‘This Little Piggy’ Hurts

Do you experience pain in your big toe? Big toe injuries impact and limit your ability to walk, exercise, and do other daily activities.  We depend on our big toe for leverage when walking, and the big toe helps provide stability and balance for our entire body. Problems with the big toe can lead to big issues that can impact your knees, hips, low back and even shoulder region because of the shift to an abnormal walking gait.

Below is a summary of three big toe issues that I commonly address at All and One Acupuncture.

Hallux limitus and Hallux rigidus

Photo Credit: Infinity Food and Ankle

Photo Credit: Infinity Foot and Ankle

Hallux (big toe) limitus is the loss of mobility in the big toe due to abnormal structural function at the big toe joint. Over time, abnormal structural biomechanics at the big toe joint leads to arthritic changes at the big toe. Not to be confused with bunions, hallux limitus is a progressive disorder that results in inflammation, swelling, pain, loss of range of motion, and arthritic deformation at the joint.  Hallux limitus can progress to hallux rigidus, wherein the bone deformation prohibits normal movement in the joint. Some people inherit specific foot structures that contribute to the development of hallux limitus. Overuse and footwear also contribute to hallux limitus. Hallux limitus is more common in women.


When patients come to me with hallux limitus, I do a thorough exam of the toe, noting swelling, pain, and range of motion of the big toe. If the patient has not been evaluated by a foot doctor, I will also refer them to a podiatrist so that an appropriate orthotic insert can be prescribed. Shoe modifications and orthotics will slow the progression of hallux limitus, so early diagnosis and treatment will have better outcomes. Acupuncture helps with hallux limitus by decreasing the local inflammation in the big toe, increasing range of motion, and reducing pain.



Gout is a form of arthritis that commonly affects the big toe. Gout is caused by the deposit of uric acid crystals into the joint, leading to swelling, stiffness, and sharp or burning pain at the joint. Gout is caused by abnormally high levels of uric acid in the bloodstream, and diet and medications can play a large role in the development of gout. Gout is more prevalent in men.

When I work with a patient with gout, I combine acupuncture, herbal therapy, and dietary therapy to address both the painful symptoms and reduce the recurrence of gout. Using this combination helps reduce the acute pain and inflammation, as well as reducing the total circulating uric acid in the bloodstream.


Sesamoid injuries

GW427H451Beneath the big toe joint on the sole of the foot are two pea shaped tiny free floating bones known as sesamoid bones. These independent bones help the tendons glide normally when walking. There are many types of sesamoid injuries, including injury to the soft tissue around the sesamoids, sesamoid fracture, and chronic inflammation or sesmoiditis. Sesamoid injuries can occur due to trauma, over extension of the big toe, excessive weight bearing activities on the big toe, and other causes. Symptoms usually involve tenderness, pain, and swelling on the underside of the big toe.

When I first see a sesamoid injury, I will assess the severity of the injury and potentially refer to a podiatrist for further evaluation. Acupuncture will help with sesamoid injuries by reducing inflammation, increasing blood flow to the foot, and reducing pain. Changing footwear, padding the region, and avoiding activities that exacerbate pain all contribute to the healing of sesamoid issues.


If you experience pain in your toes or feet, acupuncture can help aid your recovery process. Call All and One Acupuncture today to learn more.

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