Discomfort inside the big toe or hallux joint that hurts when walking is usually commonly due to osteoarthritis and it is often given the name more typically referred to as hallux rigidus when the joint is really inflexible or hallux limitus if its not so stiff. Hallux rigidus is uncomfortable while walking, so if the joint is extremely painful at rest, then it could much more likely be gout pain than a hallux rigidus. Considering the hallux rigidus, while we are walking and the heel starts to raise up off the ground, the big toe joint needs to flex for this motion to happen. In the event that movement is restricted or there’s a painful osteoarthritis in the joint, then that it is not really as easy simply to walk. It makes sense that if that big toe joint is painful if walking, then a sensible strategy to help the discomfort on movement is to restrict exactly how much the big toe joint flexes.
There are lots of different ways to achieve this. One simple way that Podiatry practitioners use is with felt pads that could be stuck on the foot under the big toe or hallux and front foot or taping could be helpful to strap the joint. Both these are generally excellent short term measures, however impracticable in the long run. If you need a foot orthotic for some other reasons, we have an extension that the Podiatrist may add on the front edge of the foot support that is referred to as a Morton’s extension that can be used to stiffen up the big toe joint by decreasing bending or flexion of the feet. One other way is to use a carbon fibre insole plate that usually are under 1.5mm thick to enable them to fit easily into the footwear and therefore are very stiff. These kinds of carbon fibre plates are likely to be used to treat hallux rigidus and other issues for example turf toe that need to restrict the movements of the hallux joint. The published evidence is that these rigid inserts are rather good at dealing the symptoms in the big toe joint with these conditions. An additional way to deal with the discomfort from the osteoarthritis and hallux rigidus could be to just use footwear which are more inflexible through the ball of the foot. The more bendable the sole of a shoe is, the more that the big toe joint will bend and also the more likely it is to be uncomfortable if walking. There are some shoes, in particular the Hoka running shoes, which have a rocker and extra padding constructed into them which are particularly beneficial at that. The consequence with the rocker in these types of shoes might be that the big toe doesn’t have to bend just as much as the foot rocks forward over the rocker. A pedorthist or shoe tech could add a rocker to many various kinds of footwear to get the same task.
In case you have hallux rigidus or osteoarthritis of the big toe or hallux joint, there are options in the short term to deal with the pain and possibilities on the longer term to deal with the movement of the joint that it is not quite as painful.