What Are The Symptoms Of Big Toe Joint Arthritis
If you have big toe joint arthritis, you will likely experience:
- Stiffness and pain in the big toe joint
- Difficulty moving the big toe up and down
- Inflammation and swelling around the joint
- Pain that worsens with an increase in activity
Some patients may also develop a bump on top of the foot at the base of the big toe that can indicate the presence of a bone spur .
There are several factors that can increase your risk for big toe joint arthritis:
- Age most cases of big toe joint arthritis develop between the ages of 30 and 60
- Occupation jobs that place significant stress on the big toe, including those which require periods spent squatting or stooping, put you at a higher risk for developing the condition
- Foot anatomy certain structural abnormalities such as flat foot or excessive pronation of the foot can make you more prone to developing hallux rigidus
- Big toe injuries significant or repeated injuries to the big toe including stubbing the toe can damage the joints cartilage and make arthritis more likely
- Inflammatory diseases certain inflammatory diseases, such as rheumatoid arthritis and gout, can cause big toe joint arthritis
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.
Cartiva Implant: The Most Advanced Treatment For Toe Arthritis
When the cartilage around the big toe joint erodes over time, it limits the function and mobility of the foot and affects our capacity to walk, run and engage in sporting, social, and even everyday activities. This pain and stiffness associated with advanced-stage arthritis of the big toe can limit what is supposed to be the best years of ones life, but there is a revolutionary new procedure for those suffering chronic big toe pain.
Big toe arthritis is extremely common, says Dr. Breslauer. I see it at least once a day and sometimes several times a day at different stages of severity among patients middle aged and older.
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Why Do Some People Develop Arthritis In Big Toe
We see significant toe arthritis in people with abnormal mechanics of the foot. In particular, a long or elevated big toe can lead to irregular forces on the joint and early arthritis. Other factors leading to arthritis include a past break or injury, wearing poorly-fitting shoes, or arthritis disorders such as gout.
What Are Some Of The Main Early Symptoms Of Big Toe Arthritis
There are three main early symptoms of hallux rigidus: stiffness, pain and swelling.
A loss of toe motion upwards is also another symptom most commonly noted early on. At a later stage, loss of motion downwards , locking and catching of the joint can occur.
In early arthritis, the pain is generally felt more over the top of the joint particularly with dorsiflexion of the joint. This is due to impingement.
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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
Symptoms Of Arthritis In Toes
Common symptoms of toe arthritis may include:
You have pain in the toes that can take hours or days to subside.
You have swelling and inflammation around the toe joints.
- With rheumatoid arthritis and psoriatic arthritis, swelling and edema is associated with redness.
- With osteoarthritis, there is more bone enlargement of the toe joints as a result of bone spur formation, says podiatrist Krista A. Archer, DPM, a podiatric surgeon who is on staff at Lenox Hill Hospital in New York City. Bone spurs are bony projections that develop along bone edges, often due to joint damage from arthritis.
You have restricted range of motion due to swelling or damage to cartilage in any joints that are in the toes, midfoot, rearfoot, and ankle, says Dr. Archer. Bone spurs will often develop around the joint, restricting movement.
You may be unable to bend your big toe upward and have pain when doing so, says Chadwick Hampton, MD, an orthopedic surgeon at Palm Beach Gardens Medical Center in Palm Beach Gardens, Florida. That can make it difficult and painful to walk.
Your toe may become bent permanently downward and cant be positioned flat on the floor.
Your pain worsens with weight-bearing activities like jogging, walking, and climbing stairs. It depends on how severe the deformity is to predict what kind of activities will be painful, says Dr. Archer.
You may have a bump form when the joints rub together. It resembles a callus or bunion.
You may have pitted, separated, or thick toenails.
