Physical Therapy For Arthritis In Toes
Your doctor may send you for physical therapy to help improve your range of motion and strengthen the muscles around your foot. Physical therapy can increase pain-free range of motion and strengthen the muscles of the foot to take pressure off the painful joint, says David Geier, MD, an orthopedic surgeon, sports medicine specialist, and author of Thats Gotta Hurt: The Injuries That Changed Sports Forever. These exercises relieve stiffness and increase your ability to move your joints through their full range of motion.
What Is Big Toe Joint Arthritis
The big toe joint, also known as the metatarsophalangeal joint, is located at the base of the big toe and is the most common site of arthritis in the foot. Big toe joint arthritis is characterized by an erosion of cartilage, which results in pain and stiffness in the toe joint. Since this joint moves every time you take a step, the condition can make walking very difficult.
Does Hallux Rigidus Require Surgery
Unfortunately, there are cases where conservative treatment will not work. The pain and stiffness continue to impact even the simplest of tasks. At this point, surgery is an effective treatment option. A surgeon can perform a cheilectomy, which involves shaving off the bone spurs causing the pain. The surgeon may also perform further procedures to cut out bone or fuse the joints. A fusion restricts the toes range of motion but can significantly improve pain.
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Home Remedies For Big Toe Arthritis
An estimated 54.4 million American adults were told they had some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia between 2013 and 2015, according to the Centers for Disease Control and Prevention .
Arthritis can affect any part of the body where joints exist and your toes are not an exception. In fact, toe arthritis is very common and many people suffer from this painful problem.
In most cases, toe arthritis attacks the big toe, but the other toes could be affected as well. Big toe arthritis, also known as hallux limitus or hallux rigidus, occurs when the big toe moves upward or begins to form bone spurs, which limits the range of motion of the toe.
Your risk of big toe arthritis increases as you age. This is mostly due to wear and tear. The risk is also higher if you have a family history of it or if you are obese.
Big toe arthritis usually starts with a stiffness of the joint and can be accompanied by swelling and redness. Other symptoms include enlargement of the joint, pain, difficulty wearing certain shoes, difficulty walking , associated deformity, and soft tissue irritation or inflammation.
It is not at all unusual for patients to confuse bunions with big toe arthritis because both conditions can cause pain and a bump and enlargement at the big toe joint. But they are actually very different.
Here are the top 10 home remedies for big toe arthritis.
What Causes Hallux Rigidus
For most people, there is no clear cause. Hallux rigidus likely develops because the toe joint experiences a lot of stress when you walk. Every step you take places a force equal to twice your body weight on the toe joint.
Other causes of hallux rigidus include:
- Overuse of the joint, such as in workers who stoop or squat or athletes who stress the joint.
- Injuries, such as stubbing the toe or spraining the joint .
- Genetics, since it can run in the family. It may come from inheriting a particular foot type or way of walking that leads to the condition.
- Osteoarthritis, which is joint inflammation due to wear and tear on the joint.
- Inflammatory diseases, such as rheumatoid arthritis or gout.
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I Have Heard It Is Very Painful
The nature of surgery means that there will be pain and swelling, usually worse the night after surgery. However, with modern anaesthetic techniques and pain killers, this can be well controlled. The level of pain experienced varies greatly from patient to patient with some experiencing no significant discomfort.
Are There A Lot Of Complications
There are risks and complications with all operations and these should be discussed in detail with your specialist. However, with most foot surgery it is important to remember that it is always possible that you may be left with some pain and stiffness and the deformity may reoccur in the future. This is why it is not advisable to have surgery if the deformity is not painful and does not limit your walking. A thorough examination of your foot and general health is important so that these complications can be minimised.
Although every effort is made to reduce complications, these can occur. In addition to the general complications that can occur with foot surgery, there are some specific risks with surgery for Hallux Limitus / Rigidus:
- Continued stiffness
- Deterioration of arthritis and therefore symptoms requiring further surgery
- Failure / rejection of implant material
- You may get discomfort in other parts of your foot during the recovery period. This
generally settles.
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How Does Hallux Rigidus Affect Me
Hallux rigidus causes pain and stiffness in the metatarsophalangeal joint. Thats the joint where your big toe meets your foot.
Hallux rigidus is a progressive condition, which means it can get worse over time. Some people find that it never gets much worse than when it started. But for others, the pain and stiffness worsen. They have less and less motion in the joint.
Diagnosing And Treating Big Toe Arthritis
Many foot specialists can make a diagnosis of big toe arthritis simply by reviewing your medical history and a physical examination, although X-rays may be taken to get a better idea of the extent of the damage and to rule out the possibility of bone spurs. If big toe arthritis is the diagnosis, your doctor will likely begin by walking you through your non-operative solutions.
