What to Do About a Big Toe That’s Curved Inward

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As we age, the big toe can 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?

Causes of a Big Toe Curved Inward

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.

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Standard Treatments for Pain and Arthritis in the Big Toe

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 (1), 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 non-steroidal 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 (2). 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.

Prevent a Bent Big Toe From Getting Worse

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 (3). Curcumin can also relieve pain from arthritis (4). If the bent big toe pain still won’t go away, consider a high-dose PRP 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.

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References

(1) Försth P, Ólafsson G, Carlsson T, et al. A Randomized, Controlled Trial of Fusion Surgery for Lumbar Spinal Stenosis. N Engl J Med. 2016;374(15):1413-1423. doi:10.1056/NEJMoa1513721

(2) Younes M, Neffati F, Touzi M, et al. Systemic effects of epidural and intra-articular glucocorticoid injections in diabetic and non-diabetic patients. Joint Bone Spine. 2007;74(5):472-476. doi:10.1016/j.jbspin.2006.10.009

(3) Zeng C, Wei J, Li H, et al. Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee. Sci Rep. 2015;5:16827. Published 2015 Nov 18. doi:10.1038/srep16827

(4) Panahi Y, Alishiri GH, Parvin S, Sahebkar A. Mitigation of Systemic Oxidative Stress by Curcuminoids in Osteoarthritis: Results of a Randomized Controlled Trial. J Diet Suppl. 2016;13(2):209-220. doi:10.3109/19390211.2015.1008611

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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

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