Everyone knows arthritis is a degenerative condition that often accompanies aging. However, few are likely aware that for 45 million Americans, arthritis afflicts the joint of the big toe, creating pain and restricting movement, especially when kneeling, squatting, running and even walking.
Arthritis of the big toe is officially called “hallux limitus.” It starts with limited toe motion and can progress to a stage of total stiffness called “hallux rigidus.” Like arthritis in other joints, hallux limitus is due to a wearing down of the cartilage that provides cushioning and a smooth, gliding surface between the bones that compose joints. Also, as with other joints, arthritis of the big toe can lead to bursa (fluid-filled sacks) and bone spurs, that cause further irritation. Hallux limitus is more common among women than men, just like bunions. In fact, often hallux limitus is mistaken for a bunion.
At Central Massachusetts Podiatry, however, we see so many of both that’s not the case. We diagnosis hallux limitus and hallux rigidus with both a physical examination and an X-ray. The physical portion of the diagnosis entails evaluating each patient’s symptoms and assessing mobility of the big toe joint. The X-ray helps determine the severity of joint damage, which informs treatment.
First-line treatment options include:
- Applying ice and anti-inflammatory medication
- Custom orthotics, designed specifically to address each patient’s symptoms
- A leg and foot brace
- Corticosteroid injections (in limited number)
If these treatments fail to provide sufficient relief, surgery may be recommended. There are several approaches that can be used. These are:
- Cheilectomy. This procedure is used to address mild to moderate pain and involves removing the bone spurs and a portion of the foot bone, giving the toe additional room to bend.
- Arthrodesis. This approach entails removing damaged cartilage and fusing together the bones of the joint so that it can no longer bend at all.
- Arthroplasty. This surgery involves removing the damaged joint surface and replacing it with an artificial joint.
- Youngswick. Named after the doctor who created the procedure, this surgery entails repositioning the metatarsal bone that connects the big toe to the ankle to create more space between it and the toe bone (proximal phalanx).
If you are having difficulty bending your toe up and down, don’t suffer in silence. Make an appointment with one of our doctors right away. Hallux limitus is far easier to treat when caught in its earliest stage.