Many cases of big toe arthritis respond well to conservative techniques. While they will not reverse the damage to the joint, these techniques can help to curb or alleviate symptoms by strengthening supportive structures both inside and around the joint. Some of the most common non-operative techniques used in combination with one another are rest, anti-inflammatory medications, footwear changes to a wider and more comfortable shoe, orthotic inserts, weight loss and physical therapy exercises.
So if you are dealing with pain, swelling and stiffness in your big toe, dont just assume it will eventually go away on its own, because odds are it will only get worse. Instead, sync up with Dr. McDonald and put an end to the problems caused by your big toe arthritis. For more information, or to set up a consultation with Dr. McDonalds office, give his team a call today at 244-8889.
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Use Topical Medications For Arthritis In The Feet
Some people find that topical medications provide relief from foot arthritis pain, Frisch says. Look for topicals with capsaicin, an ingredient found in chile peppers thats believed to decrease the amount of substance P, which transmits pain in the body. Capsaicin is sold over the counter as a cream, ointment, stick, gel, lotion, liquid, or pad and under different brand names, such as Icy Hot and Zostrix.
Use Orthotic Devices For Stability And Balance
Canes, braces, shoe inserts your specific problem will determine what you need, Frisch says. Some people with arthritis in their feet find relief simply by taping their toes together. For others, a cane helps with stability. Still others find foot pain relief from shoe inserts because they can correct misalignments and distribute weight more evenly over the bottoms of your feet. You can buy shoe inserts over the counter or have them custom-made.
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Whats Aching Your Big Toe
It is easy to forget how important your big toe is most of the time it stays out of sight and out of mind, hidden beneath our socks and shoes. But if you have ever had toe pain, you know it can keep you off your feet and up at night.
When arthritis affects the foot it usually hits at the base of the big toe in what is known as the MTP, or metatarsophalangeal joint. This can cause big problems for the tiny joint that has to bend and bear about 50% of your body weight every time you take a step.
Here are six common culprits of big toe joint painmany of which are relatedand ways you can find relief.
How Is Hallux Rigidus Treated
To relieve pain, your healthcare provider may recommend:
- Appropriate shoes: Wear shoes that have plenty of room for your toes. You may find that shoes with stiff soles relieve pain. Avoid wearing high heels.
- Limited toe movement: Place pads in your shoe to limit movement of your big toe. Avoid activities that stress your toe joint, such as jogging.
- Pain relievers: Nonsteroidal anti-inflammatory medications, such as ibuprofen, can relieve pain and reduce swelling.
- Foot soaks: Try a contrast bath, switching between hot and cold water to relieve inflammation. Place your foot in hot water for 30 seconds, then right away in cold water for 30 seconds.
- Injections: Corticosteroid injections can help relieve pain.
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What A Podiatrist Can Do
If youre having pain thats not going awayeven when youre resting and icing your footyou should see a foot specialist, says Dr. Koivunen.
To help reduce chronic inflammation in the toe joint, your doctor may recommend oral anti-inflammatory medication or a steroid injection into the joint.
When anti-inflammatories and better shoe choices arent enough to keep the pain from coming back, your doctor may recommend surgery. During a procedure called a second metatarsal osteotomy, a foot surgeon cuts away part of your second metatarsal to shorten it.
Surgery is usually a last option, says Dr. Koivunen. In most cases were able to treat it more conservatively and still help people find relief.
To find a podiatrist at Henry Ford, visit henryford.com or call .
Dr. Robert Koivunen is a foot and ankle specialist who sees patients at Henry Ford West Bloomfield Hospital and Henry Ford Medical Centers – Columbus, Livonia and Royal Oak.
Stretch Your Achilles Tendons To Increase Flexibility
You probably dont think about getting your feet in shape the way you do your stomach or your thighs. But exercising your feet can help increase your flexibility and mobility, important when you have arthritis in your feet. Good exercises involve stretching your Achilles tendon as well as the tendons in the balls of your feet and toes. A good exercise for arthritic feet is simply to wiggle your toes. Frisch has his patients use the TV as an exercise aid.
When a commercial comes on, use that time to wiggle, he says. Just dont overdo: Stretching is good to help joint mobility, but dont do it to the point where youre hurting yourself.
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Outlook For Arthritis In The Big Toe
Hallux rigidus can progress to end-stage arthritis of the big toe.
This typically corresponds to grade 4 classification on the Coughlin and Shurnas Clinical Radiographic System for Grading Hallux Rigidus, characterized by significant limitations to mobility and substantial pain.
In such cases, surgery may be necessary to relieve the pain and repair the arthritic damage.
Not all treatment options can stop the condition from progressing, and they may not be successful. However, it can be possible to perform revision surgeries.
Look Out For These Symptoms
Hallux rigidus develops slowly. The pain can be intermittent, increasing in intensity and duration. Common symptoms include stiffness, swelling, and numbness. The toe becomes challenging to bend and move without pain. Walking also feels painful, especially on uneven ground. Some people with hallux rigidus develop calluses and even a bunion.
