Arthritis can occur at any joint in the body, but the most common location for arthritis to occur in the foot is the great toe joint. The 1st metatarsophalangeal joint, as it is commonly known, helps with making walking efficient. The bending of the great toe joint allows for pushing off of the during walking. When arthritis occurs in this joint, the bending becomes less, the joint becomes stiff, and walking becomes difficult. The stiffness of the great toe joint is known as hallux limitus (hallux rigidus in more severe cases). This typically develops in people between the ages of 30-60. It can be seen following injury to the toe which damages the healthy cartilage, or can be caused by improper biomechanics of the foot in which there is more stress on the joint due to the shape of the foot and how it interacts with the ground.
Symptoms often include pain in the joint especially when pushing off, swelling at the joint, a lump or bump (similar to a bunion that develops on the top of the foot), and stiffness in the great toe with an inability to bend it. Your doctor can make the diagnosis based on a physical exam which often includes x-rays. Treatment consists of conservative as well as surgical options.
Non-surgical treatment includes the use of pain relievers and anti-inflammatory medications which can help reduce the swelling and help the pain. Wearing a shoe with a deep toe box will reduce the pressure on the toe. Orthotics (custom inserts) are also used to help reduce the motion at the toe joint and lessen the pressure at the joint.
Surgical treatment can include various options depending on the severity of the arthritis. A Cheilectomy procedure is usually performed when damage is mild. It consists of removing bone spurs and helping to increase the joint space at the great toe joint. An Arthrodesis or Fusion procedure is often recommended when the damage to the cartilage is severe. The damaged bone is removed and the joint is fixed in place with hardware such as plates or screws. This is a reliable surgery, especially when the arthritis has become quite severe. Finally, a joint implant can be used to replace this joint. The joint surface is removed and an artificial implant is used to recreate the joint. This procedure helps to preserve joint motion., and can be used for several different levels of arthritis severity.
The foot surgeons at Indiana Podiatry Group are highly experienced at treating arthritis of the big toe joint. If you are experiencing pain or stiffness of the big toe, let us help by evaluating your condition and planning an appropriate treatment plan that gets you back and moving again without pain.