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Modified Capsular Interpositional Arthroplasty Technique
Dr Ozcan has been pioneering a modified version of the capsular interpositional arthroplasty technique. This technique involves a combination of arthroplasty and cheilectomy with a tissue graft harvested from the patient’s own body. It is done as a day case under general anaesthesia and the patient gains immediate function after the surgery. The patient is capable of immediate weight-bearing in surgical sandals for 3 weeks, followed by a further 3 weeks in sport shoes. This technique has been highly successful instead of the arthrodesis, and patients are back to their own choice of foot wear without any limitations.
- Modified capsular interpositional arthroplasty surgery
- Modified capsular interpositional arthroplasty surgery
Fused joints: There are times when patients have had joint arthrodeses at the big toe joint and now may be suffering from the ill effects of this procedure. The ill effects involve joint degeneration and deformation at the nearby joints, poor gait function and pain all over the foot. Dr Ozcan uses the modified capsular arthroplasty technique to reverse the arthrodesis at these joints. He basically unfuses a fused joint without the use of any pins, screws or plates.
How Arthritis In The Toes Is Diagnosed
The diagnosis of arthritis in toes begins with taking your medical history and a physical exam of your foot. The doctor will look at your entire foot, not just your toes. Theyre looking for pain, deformity, and loss of function, says Dr. Archer. Your doctor will likely order an X-ray of the foot to help determine whether there is joint damage or changes in the alignment of bones in the foot.
If your doctor suspects you could have a type of inflammatory arthritis, such as RA or PsA, they may order blood tests to look for signs of inflammation as well as antibodies . If your doctor suspects you could have gout, they may give you a blood test to look for elevated levels of uric acid and draw fluid from the joint to look for uric acid crystals.
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What Anesthesia Is Needed For Big Toe Arthritis Surgery
Big Toe Arthritis surgery is performed as outpatient surgery . It may be performed in a hospital, ambulatory surgery center and even in the doctors office .
The surgery can be performed under a local, regional, spinal or general anesthetic. Local and regional blocks, with monitored anesthesia care are most commonly performed. This means that the foot will be numbed with an anesthetic while an anesthesiologist provides sedation to relax you.
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Will I Need Surgery For Hallux Rigidus
Sometimes, conservative measures arent enough. You may still have pain and stiffness. If the pain interferes with your life, surgery can help. Surgical procedures for hallux rigidus include:
- Cheilectomy : Shaving the bone spur can help relieve pain and preserve joint motion. A cheilectomy allows more room for the toe to bend.
- Osteotomy: Cutting the bone can realign or shorten the big toe.
- Interpositional arthroplasty: Healthcare providers may recommend this joint resurfacing procedure for younger patients. Surgeons remove some of the damaged bone. They place a spacer of donor tissue between the joint ends to relieve pain.
- Arthrodesis: For severe cases, this joint fusion procedure can provide long-lasting pain relief. Surgeons remove the damaged cartilage and join the two bones together. This surgery offers a permanent solution but may restrict big toe movement.
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Are Women More Likely To Get The Problem
It can be more common in women as they tend to wear tighter, narrower shoes with increased heel height. These shoes place a lot of pressure onto the joint and predispose to symptoms. It is common for patients to wear shoes that are too small and this can predispose to the problem. In a study we have performed, 95% of patients were in the wrong size shoes.
Maintain Healthy Blood Sugar Levels
Recent research shows that high blood sugar can help the formation of molecules that cause cartilage to stiffen. People with diabetes also experience inflammation that can cause a loss of cartilage.
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Look For Flexibility And Breathability
Investing in a good pair of Best Shoes For Arthritis In Big Toe is an important decision, as the wrong shoes can cause not just discomfort but pain. When shopping for these shoes look for two main characteristics: flexibility and breathability. Shoes that are flexible allow your feet to move naturally and bend with each step, taking the load of pressure off of painful regions.
Breathability keeps air circulating inside the shoe and keeps moisture out, easing the possibility of blistering or skin irritation. Investing in Best Shoes For Arthritis In Big Toe takes some research, but focuses on flexibility and breathability will help you find a long-lasting and comfortable pair that puts you back on track towards an active life!
