When your toes hurt, you might not suspect it to be arthritis; however, arthritis in the toes is more common than most people imagine.
The first signs of arthritis in the toes begin with pain while walking, running, or other motions. You may also see signs of inflammation in the joint, like redness and swelling, and notice a decrease in the range of motion at the joint. At first, it may be very subtle, but the joint will get increasingly more painful and inflamed with time if treatment is delayed.
Arthritis occurs when a joint becomes inflamed and starts to deteriorate. More specifically, the cartilage, which helps the two bones in a joint glide easily past one another, starts to break down, and the two bones begin to grind against each other. The most common cause of toe arthritis or hallux limitus is due to the overall structure of the foot. People with flat feet tend to get them often because flat feet cause instability and malalignment to the entire foot structure, leading to arthritis. Another cause is injuries to the joint, such as a fracture or sprain. Even if the initial pain subsides, joint deterioration may continue if there was any damage to the cartilage when the injury occurred.
Walking can irritate the joint further and worsen the symptoms of arthritis. This is because walking causes motion in the big toe joint, and when there is arthritis, any movement of that joint can lead to further damage to the cartilage and bone. However, even with arthritis, we all need to walk, so a way to delay the progression is to wear good, supportive shoes with stiff soles. These shoes can help stabilize the foot and minimize the motion that occurs at the big toe joint.
The best running shoes for big toe arthritis have a stiff sole and adequate arch support. A way to test that is by grabbing the two ends of the shoe - when you try to bend the shoe in half, the shoe should not bend easily. We want to stabilize the joint, and shoes with a stiff sole can act as a splint for the joint. Great running shoe brands that I recommend are Brooks, ASICS, and Hoka One. Hoka One shoes have an especially thick sole that will help to alleviate some of the pain while running.
Treatment options at home include:
These at-home treatment options may help relieve some of the pain, especially when you first start noticing your symptoms. However, as arthritis starts to worsen, you may see that these at-home treatments may not work as well as they did previously.
It would be best if you came to see a podiatrist when you notice increasing pain that affects your day-to-day activities despite trying treatment options at home. Some treatment options that we can offer as podiatrists include physical therapy, padding and strapping, custom foot orthoses, and some surgical options. In addition, we can evaluate you clinically and through x-rays to find you a treatment course that will work best to get you back on your feet.
You should consider surgery for hallux limitus when you've tried other treatment modalities, such as physical therapy and custom foot orthoses, but still have debilitating pain that affects your daily activities. Surgery can offer a permanent solution to toe arthritis as it will alter the structure of the joint. For many patients suffering from hallux limitus, surgery remains the best treatment option to get relief from debilitating pain. However, the recovery process can take at least 6-8 weeks, which should always be considered when deciding to proceed with surgery.
At Gotham Footcare, all conservative options are exhausted before considering surgery. However, several surgical procedures are evaluated if the pain and underlying issue is not resolved. We will evaluate your specific situation to see which procedure works best for you.
Author: Dr. Mika Hirano, Foot & Ankle Surgeon at Gotham Footcare
At Gotham Footcare in NYC, we strive at recognizing your individual needs and desired outcomes while formulating an effective and personalized treatment plan with the highest quality care available.
What sets Gotham Footcare apart from other podiatry offices is our dedication to providing you with the education you need to make well-informed decisions regarding your care. Regardless of what your foot and ankle trouble may be, at Gotham Footcare our team will work tirelessly to help you feel better. At Gotham Footcare, we help you put your best foot forward.