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FERME LAB 004Luke writes: Hello, Dr. Nirenberg. I have discomfort in my right big toe at the base or ball of my foot. Recently, if I run, jump, or simply move my foot, it feels as if there is a string tightening around the joint of my big toe, at or near the base. I dont feel any pain(yet?!?), but its an uncomfortable feeling, and I dont want to do any more damage if that is what has occured. What do you think? Thankyou!

Dr. Nirenberg’s Reply:

Hi Luke. I am glad you are being proactive and looking into this big toe problem before you have some serious foot pain. You have recognized that something doesn’t feel the same–doesn’t feel right in the big toe joint, and want it checked.

The big toe joint is actually very complex. It comprises ligaments, a joint capsule and two small bones underneath the joint that act as pulleys. These two small bones are called sesamoids or sesamoid bones. Either of these sesamoid bones can be sprained or even fractured, or the big toe joint can have arthritis or a fracture itself. You need a podiatrist to x-ray the joint.

Arthritis of the big toe joint, or a fracture or sprain of the sesamoid bone is quite common. Sesamoiditis is an inflammation of either of the sesamoids.

Sesamoiditis or a fractured sesmoid is usually treated with rest, soaks and imbolization. Often, having an orthotic rebalance the foot can help, too. In generaly, orthotics help with big toe problems.

Keep in mind, other problems in the big toe joint that can occur, but it doesn’t sound like this is going on, is infection, gout, or ligament or tendon problems.

I hope this helps. Let me know what you discover!


  • Schleibingerfam

    My foot was fine yesterday and suddenly when I went to walk I had incredible pain through the big toe joint and up and through the top/side of my foot. When I flex my big toe to walk the pain is unbearable, if I walk flat footed (sort of clump along) the pain is tolerable. At rest the pain is also there through the joint/arch and top/side of foot. Any ideas?