The most common area of arthritis in the foot is the big toe joint. Arthritis of the big toe joint most commonly affects people over 40 years of age secondary to wear and tear over many years. A previous injury to the big toe or underlying systemic arthritis condition can predispose someone to developing arthritis.
Overtime, the big toe joint loses cartilage as the bones begin to rub on each other causing pain and swelling. An overgrowth of bone may occur at the joint causing the toe not bend correctly and become stiff. This condition is known as hallux limitus or rigidus.
The big toe joint is important in gait because it is responsible for pushing off with walking and sports activity.
Big toe arthritis is easier to treat when it is diagnosed at an early stage. A routine foot x-ray can be used to diagnose the severity of the deformity, bone spurs around the joint and degeneration of cartilage in the joint.
Conservative treatment for big toe arthritis involves using anti-inflammatory medication like alleve (naprosyn) or motrin (advil) can be used to reduced swelling and pain.
Ice packs and contrast baths can also be done to help alleviate symptoms. Physical therapy can also be beneficial to help lessen arthritic pain.
Proper fitting and supportive shoes can help lessen pain with the addition of custom or over the counter arch supports (orthotics). A rocker-bottom or stiff soled shoes can be prescribed to reduced motion and stress on the big toe joint with walking.
If conservative treatment fails, big toe surgery is available to improve range of motion and decrease pain and swelling. If the arthritis and severity of the condition is mild, removing abnormal bone (cheilectomy) may be done to the joint in order to improve range of motion and salveage the joint.
If the arthritis of the big toe joint is moderate to severe, more commonly a joint destructive procedure is done involving a fusion (arthodesis) of the toe joint or replacing the arthritic joint with a metal or silastic implant (arthoplasty).