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Foot and toe arthritis is a medical problem that involves the joints. This painful condition involving one or more joints can be caused by normal aging or “wear and tear” by an injury or by inflammatory diseases (gout, rheumatoid arthritis, etc.).
The most common joint associated with foot arthritis is the first big toe joint. From sports injuries (turf toe) to genetic flat foot deformities, this joint has the highest incidence of arthritis.
Patient symptoms include pain, stiffness, swelling, and redness, all from the “joint jamming” and cartilage degeneration. The pain is characterized as dull to sharp with the first few steps in the morning and also in the evening after increased activities or with minor relief as it is “warmed up” during light walking and massage.
Depending on the severity of the issue, the patient’s lifestyle and medical history, and other factors, big toe joint arthritis can be treated using conservative treatment or surgical treatment.
Oral anti-inflammatory medication can assist with easing chronic pain, but should not be considered as a permanent treatment for acute pain associated with arthritis.
Temporary arch supports, supportive athletic shoes, and custom molded orthotic inserts are a great way to reduce the amount of forces and excessive motion in the involved joints.
Physical therapy practices such as massage, cold therapy, contrast baths, stretching, ultrasound, and electric stimulation can all help ease the pain and treat big toe joint arthritis.
Anti-inflammatory medication can be injected directly into the joint where it can be most effective without becoming a problem to the rest of the body. These injections can be administered with very minimal discomfort.
During the surgical procedure for big toe joint preservation, detached cartilage is removed and remaining bone is debrided or drilled to promote new cartilage growth. Additional joint decompression osteotomy, or shortening, to prevent joint jamming and increase range of motion. The surgery is performed at an outpatient center or hospital facility with sedation and/or general anesthesia.
Patients should be non weight-bearing while wearing a removable CAM (controlled ankle motion) walker boot placing stabilizing pressure on the heel until the sutures are removed after 2 weeks.
Patients should follow an additional non weight-bearing instruction for 2 more weeks, followed by partial weight-bearing and gradual return to full weight-bearing with a supportive shoe in 4-6 weeks.
Detached cartilage is removed and the remaining bone is debrided or drilled to promote bone fusion with an internal plate and screws. Joint fusion is a permanent procedure, although reversal and joint replacement is possible for some fusion patients with poor outcomes. The surgery is performed at an outpatient center or hospital facility with sedation and/or general anesthesia.
Patients should not bear weight and use a removable CAM walker boot to add pressure on the heel until the sutures are removed at 2 weeks. Patients can weight bear at 2-3 weeks with the total joint implant.
Patients with the joint fusion procedure should allow for non weight-bearing for 6 weeks, followed by partial weight bearing and gradual return to full weight bearing with a supportive shoe in 8-12 weeks.
The most common reason for the big toe to hurt at the joint is because this is where all the motion occurs during walking and running. Causes can vary, but they are all centered around ‘jamming’ of the joint and damage to the cartilage.
The most common reason for big toe joint pain is arthritis. The pain is usually worse at night, with the first few steps in the morning, and with increased activity. There are other causes like gout, but stress and damage to the big toe joint is the underlying problem.
The simplest way to get rid of joint pain in your big toe is to first assess where the big toe pain is. For example, the toe nail can become very painful with excessive shoe pressure, and wearing bigger, or open-toed shoes can get rid of this pain. Joint pain can be treated with more support, custom molded orthotics and oral anti-inflammatories.
One should worry about toe pain if it gets worse, does not feel better with rest, throbs or aches at night, is warm or red, or shows signs of infection like odor or drainage.
It is very rare for any fungus to get into your bloodstream. Unless a person is immunologically compromised and/or on high doses of immunosuppressive drugs, toenail fungus will grow only externally.
Pain in your feet is not always a sign of diabetes. The pain in your feet due to diabetes is most commonly caused by decreased circulation and nerve damage.
“Great doctor! He worked with me to avoid surgery when I first went there (unlike other doctors who led me to believe that I had no other option!), and when it was apparent that surgery was necessary on the other foot, it went very well. Great staff, would highly recommend.”
-Terri
Live your life pain-free — start your journey of healing today! Contact Moore Foot and Ankle Specialists to discuss treatment for big toe joint arthritis.
Our doctors have extended specialist medical training focused on the foot, ankle and lower leg. We are board-certified surgeons and experts in delivering care for complex foot and ankle disorders as well as cosmetic or reconstructive procedures and problems related to sports injuries and other medical conditions.
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