Pain in your big toe, especially arthritis pain can cause problems with your walking and standing. But as most anyone who suffers from arthritis can tell you, it’s the emotional toll of having to deal with chronic pain that can wear you down.
Here is some information about arthritis in your big toe. We, of course, want you to be informed but more important – if you suffer from Hallux Rigidis, get professional help from a podiatrist like Dr Marc Klein in Boca Raton.
What is Arthritis?
Arthritis (osteoarthritis) is a gradual and debilitating breakdown of the body’s joints due to routine wear and tear, overuse and mechanical abuse. The big toe is a key joint in the foot which, because of the high repetitive forces that pass through it with all weigh-bearing activities, is unusually susceptible to arthritis in middle age and older adults.
The medical term for arthritis in the big toe is Hallux Rigidus. This condition is a type of degenerative arthritis in which the joint surfaces at one of the joints in your big toe begin to both wear away and develop extra, joint limiting bone along the margins, called osteophytes or ‘spurs’.
Arthritis features a number of negative changes to joint tissues and function. The most important change is the thinning and eventual disappearance of joint cartilage.
Cartilage is the smooth, lubricated surface at the ends of the bones in all normal joints that is responsible for normal function. It allows the joint to move smoothly with minimal friction and is capable of handling large compressive forces without pain or damage to the joint.
It has no nerve endings so even heavy loads are not usually painful.
When a joint is subject to routine, abnormal wear and tear or unusual mechanical strain, the cartilage may be worn thin or obliterated completely.
The cartilage develops cracks or fissures, loses its lubrication and the cells gradually die. The involved joint becomes swollen and painful; excess bone frequently develops along the joint margins (called “lipping”) as a response to the abnormal trauma and tends to progressively limit joint range of motion as the arthritis advances.
The toe is designed to take the majority of stress as the forefoot loads and we propel ourselves forward with each step. When the main arch of the foot flattens (flat feet), though, the big toe function becomes limited by abnormal ligament restraint.
The toe cannot raise upwards when the forefoot is loaded but the forward motion of the foot occurs anyway, forcing the joint into a position it cannot assume freely.
This forcing of the big toe motion is abnormally stressful to the joint. Over time, the joint begins to show the negative changes of arthritis described above.
The base of the big toe becomes thicker, begins to swell especially after prolonged weight-bearing activities, and gets progressively stiffer and painful with age.
Bad weather may elicit soreness in the joint because it promotes swelling. Besides poor foot mechanics due to flat feet (most common), arthritis of the big toe may come from a sports injury, a traumatic accident or the medical condition known as gout.
Common Symptoms of Hallux Rigidus
The common signs people with hallux rigidus notice include:
- Swelling in the big toe
- Pain in the big toe, mainly the base
- Difficulty performing activities such as running, walking (especially up hills) and climbing stairs
How Is Hallux Rigidus Treated?
- Anti-Inflammatory Agents: These may include ice and oral anti-inflammatory medications. These may provide some temporary relief and ease the pain of inflammation, but are not helpful in addressing the underlying cause of your condition.
- Footwear: Advice that focuses on taking the pressure off the big toe should be followed. A stiff soled shoe with a rocker or roller bottom may be recommended to help you walk and lessen the bend in the big toe. A shoe with a wide toe box may also help relieve pain. Avoiding high heels and weight loss are other important considerations.
- Surgery: In cases that do not respond to conservative measures, your doctor may recommend surgery. There are a few common surgeries that are performed depending on the degree of arthritic changes. Removal of the bone spurs, joint fusion, and complete joint replacement can be performed. These procedures are not without risks and often the disease continues to progress after a temporary period of pain relief. Also, operative measures performed on one foot may have negative effects on the other foot due to the excessive load.
- Foot Orthotics: The right custom made orthotics will address your pain by restoring correct arch height and function, effectively releasing the big toe, allowing it to unlock and function properly. When this is done, the cause of your pain is being addressed rather than just the symptoms. An ICON orthotic, unlike typical custom orthotics, is designed to completely support the corrected arch of your foot, determined by a unique way of capturing your optimal foot position. Abnormal joint stresses can be reversed, allowing affected tissues to heal and normal joint function to be restored. In this way the orthotic provides both primary treatment and preventative care by restoring normal weight bearing function and range of motion to your big toe.