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Arthritis in the big toe joint

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Description

The most common place for arthritis in the foot is the base of the big toe. That’s where the metatarsophalangeal (MTP) joint connects the long bone in the forefoot to the big toe bone. If this joint gets stiff, it makes even simple things like walking difficult.


Causes and symptoms

Arthritis in the big toe is usually caused by a misaligned bone behind the MTP joint. When this happens, the joint can’t move smoothly, and jamming occurs. This can lead to a variety of symptoms, including pain, stiffness and the development of bony bumps called spurs.

In addition, painful callouses can develop on the bottom of the big toe. This happens because the toe doesn’t bend upward enough when it hits the ground. People who have diabetes must watch callouses carefully. Sores can develop that might become infected.

Another cause of arthritis in the big toe is normal wear and tear. Over time, the cartilage that protects the ends of the bones in the MTP joint wears out and the bones rub together. The result is a stiff big toe.

As stiffness in the big toe gets worse, the joint will begin to degenerate. And left untreated, the joint can be destroyed.


Diagnosis

Diagnosis is made by a physical exam of the foot and taking X-rays. If the condition is in an early stage, the X-rays might appear normal. In later stages, narrowing of the joint and/or bone spurs may be seen.


Treatment

Treatment depends on the severity of the condition. Options include:

  • Anti-inflammatory medication and cortisone shots to help reduce the pain
  • Prescription shoe inserts (orthotics) to slow down or stop further damage to the joint 
  • Surgery if the condition gets worse and causes bone spurs around the joint
  • Surgery to remove bone spurs around the big toe joint or to replace the joint

After surgery, orthotics can help improve the function of the joint. Surgery or orthotics can also help make painful callouses on the bottom of the big toe go away.

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