Big Toe Joint Pain Information
Big Toe Joint Pain Caused by Arthritis
Pain in the main joint of the big toe is most often caused by arthritis. If you suspect you suffer from this, read on for information on symptoms, prevention and treatment. A lot can be done to ease the pain.
Arthritis in the main joint of the big toe is a state characterized by pain and reduced mobility. Usually its accompanied with swelling as well, especially on the top side.
The swelling is due to irritation in the mucous membrane, increased connective tissue formation in the joint-cavity, and, last but not least, new formation of cartilage and bone tissue at the edges of the joint.
In a few cases patients suffering from arthritis in the big toe feel no significant pain, in these cases it is often the swelling of the joint that is bothersome, for example making it difficult to wear shoes. The vast majority though, suffer very much from pain caused by the arthritis.
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The first symptom is pain in - or around - the main joint of the big toe when walking, running or squatting. Generally, the symptoms gradually worsen. Eventually you will be able to see that the joint is swollen. This can also be felt as footwear will start to feel tighter.
It will hurt when the big toe bends upwards or downwards.
The severity of the pain may depend on strain and choice of footwear. Use of footwear with thin, flexible soles - or high-heeled shoes - will make things worse, while loose-fitting shoes with strong, stiff soles will be soothing.
Most will change their style of walking, so that the pressure is applied on the external edge of the foot. When running the steps become shorter. Thus the strain on the big toe's main joint is reduced. These changes may create secondary pains in the knees and in the hip.
Causes and Predisposition
Arthritis, causing big toe joint pain, may be caused by previous damages to the main joint of the big toe. These damages lead to bleeding in the joint or irregularities on the joint surface.
However, certain factors given by nature also exist. A family history of arthritis increases the risk. The same applies to a long big toe.
Lower risk is associated with a shorter big toe, a sphere shape of the "head" of the main joint, and no family history.
Making a worn-down big toe joint normal again is unfortunately not possible; not even with an operation.
Instead, treatment aims at reducing the pain and preserving the mobility to the greatest possible extent.
What you can do yourself:
Prevention is the best treatment; avoid severe, repeated strain on the big toe.
If arthritis is starting to show, it's very important to continue using the joint, but don't move the toe to the point where it starts to hurt. It may be necessary to avoid high-heeled shoes and to switch from running to, for example, bicycling or rowing.
If the symptoms are more pronounced, shoes with a strong and stiff sole can reduce the sense of discomfort when walking. On longer walks hiking boots would be ideal.
What your doctor can do for you:
Asses the degree of arthritis, often a x-ray is required.
If a reasonable layer of cartilage remain and there is still decent mobility in the joint, the symptoms might be caused by irritation in the joint. This can be treated by altering the strain put on the toe, by medicine, or by injection of corticosteroid into the joint. The latter is often very effective against the pains (even though it doesn't cure the cause), but the effect is usually temporary. It is not recommended repeating the treatment indefinitely. Finally, some patients have experienced pleasant results from medical treatment using Glucosamin and Chondroitinsulfat, both are thought to preserve the remaining joint cartilage.
In severe cases, an operation might be required. Two main types of operations are:
- Removal of excess bone structure and remains from the joint. The operation has the benefit of preserving the joint, meaning that, later, the patient can undergo surgical procedures. However, the operation is not helpful for everybody and doesn't provide a permanent effect. Likewise, the joint can not be too severely damaged and the rehabilitation requires a long time.
- Removing part of the big toe, hoping to improve mobility and reduce the pain. In practice, the operation often works well, but it has many problems. The big toe becomes very short and loses strength. When the big toe cannot carry the weight it used to, toe no. 2 must take over. This results in pain under the front of the foot and will, often, lead to deformity of toe no. 2. In the long run, the big toe alters position, as it starts to point upwards and leans against toe no. 2.
If you suspect you have arthritis and that is causing big toe pain, it is crucial that you go to your doctor.
The ordinary clinical examination is the first and most important step. Examination will include position of the feet, flat feet, and stiffness in the big toe's joint. It's important to reveal whether the pains are caused by pressure from the footwear on the swollen joint, or whether it's the actual arthritis or irritation in the joint. Such an examination can create the foundation for the choice of treatment.
Examination using X-ray is usually performed. This will enable estimation of the extent and degree of the arthritis, and often make possible cartilage damage visible. X-ray pictures aren't useful in revealing possible remains in the joint, in this case, ultrasound investigations are preferable.
Using ultrasound will immediately give a diagnosis, but the degree of the condition can only be based on an x-ray examination.
MR scanning is seldom necessary, unless there is suspicion of another cause of the pain.
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