Did you know that the most common site of arthritis in the foot is at the base of the big toe? Can you imagine trying to get around with a big toe that does not want to flex? The joint affected by this is called the metatarsophalangeal, or MTP, joint. Every time you take a step, this joint bends. There’s an old saying, “You never miss the water ‘till the well runs dry.” You will never know the importance of the ability to flex your big toe until the day it becomes too stiff to move.
The cartilage that covers the ends of your bones serves as a cushion and it provides a smooth surface for the bones to move along so the joints can work properly. Wear and tear or damage to the cartilage as a result of injury can cause movement in the joint to become difficult.
If the cartilage is damaged or worn to the point where bone is rubbing on bone, the joint becomes painful and a bone spur may develop. A bone spur is an overgrowth of bone and it can interfere with the flexibility of the joint. When this happens in the big toe, preventing the toe from bending, the condition is called hallux rigidus.
Not everyone who has cartilage damage in their big toe will develop hallux rigidus. In fact, it is unknown why some people have it and not others. It usually begins to develop in adults between 30 and 60 years of age.
You will not wake up one morning with a rigid toe. Hallux rigidus develops over time and the warning signs can be very subtle. You may notice some mild pain and a little stiffness. There may be some swelling around the joint of your big toe. You will probably take a couple of acetaminophen tablets for the pain and go about your business. As long as you do not feel discomfort, you will probably forget about it.
This may go on for a while until you realize that your toe joint is becoming stiffer, and one day it may be totally rigid. You may notice a hard lump over the top of your joint. That is the bone spur. Since you can no longer bend your toe, the way you walk changes. Your gait shifts to relieve the pain you feel in your toe. Soon, your lower back starts to ache. You feel pain in your hip and even your other foot begins to cause discomfort. All this because your big toe is not bending. Hallux rigidus is now a reality in your life.
Fortunately, hallux rigidus is not necessarily inevitable if you catch it early enough. This is a progressive condition, which means when you first experience the warning signs, you should seek medical attention. An occasional bout of limited motion, pain or discomfort is easy to shrug off; however, it may also be indicative of a condition called hallux limitus, which is the earlier stage of hallux rigidus. Both conditions respond to effective treatment and the earlier you seek medical attention, the more successful the outcome.
Treatment for hallux rigidus includes non-surgical options such as steroid injections, orthobiologic injections and orthotics. Unfortunately, these measures do not cure the condition. Eventually, you may need further interventions that may require surgery. Your doctor will recommend options in accordance with the severity of the condition.
Pain or stiffness in the big toe is not a normal occurrence. You may be tempted to say it is just another signal that you are getting older. Actually, it is a signal that you need to have a doctor examine the joint, identify the problem and start treatment.
The doctors at Silicon Valley Orthopaedics have the expertise and skill to successfully treat all types of problems with the feet and ankles. If you are experiencing discomfort or stiffness, give us a call and schedule an appointment for an examination and consultation.