In my NYC podiatry office, many patients with pain in the big toe joint similar to, yet unlike a typical bunion that’s more crooked than a congressional delegation, the big toe is straight, painful and has limited motion.  So what’s going on here, and what are the treatment options?  Another exciting and fun filled blog has just now begun, and you my dear reader, are about to embark on a big (toe joint) adventure.

The big toe joint is comprised of, well you guessed it, the big toe, and the first metatarsal, or long bone.  A bunion is formed when the metatarsal bone deviates away from the other metatarsal bones, and the big toe often deviates toward the toes, leading to the formation of a large bump of bone on the side of the joint.  However, there is another condition that afflicts the big toe joint, known as Hallux Rigidus, or a stiff big toe.  This is a progressive deformity in which the motion of the big toe becomes limited over time, often due to arthritis and cartilage degeneration in the joint, which can happen as a result of repetitive stress, trauma, genetics, or just bad luck apparently. Sometimes the anatomy of the joint itself leads Hallux Rigidus.   Over time the big toe becomes more and more stiff and painful, limiting daily tasks such as putting on shoes, walking, standing, working, and exercise.

Initial treatment of this condition is conservative, as with most conditions.  Orthotics can help optimize the motion of the joint, and shoes should be flexible and soft enough to limit pressure on the joint.  As with any arthritic condition it’s always important to continue to move the joint as much as is tolerated, by walking, exercising, and sometimes even manually moving the toe up and down.  In cases of severe pain, corticosteroid injections can provide temporary relief as well.  And when conservative treatment fails, surgery is a viable option.  What does that involve? Tune in next week for our exciting part 2: surgical treatment of Hallux Rigidus.

So if you have a painful big toe joint, or any other foot pain, and are curious to know what the treatment options are, make an appointment with your friendly local NYC podiatrist or read next week’s action packed blog.

See you in the office.

Ernest Isaacson