The big toe is one of the most common locations of foot arthritis. The MTP, metatarsophalangeal, joint is one of the most important joints in your feet because its main purpose is to bend every time you take a step. However, if the metatarsophalangeal joint stiffens, it can create a lot of pain when one walks.
There is only smooth articular cartilage covering the ends of the bones in the MTP joint, just like any other joint. If there is injury to the cartilage, the bone ends can become raw and rub together. Overgrowth or bone spurs can develop on top of these bones. When affecting your metatarsophalangeal joint, the overgrowth can prevent the toe from bending as much as you need it to as you walk, which in turn, causes a stiff toe. This stiff toe can also be known as hallux rigidus.
This stiff toe usually occurs to adults from thirty years of age to sixty years of age. Researchers are not entirely sure why it appears for some people, but not for others. Sometimes hallux rigidus is the result from an injury to the toe, or possible foot anatomy differences which causes stress on the joint.
SYMPTOMS
Here are some symptoms of hallux rigidus:
- Inability to be able to bend up or down your big toe up and down as well as stiffness.
- The metatarsophalangeal joint may have swelling surrounding it.
- If you push off your toes or are extremely active, you may get pain in the joint.
- A bump can develop on top of your foot, which may be akin to a callus or bunion.
DIAGNOSIS
It’s recommended to see your doctor straight away if you find it hard to move your big toe up and down, or if there’s extreme pain which results in the fact that you need to walk on the outside of your foot to avoid pressure. If you catch hallux rigidus on it earlier stages, then it may be easier to treat, however, if the condition has gotten worse, treatment will be more difficult.
Your physician will utilize x-rays to see if there are any bone spurs, as well as the deterioration of the cartilage in the joint space. They may also move your toe around to see the pain levels with certain motions.
TREATMENT
There are two different options for treatment of hallux rigidus. There are the options of nonsurgical and surgical treatments for this stiff toe.
With nonsurgical treatments it’s suggested to ease the pain and swelling with anti-inflammatory medications like ibuprofen. There’s also the suggestion for reducing inflammation through applying ice packs or contrast baths, which may control the symptoms for a small period of time.
Shoes with large toe boxes will prevent pressure on your toe. For those who like wearing high heels, it’s not recommended to wear them while having this ailment. Your personal doctor may recommend you to get shoes with a rocker bottom design, stiff-soled shoes, or even shoes with a metal brace in the sole. These shoes support your feet easily and reduce the bending of your big toe.
With surgical treatment, however, it’s usually recommended to look into cheilectomy when the damage is moderate or mild. The orthopedic surgery removes a portion of the foot bone as well as the bone spurs from an incision at the top of the foot, so that your toe has more space to bend. After this operation, your toe and incision site will be swollen for many months. It’s required to wear wooden soled sandals for at least two weeks, as well. Most patients receive relief in the long-term after this surgery.
Another type of surgery is arthrodesis, which fuses the bones together. This operation is usually recommended when damage is severe. With this surgery, the cartilage that is massively damage is removed. In order to fix the joint, the orthopedic doctor will use pins, screws or even a plate to put the joint into position. These bones will eventually grow together. In result of this surgery, you will not be able to bend your toe whatsoever. This, however, is the best way to get rid of your pain with a most severe case.
After surgery, you will have to wear a cast for the first six weeks. After these six weeks, you will be put on crutches for another six weeks. This foot surgery will affect your ability to wear certain types of shoes. It’s recommended to wear a rocker-type soled shoe.
