As we age, the big toe can actually begin to bend sideways. You may not visually notice it at first, but as it gradually worsens, not only will the bend become obvious, but how the foot functions may change. In fact, up until this point, you may not even realize how much work your big toe really does. You may experience pain in the big toe, discomfort in certain shoes, and even trouble with pushing off (a main function of your big toe) when you walk. The foot or ankle may even become stressed as they attempt to compensate for the disrupted function in the big toe. So what causes a bent big toe, and what can you do about it?
The medical term for a bent big toe is hallux valgus, and it is an early sign of arthritis setting into the metatarsophalangeal (MTP) joint at the base of the big toe. It’s best to address it as soon as possible, not only to address discomfort but also to try to head arthritis off at the pass, before it advances and causes serious trouble. Why? If you let it go long enough, it will lead to hallux rigidus, which means that the toe becomes so arthritic that it gets locked in one position and can’t bend.
When arthritis in the big toe advances to the point of hallux rigidus, unfortunately, orthopedic surgeons like to operate. One drastic surgery to the big toe is an MTP-joint fusion, which involves placing screws across the joint to fuse it solid. Just like a back fusion leads to disease in the adjacent segments, a big toe fusion causes problems in the ankle and other toe joints as they have to bear the extra load.
Other treatments you might be presented with for pain from a bent big toe include steroid shots or pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. These, too, are bad news. Steroid shots have been shown to destroy local cartilage in the joint (which can only progress arthritis) while providing no significant pain improvement. NSAIDs come with a long and growing list of dangerous side effects, such as sudden-death heart attacks, stroke, and GI bleeding, and addiction and overdose due to prescription opioids have reached epidemic proportions in the U.S.
So how do you help a bent big toe before arthritis fully sets in? First, make sure your shoes aren’t wearing too much on the outside. If they are, your foot isn’t hitting the ground correctly, and that could be causing forces which have bent the big toe joint. The solution to this is to get orthotics to help redistribute the forces properly as your foot strikes the ground. Second, avoid high heels, pointy-toed shoes, and other shoes that force or reinforce that big toe into a bent position. Third, you can use a toe straightener—yes, such a thing really exists—when you sleep. There are many brands on the market, and they can help to gradually and gently realign a bent big toe.
In the meantime, if you also have pain, the supplements chondroitin and glucosamine have been shown to be effective pain relievers, and they preserve cartilage. Curcumin can also relieve pain from arthritis. If the bent big toe pain still won’t go away, consider a high-dose PRP or a stem cell injection.
The upshot? The best solution for helping a bent big toe is don’t procrastinate. Address it early and treat it quickly! Once arthritis sets in and advances, it creates a more challenging problem to deal with. Additionally, that bent big toe can put more stress on the surrounding structures and even disrupt body symmetry, leading to more problems elsewhere.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…