Soothe With Ice And Heat
Cold therapy can provide relief for inflamed joints in the wrist. Cold constricts the blood vessels in the muscles, which decreases blood flow to the joint area to help reduce swelling and inflammation. Heat therapy warms the skin and the joints, which causes blood vessels to dilate, and sends more oxygen and nutrients to the joints and muscles. Try both and see which makes you feel best.
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Set A Weight Loss Goal
When it comes to arthritis, what your scale says really matters. People with a higher body weight are diagnosed with arthritis at an earlier age and have more severe arthritis. It makes sense: Feet have weight-bearing joints, so obesity makes arthritis worse, says Dr Domingues. Even one extra kilogram on your frame can equal about five extra kilos of force on your feet. Losing 10 kilos can mean sparing your feet from an extra 50 kilos of force with every stride.
Excess body weight also increases inflammation. This can fuel the painful symptoms of inflammatory types of arthritis like rheumatoid arthritis and psoriatic arthritis. Its not easy to lose weight when you have stiff or sore joints. However, even a five to 10 per cent reduction in body weight has been shown to dramatically diminish joint pain and improve exercise tolerance.
What Are The Symptoms Of Oa In The Toe
Even in the early stages, arthritis in the toe can cause tenderness, achiness, and joint pain. You may also feel achiness or pain in other toes or the arch of your foot as you walk.
Over time, you may even develop a burning sensation, which is a hallmark sign of nerve pain, or neuropathy.
An arthritic toe may ache after long periods of sitting or when you first wake up in the morning. Stiffness and pain is typically a sign of OA after long periods of inactivity or immobility.
Overgrowth of the big toe bone can make it difficult or even impossible to bend your toe.
More specifically, in people with OA, the joint degenerates and a reactive bone process is triggered, such as spurs or ankylosing. The excess bone growth can lead to fusion of the joint and a fixed, or non-bending joint. The result is a stiff toe, which is also called hallux rigidus.
What Is Hallux Rigidus
Hallux rigidus is arthritis of the joint at the base of the big toe. It is the most common arthritic condition of the foot, affecting 1 in 40 people over the age of 50 and typically developing in those over age 30. Big toe arthritis tends to affect women more than men.
The big toe joint is called the hallux metatarsal phalangeal joint. This joint connects the head of the first foot bone with the base of the first toe bone and the two tiny bones underneath the metatarsal. Usually the greatest area of wear is at the top of the joint.
Big Toe Joint Arthritis Surgery
Surgery for arthritis of the big toe joint is separated into two types of procedures those that spare the joint or those that remove the joint .
A sparing procedure allows for continued motion with the joint surgically modified or cleaned up of the arthritis to alleviate pain and increase motion. A destructive procedure involves removing the joint and performing a fusion or a joint replacement .
The extent of the arthritis dictates whether or not the joint could be saved. Dr. Blitz evaluates each joint carefully, and takes significant measures to prevent joint destructive procedures while still preserving motion and decreasing/eliminating pain.
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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.
How To Diagnose Arthritis In The Big Toe
If you are experiencing pain and swelling in your big toe and you suspect you are developing arthritis, it makes sense to seek out specialist help as soon as possible.
Getting a diagnosis from Dr Bhadauria is easy. Simply contact our friendly team to book a private consultation in one of our London-based clinics. Dr Bhadauria will give your feet a physical examination, discuss your symptoms and schedule the most appropriate diagnostic tests needed to provide you with a proper diagnosis.
You may need an X-ray of your big toe to assess the level of joint degeneration and even a scan to determine the health of your joint cartilage. It is essential to have a specialist diagnosis to rule out any other possible causes for your symptoms.
You are more likely to develop arthritis if:
- There is a family history of it
- You are overweight
- You have an old injury to your foot
- Hallux rigidus also can occur after a toe injury or deformity of the foot
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