Functional Hallux Limitus – the Most Common Cause of Achy Big Toe Joints

There are a number of reasons that you may experience painful big toes. The three most common are all related to abnormal function of the big toe joint. Those are:

  1. Bunions (enlargement of the big toe joint)
  2. Hallux Rigidus (arthritis of the big toe joint).
    “Hallux” means big toe. “Rigidus” means rigid joint.
  3. Functional Hallux Limitus (jamming of the big toe joint).
    “Limitus” means a limited amount of motion. “Functional” means that it happens during function or while walking, but there is not necessarily any permanent damage to the joint.

You can use the links to learn about bunions and hallux rigidus.

You can learn about home treatments for all of these big toe joint problem here.

On this page we are going to discuss functional hallux limitus (FHL). In many ways this is the most important of the three big toe joint problems, because hallux limitus is not only the most common cause of pain in the big toe joint, but it is also the cause of bunions and hallux rigidus.

What is Hallux Limitus?

Hallux limitus is essentially a jamming of the big toe joint and if your big toe joint hurts it is the most common cause.

At the end of every step we take the big toe joint should bend about 80 degrees. This motion is called dorsiflexion. Sometimes, however, something happens during the step that prevents that normal motion from occurring. Most often it is an excessive rolling in of the foot (too much pronation) that causes the jamming of the joint.

You can see in figure 1 that when the foot pronates too much, it rolls in, increasing the pressure under the big toe joint. This pressure stops the big toe joint from bending properly. When the big toe joint can’t bend, all the force that should be used to bend the big toe joint instead jams the joint. This jamming is called “functional hallux limitus”.

big toe pain, hallux limitus

Figure 1: Showing pronation.

What Problems Does Hallux Limitus Cause?

Hallux limitus leads to several problems:

Pain in the Big Toe Jont

The first is simply pain. The big toe bone presses against the metatarsal bone causing severe pressure in the big toe joint. This pressure leads to big toe joint pain and an ache in the toe.

Big Toe Joint Damage

Over time all this pressure can start to damage the joint. In some people the pressure causes the big toe to drift off toward the other toes and you develop a bunion. In other people, the toe doesn’t drift but instead you just get more and more pressure within the joint. This increased pressure starts to damage the cartilage of the joint and you develop arthritis of the joint – also called hallux rigidus.

What is the Treatment for Hallux Limitus?

Our primary goal is to help the big toe joint work normally and prevent the jamming in the joint.

Orthotics for Big Toe Joint Pain

Proper orthotics can help eliminate pain and help prevent further damage to the joint. For some people a prefabricated orthotic will do the job. Others will need a custom orthotic.

The orthotics for this problem should conform very close to the arch of the foot in order to reduce pressure within the big toe joint. These are called “total contact orthotics” and will do the best job of protecting the joint. Custom orthotics that are prescribed specifically to improve big toe joint motion will offer the best joint protection and pain relief.  You can learn about custom orthotics for big toe joint pain here.

Home Treatment for Big Toe Joint Pain

Although custom orthotics for hallux limitus will usually work best, there are some very good prefabricated orthotics that will help protect the big toe joint and reduce pain.

Our recommended prefabricated orthotic for hallux limitus is the the FootChair Adjustable Arch Orthotic. This unique arch support FootChair orthoticshas a pocket in the arch into which can be inserted special arch pads. These pads raise the arch and help decompress the big toe joint. FootChair orthotics come with two pads per side and, as long as they are comfortable, we recommend using both pads for people with big toe joint pain.

Sandals and Slippers for Big Toe Pain

When you are not wearing shoes it is still critical to wear arch support that decompresses the big toe Vionic Sandalsjoint. For those times we recommend the use of sandals or slippers with exceptional arch support.

Our recommended sandals and slippers for hallux limitus are by Vionic.

Vionic sandals and Vionic Slippers both have a built-in arch support that we have found is the best on the market for our patients with big toe pain.Vionic Slippers

Read here about other home treatments for a painful big toe joint.

Don’t live with big toe pain. Contact us today for an appointment in our Seattle foot clinic.