A few blogs back, we talked about the horror, the horror, of the painful big toe joint, or Hallux Rigidus.  There are those who stagger into my NYC podiatry office with a painful bunion, and the deformity is obvious, while there are those who limp in with a deformity that is, shall we say, subtle and sublime.  For those who suffer from pain in a big toe joint that is straighter than George Clooney on vacation, and are curious about surgical treatment options, this blog’s for you.

As with many foot and ankle deformities, the severity of big toe joint arthritis and cartilage degeneration can be broken down into four stages, from a painful joint that appears healthy on X-ray to a completely stiff joint in which the cartilage has been entirely worn away.  And staging the level of arthritis is very helpful in determining the best surgical treatment option, along with the health, age, lifestyle and expectations of each individual patient.  In the early stages, procedures such as a metatarsal osteotomy, or cutting and repositioning the long bone near the big toe, can increase the efficiency of motion within the joint.  A more advanced level of cartilage and bone degeneration may benefit from a joint replacement, in which, just like a knee or hip, a titanium implant is placed on one of the joint surfaces to eliminate the bone to bone grinding and friction that is often the source of pain.  And a severely arthritic joint is amenable to surgical fusion, which involves removing the remaining cartilage and locking the joint in place, thus permanently eliminating arthritis pain.  Despite how it sounds, even after a fusion patients can regain full activity and quality of life, and participate in almost any type of exercise.

The good news is that the materials and procedures get better every year. Surgical procedures for the treatment of Hallux Rigidus are some of my most gratifying procedures, as NYC podiatry patients with a painful big toe joint can go from preoperative pain so severe that the act of putting on shoes is painful to complete resolution of pain postoperatively and resumption of almost all activity.

So if your big toe joint is painful and stiff, don’t worry that you’ve waited too long to see a NYC podiatrist.  It’s never too late to explore the many surgical and non-surgical treatment options that can relieve your pain and restore your quality of life.

See you in the office.

Ernest Isaacson

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Ernest L Isaacson DPM PC
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