Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, you will find out everything you need to know about arthritis in the big toe and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Introduction
Arthritis in the big toe—also known as hallux rigidus or big toe osteoarthritis—is a common cause of foot pain, stiffness, and difficulty walking. It can affect people of all ages, but is especially common in those over 40 or with a history of foot injuries. This expert-reviewed guide explains the causes, symptoms, and best treatments for arthritis in the big toe, including advanced options like Prolotherapy.
What is Arthritis in the Big Toe?
Arthritis in the big toe occurs when the cartilage in the first metatarsophalangeal (MTP) joint wears down, leading to pain, swelling, and reduced movement. Over time, bone spurs may develop, and the joint can become stiff or even frozen. This condition is a leading cause of pain at the base of the big toe and can make walking, running, or wearing certain shoes difficult (NHS, 2023).
Causes and Risk Factors
- Age: Risk increases with age, especially over 40.
- Previous injury: Sprains, fractures, or turf toe can damage the joint.
- Genetics: Family history of arthritis or foot problems.
- Repetitive stress: Running, sports, or jobs that put pressure on the big toe.
- Foot structure: Flat feet, bunions, or abnormal gait.
- Other arthritis types: Rheumatoid arthritis or gout can also affect the big toe.
Citations: Arthritis Foundation, 2023; NHS, 2023
Symptoms and When to Seek Help
- Pain and stiffness at the base of the big toe, especially when walking or standing
- Swelling or tenderness around the joint
- Difficulty bending the toe up or down
- Grinding, clicking, or popping sensations
- Development of a bony bump (dorsal bunion)
- Redness or warmth (inflammatory arthritis or infection)
Seek medical attention if:
- Pain is severe or sudden
- You notice significant swelling, redness, or warmth
- You cannot walk or bear weight
- There is significant deformity or locking of the toe
Diagnosis
A healthcare professional will diagnose arthritis in the big toe by:
- Taking a detailed medical history and asking about your symptoms, activity levels, and previous injuries
- Performing a physical examination, checking for tenderness, swelling, and range of motion
- Ordering imaging tests (X-ray, MRI, or ultrasound) to assess joint damage, bone spurs, or other causes
- Blood tests if inflammatory arthritis or gout is suspected
Early diagnosis is key to effective treatment and preventing further joint damage.
Citation: NHS, 2023
Treatment Options
Treatment for arthritis in the big toe depends on the underlying cause, severity, and your overall health. Most people benefit from a combination of self-care, medical treatments, and lifestyle changes.
Self-Care and Lifestyle
- Rest and activity modification: Avoid activities that worsen pain, such as running or high-impact sports.
- Ice therapy: Apply ice packs for 15–20 minutes after activity to reduce inflammation.
- Supportive footwear: Wear shoes with a wide toe box, stiff sole, or rocker bottom to reduce pressure on the joint.
- Gentle stretching and strengthening: Focus on the foot and calf muscles.
- Weight management: Maintaining a healthy weight reduces stress on the big toe joint.
Medical Treatments
- Pain relief: Over-the-counter medications such as paracetamol or ibuprofen.
- Topical treatments: Anti-inflammatory creams or gels applied directly to the toe.
- Physical therapy: A physiotherapist can design a program to improve mobility and strength.
- Injections: Corticosteroid or hyaluronic acid injections may be considered for persistent pain.
- Treatment of underlying conditions: Managing gout, rheumatoid arthritis, or other systemic diseases is crucial.
Citations: Versus Arthritis, 2023; NHS, 2023
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat arthritis in big toe. Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with arthritis in big toe.
As prolotherapy is helping to treat the root cause of arthritis in big toe, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Case Studies
Case Study 1: Mary, a 58-year-old teacher, developed arthritis in her big toe after years of running. She received a combination of physiotherapy, footwear advice, and prolotherapy. Within three months, her pain reduced and she returned to walking daily.
Case Study 2: Tom, a 45-year-old office worker, experienced chronic big toe pain due to osteoarthritis. After prolotherapy and a tailored exercise program, he regained mobility and now enjoys hiking again.
FAQs
What causes arthritis in the big toe?
Common causes include age-related wear and tear, previous injuries, genetics, repetitive stress, and inflammatory conditions like gout or rheumatoid arthritis.
Can I exercise with arthritis in my big toe?
Yes, but focus on low-impact activities and gentle stretching. Avoid activities that worsen pain and consult a physiotherapist for guidance.
Is prolotherapy safe for arthritis in the big toe?
Prolotherapy is considered safe when performed by a qualified practitioner. It is minimally invasive and has a low risk of complications.
When should I see a doctor?
If you have severe pain, swelling, redness, or cannot walk, or if symptoms persist despite self-care, consult a healthcare professional.
How long does it take to see results from treatment?
Most people notice improvement within a few weeks, but full recovery may take several months depending on the cause and treatment plan.
Conclusion
Arthritis in the big toe can be painful and limiting, but effective solutions are available. By understanding the causes, seeking early diagnosis, and following a comprehensive treatment plan—including innovative options like prolotherapy—you can achieve lasting relief and return to your active lifestyle.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating arthritis in big toe, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with arthritis in big toe and providing effective treatment options to alleviate them.
He first trained in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy and continued on to complete further training with the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Mr Eaton developed his treatment and examination approach through the process of treating his own chronic symptoms and is committed to making sure his patients experience the same life-changing effects his treatments had on him.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
LinkedIn profile: https://www.linkedin.com/in/oliver-eaton-4338225b/
References
- NHS. (2023). Osteoarthritis
- Arthritis Foundation. (2023). Hallux Rigidus (Big Toe Arthritis)
- Versus Arthritis. (2023). Osteoarthritis
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.