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Bunions or Arthritis? The Real Cause of Your Big Toe Joint Pain


You may be familiar with bunions and the pain and frustration that comes along with the foot condition. Shoes don’t fit, normal activities become uncomfortable, not to mention, they’re unsightly. During the colder months, it may seem like your bunion pain is getting worse, but as it turns out, there’s another condition that frequently gets misconstrued for bunions — arthritis.

That’s right. Your big toe can become arthritic, and unfortunately, distinguishing between a bunion and an arthritic toe joint can be a little tricky. Generally, an arthritic toe joint can feel more like a stabbing, intense pain, whereas bunion pain can be dull (though sometimes worsening) and comes secondary to the physical bone deformity. 

A bunion is a bone deformity that occurs at the base of the big toe. Though we don’t know exactly what causes them, they are often hereditary and it’s known that wearing unsupportive shoes can make them worse. Symptoms include swelling and pain at the base of the big toe, callused skin under the toe, and a protruding bump on the inside edge of the foot. Treating bunion pain typically involves at-home remedies like application of heat or ice, OTC anti-inflammatory medications like ibuprofen, massage, and shoe inserts. The bunion will not go away without surgery, which is needed in some more serious cases. 

So what’s the difference between bunions and arthritis? “A bunion of the big toe is where the big toe starts leaning towards the smaller toes,” explains Selene G. Parekh, MD, Board Certified Orthopedic Surgeon. “It results in a bump on the inside aspect of the knuckle of the big toe. Arthritis of the big toe is a wear-and-tear issue of the knuckle of the big toe. In this scenario, the joint begins to wear, becomes thinner and thinner, and as the bones start approaching one another, the body starts creating bone spurs to limit the joint motion. In this disease, the bone spur is typically on the upper surface of the joint of the big knuckle.” 

Many will confuse the two conditions during this time of year as the cold weather makes our joints a bit more stiff and achey, but if it does happen to be arthritis, you wouldn’t want to delay treatment and allow the condition to worsen. “Symptoms of arthritis of the big toe can include increased pain, swelling, and stiffness, as well as difficulty with shoe wear and other activities, especially those requiring lots of bending of the toe, like squatting and kneeling,” says Craig S. Radnay, MD, MPH, another Board Certified Orthopedic Surgeon. 

Arthritis Treatment Options

When it comes to treating arthritic toe pain, there are things you can do right at home. “Patients can try over-the-counter standardized turmeric, over-the-counter anti-inflammatory pills, different types of pain creams, and stiff [shoe] inserts,” says Dr. Parekh. And Dr. Radnay adds: “Ice and heat can help in addition to oral anti-inflammatories. Massage can also help relieve some of the pain.” 

However, if your symptoms persist and you’re having trouble with normal daily activities, it may be time to see a doctor. “Once you start noticing regular pain, swelling and/or stiffness which increasingly limit you from doing activities that you otherwise would like to do, it is probably a good idea to see a foot and ankle specialist,” says Dr. Radnay. So, don’t ignore the pain and think it will get better on its own! Luckily, there are many treatment options for big toe arthritis, and your specialist can help you choose the right one. 

“Certainly, initial shoe wear and activity modification and anti-inflammatories can help,” explains Dr. Radnay. He also says cortisone injections can provide temporary relief and with persistent pain, surgical intervention might be needed for arthritis as well. 

So if you’ve noticed toe pain that simply isn’t going away, you can try some of these at-home remedies, but be sure to see a specialist if you’re not seeing improvements. Getting the proper care can help you avoid bigger problems in the long-term and help you get your mobility back! Interested in trying a turmeric supplement for the pain? We love this one from Nature’s Nutrition ($14.92, Amazon).

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