Arthritis in the big toe can be quite painful, since the big toe is such a vital part of walking. A main cause is Hallux Limitus, which will develop into a painful, degenerative condition if left untreated.
When we humans walk, our big toe joint bends up to an impressive 75 degrees just before the foot leaves the ground. But sometimes, due to unusual wearing and tearing of the cartilage in the toe joint, the toe becomes stiff and starts to hurt. It’s a condition known as Hallux Limitus, in which the toe’s movement is limited.
When that happens, instead of bending at that awesome angle, the toe is pushed toward the ground each time you take a step.
This just causes even more wear and tear on the joint, leading to more pain, more damage and eventually arthritis.
If left untreated, Hallux Limitus can turn into Hallux Rigidus, which is a stiff big toe joint that won’t move. We need to make sure it never gets that far.
- Repetitive injuries caused by running on your toes, dropping heavy things on your big toe joint, wearing stilettos or shoes that don’t fit, and squatting for long periods of time (So watch out, baseball catchers!)
- Pronation, which is when the feet roll outward when walking, which places excessive pressure on the big toe
- Genetic defects in the toe and joint
- Overly high arches
- Osteoarthritis, a type of arthritis that usually just comes with age
You need to schedule an appointment for an evaluation so it can be properly diagnosed, because this isn’t a condition you want to mess around with. But the symptoms include:
- Pain or stiffness in the big toe, especially when it’s in use;
- Swelling or a tight feeling around the big toe joint; and
- Aches in the joint that are brought on by cold, damp weather.
If the condition progresses into Hallux Rigidus, these symptoms become more serious. You might feel a constant pain in the big toe joint, whether or not it’s in motion.
The toe will become very stiff and unable to bend, making it extremely painful to walk. Some patients say they can literally feel the bones grinding against each other as they walk.
Another sure sign is getting bone spurs, which happen when the worn bone tries to regenerate and small bumps of bone pop up around the big toe and on top of the joint. Sometimes you can even see these from the outside.
If an elderly relative complains that it hurts to wear shoes, hurts to walk, or they start to limp or show signs of bone spurs, bring them in for a check-up. These can all be signs of Hallux Limitus and Hallux Rigidus.
As with most conditions, how we treat it varies by your foot type, how bad pain is, and how much it has limited your mobility.
The good news is, we can usually relieve the pain and avoid surgery if we catch it early enough.
First, we’ll take steps to correct any issues with the foot that might be contributing to the condition, such as supporting high arches, preventing pronation, and stabilizing the toe.
This is usually done with a custom foot orthotic that will offer support and immobilize the toe to prevent further damage.
We’ll also take a look at the type of shoes you wear and the type of activities and exercise you frequently do to see if any adjustments need to be made.
In advanced cases of Hallux Rigidus, surgery might be necessary to correct the problem and relieve the pain.
But this is only when the other treatments aren’t effective. Dr. Amy Barko, CWSP will discuss all considerations such as time off work, activity level and expectations.
There are several options, including joint fusion or the Captiva implant.
This BEFORE and AFTER (one week post-op) is of a patient that had Hallux Rigidus surgery. You can imagine the level of relief she is now feeling.
If you are experiencing foot pain, call our office or make an online appointment
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