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Footnotes / Blog

Arthritis

Monday, January 24th, 2011 Kenneth Donovan

Millions of people world wide suffer from arthritis. With regard to arthritis in the foot, the big toe joint is the most commonly affected joint. Arthritis is defined as the degeneration of cartilage between two bones. Cartilage is the soft spongy material between bones that allows the bones to glide pass each other during movement. Unfortunately there currently is no cure for arthritis at the moment, only treatments.

What makes the big toe joint susceptible to arthritis depends on how a person walks. The most common condition that leads to big toe arthritis is called Hallux Limitus, which is a fancy latin word for “loss of motion at the big toe joint”. People that tend to be susceptible to hallux limitus tend to over pronate (ie “flat feet”). This over pronation causes destablization of the inside of foot, causing the arch to collapse. Without an arch, the ground pushes up near the ball of the foot, causing the metatarsal to pop-up. Over time the 1st metatarsal bone pictured here…

…….become fixated in this elevated position. This elevated position becomes deleterious to the motion of the big toe joint, causing eventual pain and loss of motion. The eventual result is narrowing of the big toe joint, loss of cartilage, and bone spurring.

Overtime various treatments have been used for big toe arthritis depending on its severity. Initially most patients are started on a short course of anti-inflammatories such as Meloxicam. If pain persists a steriod injection maybe needed, as well as shoe gear modification which can include innersole or outersole modifications. In more severe or persistent cases, surgery may be required which can include simple cleaning the joint of debris or more serious total joint replacements.