What causes big toe arthritis?

Arthritis is caused when the cartilage (the soft smooth shiny surface) of joints wears out. This problem will likely get worse over time.

What problems does it cause?

This causes pain in the joint as the bone ends rub together without their shiny smooth surfaces. The joint can also grow bony bumps around the edges (osteophytes), which stops the joint moving making it painful when your big toe is bent upwards during walking.

Non-surgical treatment:

It is important you are assessed by a specialist to diagnose the problem properly and design the treatment to suit your specific problem and needs.

Shoes that are too flimsy allow your toes to bend whilst walking and this can be painful. If you can bend the sole of a shoe with 2 fingers then it fails my “2-finger test” and they will not support your toes.

Stiff soled shoes, such as hiking boots, stop your toes bending while you walk which can help your pain.

Shoes that have a curved sole (Rocker bottom shoes) can allow you to walk without your toes bending and this can effectively reduce the pain when walking.

There are even running trainers with curved soles to allow you to continue playing sports and running. There are special shops that sell these and many different styles are available on the Internet. Search online for “rocker bottom shoes”, make sure the sole has a good curve at the front under the toes and that you cant bend the soles with 2 fingers.

Surgery

Surgery depends on your lifestyle and how bad the arthritis is. There are several operations available and it is important to talk to your specialist about the pros and cons of each of these to find the best option to suit you. Some operations aim to get the joint moving better, the other option is to fuse the joint permanently together to stop the pain.

Injection: A steroid and local anaesthetic mix can be injected into the joint and is often done in theatre under Xray control. This may give temporary pain relief and also helps your doctor to see if the diagnosis is correct and if surgery is likely to help.

Cheilectomy and joint release: Some patients just need the joint freeing up to improve the stiffness of the joint. The bony bumps (osteophytes) are removed and the tight joint capsule is released to allow the joint to move more freely.

Joint replacement: Some patients may be candidates for a joint replacement to the big toe to improve pain whilst keeping the toe joint moving. This is useful for those that want to keep movement (such as runners, dancers, people who wear heels and those that do yoga)

Fusion: This method removes the joint and permanently fuses the 2 bones together. This is done with the toe in the correct position to allow you to walk normally. This operation is very good at improving the pain more permanently.