Big Toe Osteoarthritis and Hyaluronic Acid Injection: A Patient Success Story

Introduction
Big toe pain caused by osteoarthritis (OA) is a surprisingly common issue, especially among older adults who remain active. In this case study, we share how a 56-year-old man with advanced big toe arthritis achieved significant pain relief through a single hyaluronic acid injection at McFerran Physio — after years of trying nearly every other treatment.

Patient Background
The patient, a 56-year-old male, had suffered with pain in his big toe for many years. An X-ray taken several years earlier confirmed advanced osteoarthritis in the joint at the base of the toe — the first metatarsophalangeal (MTP) joint.

He had previously tried:

• Orthotic insoles (prescribed by podiatry).
• Oral anti-inflammatory medications (e.g. ibuprofen, paracetamol).
• Hot/cold therapy and topical gels.
• Two steroid injections, which offered only limited relief.

At the time of contact, he was specifically seeking a hyaluronic acid injection — having heard about its benefits and success from others. He was not interested in physiotherapy or exercise-based rehab, just the injection itself.

Pre-Injection Screening & Consultation

We held a brief phone consultation to:

• Explain what hyaluronic acid injections are.
• Discuss potential benefits and risks.
• Screen for contraindications (e.g. current infection, recent antibiotic use, history of anaphylaxis).

After confirming he was a suitable candidate and obtaining written consent, we scheduled his injection.

Assessment Findings

During the in-person visit, a physical examination of the big toe showed:

• Swelling and enlargement of the MTP joint compared to the opposite toe.
• Marked loss of movement:
  • Significantly restricted flexion (toe bending down).
  • Significantly restricted extension (toe lifting up).
• Joint line tenderness directly over the arthritic joint.

Combined with his X-ray history and clinical symptoms, the patient was a clear candidate for hyaluronic acid injection into the first MTP joint.

The Injection Procedure

Despite the small size of the joint, the injection:

• Was administered smoothly and successfully
• Caused minimal discomfort
• Delivered the hyaluronic acid directly into the joint capsule with no complications

Patient Outcome

A few days after the procedure, the patient reached out:

“This is the most relief I’ve had in years.”

He was:

• Walking with no pain.
• Sleeping better.
• Enjoying daily activities without constant toe discomfort.

Three months later, he contacted us again to report he was still pain-free, which had not been the case in over a decade.

Six months after the injection, the patient proactively inquired about booking a second injection, knowing that the effects — while long-lasting — are not permanent.

Conclusion

This case illustrates how hyaluronic acid injections can be a highly effective, non-surgical option for managing advanced osteoarthritis — not just in the knee, but in smaller joints like the big toe as well.

At McFerran Physio, we offer:

• Expert clinical assessment.
• Direct access to in-house hyaluronic acid injections.
• Flexible options for patients who know what they need (including direct booking for repeat injections).

If you suffer from big toe pain or arthritis in a small joint, hyaluronic acid may help restore your quality of life — even when other treatments have failed.

Book your injection consultation today.