger joints and tried a similar up and down motion, you’ll notice the other joints pick up the slack and may even start to cause discomfort.

This leads me to talk about the unfortunate case of the joint becoming almost fused or rigid.

Hallux Rigidus causes pain top of foot near big toe.

As mentioned above, Hallux Rigidus is practically a fusion and often results in pain top of foot near big toe.Hallux Rigidus X-Ray

Often this condition requires surgery, as the soft tissues around the joint are under too much pressure and constantly painful.

As the image suggests, a large amount of bone may need to be removed, further adding to the risk of complications and long term pain management and rehabilitation.

For this reason surgery is a very serious matter and the pros and cons must be well thought out.

Due to the obvious change in biomechanics, multiple areas of the body may come under fire also.

For example, the lesser toes and ankle may hurt because of the new twisting away from the big toe.

The knee and lower limb can also struggle with the change in alignment.

Patients often need to wear a rocker soled shoe to give them some sort of flow with their stride and try to relief the various soft and bony tissue.

At the end of the day the obvious thing to do is try prevent pain top of foot near big toe from happening in the first place.

In the early stages one can easily offload the joint with appropriate orthotic therapy


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