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. 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. 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. 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.

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. If we can do that we can not only get rid of your pain but also help prevent further damage to the joint. Several studies have shown how a very specific type of orthotic can help the big toe joint work the way it should and prevent jamming in the joint. You can read about orthotics for big toe joint pain here.

These special custom orthotics have been shown to be the best treatment for hallux limitus, but there are some simple treatments that you can try at home to help reduce the pain. Read here about our home treatment plans for a painful big toe joint.

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