Walking is often taken for granted until something limits our abilities and restricts us from moving about freely. This month is all about the Toe and today we are going to talk about our BIG toe and keeping it healthy. If you have pain or swelling in your big toe, it’s likely a result of Hallux rigidus or commonly known as big stiff toe. Degenerative arthritis and stiffness due to bone spurs affecting the MTP joint is call Hallux rigidus. Our big toe is critical to all upright movements and unfortunately, the most common site of arthritis in the foot is at the base of the big toe. In the MTP joint, the ends of the bones are covered by smooth cartilage. Normal wear and tear or an injury can damage the cartilage causing the bones to rub together. A bone spur or overgrowth may develop on top of the bone and will prevent the toe from bending as much as you need it to. Symptoms of Hallux rigidus include pain and stiffness in the joint around the base of the joint, difficulty with running, walking, squatting and visible swelling and inflammation.
Hallux rigidus usually develops in adults ages 30 to 60 years and no one knows why it appears in some over others.
There are several treatment options, both nonsurgical and surgical. On the nonsurgical side, pain relievers and anti-flammatory medications such as ibuprofen can help reduce swelling and ease the pain. These most likely will not treat the condition though.
The three (permanent) surgical options are:
• Cheilectomy – This surgery is usually recommended when damage is mild or moderate. It involves removing the bone spurs as well as a portion of the foot bone, so the toe has more room to bend. The incision is made on the top of the foot. The toe and the operative site may remain swollen for several months after the operation, and you will have to wear a wooden-soled sandal for at least two weeks after the surgery. But most patients do experience long-term relief.
• Arthrodesis – Fusing the bones together (arthrodesis) is often recommended when the damage to the cartilage is severe. The damaged cartilage is removed and pins, screws, or a plate are used to fix the joint in a permanent position. Gradually, the bones grow together. This type of surgery means that you will not be able to bend the toe at all. However, it is the most reliable way to reduce pain in these severe cases. For the first six weeks after surgery, you will have to wear a cast and then use crutches for about another six weeks. You won’t be able to wear high heels, and you may need to wear a shoe with a rocker-type sole.
• Older patients who place few functional demands on the feet may be candidates for joint replacement surgery. The joint surfaces are removed and an artificial joint is implanted. This procedure may relieve pain and preserve joint motion.
Post surgery, regaining full range of motion of your big toe is really important. Wearing a Toe Dynasplint System is easy, comfortable and can help in the recovery process to regain range of motion.