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Arthritis in the Big Toe Joint

Osteoarthritis (OA) is the most common type of arthritis, and it can affect joints anywhere in the body. When cartilage in the joints wears down, bones become exposed and rub against each other. This causes swelling and pain in the joint and can limit your range of motion. OA generally starts slowly but worsens over time. The base of the big toe, known as the first metatarsophalangeal joint, is a common site of OA.

Hallux Limitus vs Hallux Rigidus

'Hallux' is the medical term for the big toe. When there is stiffness in the big toe joint it is called 'Hallux Limitus'. When the big toe possesses no motion at all, it is termed 'Hallux Rigidus'. Sometimes the big toe joint may appear to have normal motion when non-weightbearing, but this motion can be limited when weight is on the foot and when walking. This is termed 'functional Hallux limitus', because it occurs during the normal functioning of the foot while walking. As with many conditions that affect the foot, functional conditions progress to structural deformities. As the condition progresses, a degenerative type of arthritis develops in the big toe joint.

When there is jamming in the big toe joint it can also cause callus underneath the joint or bone spurs on top of the joint.

SYMPTOMS

Pain with motion, walking, running.
Pain associated with vigorous activity
Pain and tenderness when pressure is applied to the affected area
Inflammation of joint, redness of the affected area.
Deformity of associated joints.

DIAGNOSIS

Diagnosis occurs following a clinical examination.

X-ray and other methods of internal body scanning allow the type of arthritis to be determined. Blood testing may also offer your doctor which type of arthritis is being suffered.

MANAGEMENT

Initial conservative treatment consists of using oral anti-inflammatory medications, Custom-made Foot Orthoses, suitable footwear and modifying activities.

Oral medications are useful in treating the pain associated with the condition, but will not stop the process because they do not address the underlying cause of the condition.

Functional orthoses, however, are designed to treat the cause of the condition. These devices will generally fit into normal shoes and correct the underlying functional problem with the joint. Orthoses will not reverse what damage may have occurred, but can slow or halt the on-going damage to the joint.

Wearing appropriate footwear is also a key aspect of managing arthritis. A shoe with a harder sole that is difficult to bend at the toe will reduce the amount the toe has to bend during walking.

If conservative treatment is not providing enough pain relief, the Podiatrist will refer you for cortisone injections and a surgical opinion.

HOW CAN FIREFLY FOOT & ANKLE CLINICS HELP?

Firefly's podiatrists can advise:

on appropriate footwear
advise on exercises
Prescribe assistive orthotics such as an Ankle Foot Orthosis [AFO] to help improve mobility.
Prescribe custom made orthotics to correct foot position of a deformed foot to reduce pain in the foot or joint.
Advise on surgery.

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