Arthritis in the Big Toe

Do you have pain and difficulty bending your big toe at the joint where it connects to foot? If so, it’s quite possible you have developed a condition known as hallux rigidus. Don’t let the fancy name intimidate you, though! “Hallux” refers to the big toe and “rigidus,” as you might expect, means the toe is rigid and cannot move. To put it another way, this condition is degenerative arthritis in the big toe.

The affected joint in this case has another intimidating name—the metatarsophalangeal (MTP) joint—but it might be easier just to think of this as the joint where your toe connects to the foot.

If you have arthritis in your big toe, you will likely find the MTP joint to be stiff and causing pain. Over time, you will find it increasingly difficult to bend the affected toe. Take a moment to think about how you push off with your toes at the end of the ground portion of your gait cycle—yet another technical term we’ll explain in a moment—and you will understand why this is such a big problem.

“Gait” simply refers to how your body moves when you take a step. Due to natural differences in foot structure (even subtle ones), everyone’s gait is unique to at least a certain degree. Issues like hallux rigidus can have a definite effect on your gait pattern and change the way you walk.

When left untreated, hallux rigidus will eventually reach the point where the big toe becomes completely stiff from what is sometimes called a frozen joint. For this reason, it is important to recognize early symptoms like:

• Pain and stiffness in the big toe while walking, standing, bending, etc.
• Difficulty performing certain activities, like running and squatting
• Inflammation and swelling around the joint
• Pain and stiffness aggravated by cold and damp weather

As the condition progresses over time, additional symptoms will likely develop. These include:

• Pain during rest (and not only during activity)
• Dull pain in your knee, hip, or lower back that can be attributed to changes in the way you walk (your gait cycle)
• Difficulty wearing shoes on account of bone spurs
• Limping

Now, some patients will confuse hallux rigidus with other conditions that can develop in the same joint—the big toe’s MTP joint—but these are not the same and require different treatment methods. Of course, they are all similar in the fact that early treatment is best. This is especially true in the case of hallux rigidus, since the condition is progressive.

Progressive conditions are those which worsen over time and cannot be corrected without surgical intervention. That being said, conservative care and treatment may be used to both address present symptoms and keep the condition from becoming more severe. For example, we might prescribe medication to relieve pain and swelling, along with custom orthotic devices to reduce physical stress on the joint. These options are generally more likely to produce the results you hope to see when the problem is addressed early (before the joint’s range motion becomes severely limited).

Beyond medication and custom orthotics, other nonsurgical treatment options include:

• Shoe modifications. We may recommend changing footwear to types that feature wide, deep toe boxes (area in the front of a shoe) so there is less pressure on your big toe. Stiff or rocker-bottom soles are other possible options.
• Injection therapy. Corticosteroid injections may be used to reduce both pain and inflammation.
• MLS Laser treatment. Laser therapy is an advanced treatment we offer that can reduce inflammation in arthritic joints, increase blood flow to the area, and reduce pain and stiffness.
• Physical therapy. Physical therapy modalities are further options that may provide temporary relief.

Depending on the nature and severity of your condition, we may be able to incorporate conservative treatment options in your treatment plan. In some cases, however, surgery may be the best course of action to address the problem. If this is the case, we will take the time carefully discuss your options and make sure you are able to make an informed decision.

No matter what form of treatment will work best for you, our team at Eagle-Summit Foot & Ankle is ready to provide it. Simply contact our Avon office by calling (970) 949-0500, our Frisco Station office by calling (970) 668-4565, or take advantage of our online form to connect with us right now.