Bunions and Great Toe Arthritis/Hallux Limitus
For Information on Bunion Surgery Click Here.
If you have pain in the big toe joint you are likely experiencing one of three related conditions:
- Hallux Limitus (Pain in
the big toe joint due to too much pressure)
- Hallux Rigidus (Arthritis in the big toe joint)
- Bunions (Enlargement of the big toe joint)
On this page you will learn about bunions. You can use the links to learn more about
hallux limitus and
hallux rigidus. All of these problems can be usually be treated non-surgically, but if not treated will get worse over time. If you are experiencing any pain in the big toe joint or can see changes in that joint you should call today for an appointment to see us in our Seattle foot and ankle clinic.
If you are
experiencing any pain in the big toe joint or can see changes in that
joint you should call today for an
appointment to see us in our Seattle office.
The Cause of Big Toe Pain and Bunions
When humans walk, during the last part of a step, just before the foot
comes off the ground, the big toe joint should bend up about 75 degrees. If this natural motion is not allowed, pain
and deformity can develop.
Some people have a foot that rolls inward - or “over-pronates” - too
much as they walk. When the foot over-pronates, the big toe joint is
pushed into the ground. This prevents the big toe joint from bending
naturally during the step.
Figure 1: Foot rolling inwards
Figure 2: Pressure map shows big toe joint twisted and pushed out on the
side of the foot. Highest pressure is around bunion area and so has the
potential to get worse.
Treatment Goals: Relieve Pain and Avoid Further Damage to your Joint
If you are experiencing bunions or big toe joint pain,
you should make
an appointment to see us as soon as possible
. Left untreated, these
problems only get worse – bunions get bigger or the joint develops
arthritis. But we can usually eliminate your pain and protect your joint
without having to do surgery. Hallux Limitus and bunion treatment varies
depending on your foot type, severity of the deformity, your activities
and your symptoms. Evaluation should be sought at the first sign of a
bunion condition, so severe deformity and arthritic changes can be
Early Treatment Helps Prevent Future Problems
The primary purpose of early treatment is to relieve pressure within the
big toe joint and to diminish the progression of joint damage. The main
conservative therapies include:
foot orthotics for bunions and big toe joint pain
; prescribed and cast by your doctor and designed
to relieve pressure within the big toe joint
• Shoe Therapy; including proper shoes for your foot type and activities
and possible modifications to your shoes
• Accommodative Padding
Custom Orthotics Can Relieve Big Toe Problems
Custom functional orthotics are useful in controlling abnormal foot
mechanics and preventing the need for surgery.
Orthotics for big toe joint problems
are prescribed specifically to help
decompress the big toe joint and help it work in a way that decreases
the chance of joint damage. In order to ensure best outcomes we first
perform a detailed examination, including slow motion video analysis, of
how you walk and how your big toe joint works. A mold of your foot is
then taken in a very specific position and the orthotic devices are
prescribed in a manner to best protect the joints.
In order to best improve function of your big toe joints, research has
shown that orthotics must be made from
non-weightbearing casts of your
with the foot held in the position that provides the best function
of the big toe joint.
Also, studies have indicated that a very specific type of foot orthotic
does the best job at helping the big toe joint work as it should. These
are Total Contact Foot Orthotics
- orthotics that conform extremely
close to the arch of your foot
Hallux Limitus and bunions are progressive deformities and will get
worse over time if not treated correctly. The correct orthotic can help
decrease pain and possibly prevent progression.
What Causes Pain in the Big Toe Joint?
When the big toe cannot bend upward, excessive force builds up inside
the joint each time that you take a step. This joint “jamming” can cause
pain in the joint and over time lead joint damage such as arthritis.
This pain and damage is called Hallux Limitus.
People with Hallux Limitus will have pain in the joint when they walk
and sometimes after activity. It can be worse in some shoes than in
others. There may or may not be visible signs of changes to the joint
and a bunion may or may not be present.
Pain in the big toe joint, even if there is no visible sign of change,
is an indication that there is damage occurring to the joint. This
warning sign should not be ignored. Hallux Limitus is a progressive
deformity and early treatment can help prevent future problems.
What is a Bunion?
In some feet with Hallux Limitus, the first toe starts to move toward
the second toe as a means of relieving the excessive force within the
joint. This causes an angulation of the toe to the metatarsal bone and
the appearance of a bump on the big toe joint. This combination of
angulation of the toes and the bump on the outside of the joint is what
is commonly known as a bunion deformity. The deformity is also known as
Hallux Abducto Valgus or HAV.
The deformity does run in families; however, the foot type is
hereditary, not the bunion. Shoes do not usually cause bunions, although
the wrong shoes can make the deformity more painful.
HAV is a progressive deformity. Treatment can slow or stop the
progression in many cases and help prevent joint damage or the need for
When is Bunion or Big Toe Joint Surgery Needed?
For Information on Bunion Surgery Click here.
When you start to have joint pain or the bunion condition limits your
activities and all conservative options have failed, surgery may be
necessary. Joint pain may indicate degeneration of the joint cartilage.
One of the goals in surgery is to realign the joint to prevent further
loss of joint cartilage.
Pain and deformity are significantly reduced in the great majority of
patients who undergo bunion surgery. Bunion surgery allows for
realignment of the joint. After surgery the foot should be able to carry
the body’s weight in a more normal fashion and special shoes should no
longer be required. Postoperative orthoses may be recommended to improve
foot function and limit excessive forces through the great toe joint.
Don’t let your bunions or big toe pain get worse. Early treatment can
prevent future problems. Call today for an appointment in our Seattle
Don’t let your bunions or big toe pain get worse. Early treatment can
prevent future problems. Call today for
an appointment in our Seattle office.
For website errors ONLY email webmaster at
All pages on this website © 2005-2013
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.