Trigger toe is a recognized condition. It is a common issue involving the tendons in the toe, primarily characterized by a catching or locking sensation. This condition can lead to discomfort and interfere with normal toe function.
Understanding Trigger Toe
Trigger toe, also known as flexor hallucis longus (FHL) tenosynovitis, is when the long tendon that helps bend the big toe becomes irritated or inflamed. This tendon, the FHL, runs through a protective sheath. When it or the sheath swells, the tendon’s smooth gliding motion is inhibited. The affected tendon may even develop frayed areas or nodules, further impeding its movement within the narrowed sheath.
Individuals with trigger toe often experience a catching, clicking, or locking sensation when bending or straightening the affected toe. This can be accompanied by pain at the base of the toe and stiffness. While it most commonly affects the big toe, trigger toe can occur in any toe.
Common Causes and Risk Factors
Trigger toe often develops due to repetitive gripping or flexing actions of the toes. Activities that involve prolonged standing or repeated pressure on the toes can also contribute to its onset. Overuse and strain can cause the tendon sheath to become inflamed and swollen, impeding tendon movement.
Certain underlying medical conditions can increase risk, including arthritis (such as rheumatoid arthritis) and metabolic conditions like diabetes mellitus. Neuromuscular imbalances and highly arched feet are also contributing factors. It is more frequent in middle-aged and older adults, and women tend to experience it more often than men.
Treatment and Management
Initial approaches to managing trigger toe typically involve non-surgical methods to reduce inflammation and restore normal toe movement. Rest is often recommended, along with applying ice to the affected area. Over-the-counter anti-inflammatory medications, such as NSAIDs, can help alleviate pain and swelling.
Splinting or taping the toe can help reduce movement and allow the tendon to rest. Physical therapy exercises, including gentle stretching, may be advised to maintain toe mobility and strengthen surrounding muscles. For persistent symptoms, a corticosteroid injection directly into the tendon sheath can reduce inflammation and allow the tendon to glide more freely.
If conservative treatments do not provide sufficient relief, surgical options may be considered. Procedures such as tenolysis or release of the tendon sheath aim to widen the space around the tendon.
To help prevent trigger toe, avoid prolonged repetitive toe movements and ensure footwear provides adequate space for the toes. Regular, gentle stretching of the toes and feet promotes tendon flexibility. Seeking professional medical attention from a podiatrist is advisable if symptoms persist or worsen.