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Foot Trauma Or Injuries
Patients who have sustained a focal injury to a portion of the cartilage of the great toe joint, specifically athletes, may also go on to develop arthritis of this joint. This injury may have happened in their teens and twenties, unbeknownst to the patient, but the arthritis may present much later in life.
Great toe fracture or other higher-energy trauma may also damage the cartilage and cause great toe arthritis in the long run.
What Is Hallux Rigidus Anyway
In simple terms, hallux rigidus means stiff big toe. With hallux rigidus, the MTP or metatarsophalangeal joint degenerates due to arthritis. Over time, people with hallux rigidus feel pain and stiffness that impacts walking and standing. Hallux rigidus is also called turf toe, a common complaint of athletes. The condition can be hereditary. However, overuse of the joint, a previous injury, gout, or rheumatoid arthritis are also common risk factors.
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Will I Have To Have A Plaster Cast
Not necessarily. In the majority of cases, newer techniques mean patients do not need a plaster cast and can walk a lot sooner. However, in more severe cases, this may be necessary due to the nature of the operation required for adequate correction. In these instances, you may not be able to walk on the foot for up to 6 weeks.
What Is Osteoarthritis Of The Big Toe
Your big toe joint is called the 1st metatarsophalangeal joint. There are many reasons why someone can develop pain in this region. One of the more common problems is osteoarthritis. Not everyone who has arthritis will suffer with symptoms, but those that do can experience pain, stiffness, reduced mobility and function.
The experience of big toe osteoarthritis is often unique to each individual but often people with symptomatic osteoarthritis report stiffness in a morning, pain during activity such as walking or going onto your tip toes. There is usually reduced movement to the joint and sometimes the toe can angle over towards your second toe. Some people may also experience crepitus. This is a crunching or cracking noise or feeling that usually isnt anything to worry about.
Contrary to popular belief, osteoarthritis is not caused by ageing and does not necessarily deteriorate with time. At the end of each bone we have a type of cartilage known as hyaline cartilage. Osteoarthritis is the localised loss of this cartilage . This is associated with inflammation and bony remodelling . Bony remodelling is normal and is not correlated with symptoms. You can have a large amount of remodelling and no pain or you can have barely any remodelling and have severe pain. This remodelling explains why some people get crepitus. As your joints repair themselves through your lifetime, their shape and structure can change slightly which can lead to crepitus.
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Arthritis Of The Big Toe: What Are My Treatment Options
What is it?
Arthritis is a condition that occurs when the cartilage that covers both sides of a joint deteriorates and the joint space narrows. Arthritis of the big toe can cause disabling pain, limited motion, and loss of the normal function of the foot when walking. This can make shoe selection difficult and limit your desired activity level. Arthritis in the big toe joint can be caused by degenerative arthritis, rheumatoid arthritis, or an associated bunion deformity. When there is a limited range of motion at the joint the condition is termed hallux limitus . If the joint damage has progressed and there is little to no motion remaining in the joint, the condition is called hallux rigidus and you may have pain in the joint even when at rest.
Diagnosis
Most cases can be diagnosed based on the clinical history and physical examination alone. However, X-rays are extremely important and help understand the extent of arthritis, the size, and the location of the bone spurs.
Figure 1. Arthritis of the big toe joint. The white arrow points to a chip fracture of the base of the big toe. The red arrows identify joint space narrowing and degeneration of the metatarsal head.
Figure 2. Side view of the big toe joint outlined in yellow with red arrows pointing to a large spur of the metatarsal head which causes jamming of the joint when the toe flexes upward.
Treatment Options
- Figure 3 Before
- Figure 3 After
Talk to a Podiatrist
Maintain A Healthy Weight
Your entire body weight falls on your feet while standing, which puts a lot of strain on your toe joints. The heavier you are, the more stress your joints will have to endure.
Under such conditions, even simple but regular activities such as walking can cause wear and tear in your joints, which can worsen over time. Maintaining a healthy weight is therefore very important to minimize joint degeneration.
The best way to stay fit and reach your weight goals involves a 2-part approach:
- Eating a nutritious, well-balanced diet
- Burning the extra calories through some form of physical activity done for about 30 minutes daily
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Risk Factors And Prevention
The main underlying cause of the cartilage degeneration is unknown in most cases, but multiple risk factors may contribute, including:
- family history of hallux rigidus
- repetitive stress on the MTP joint
- inflammatory conditions, such as gout, rheumatoid arthritis, or certain metabolic conditions
- injury that damages the articular cartilage in the MTP joint
- in adolescents, it has been seen alongside osteochondritis, in which the cartilage sustains damage from a lack of blood flow
- having a certain foot structure or anatomy that increases stress on the joint