4 Popular Big Toe Joint Arthritis Treatments.

Large Bone Spurs on the top of the Big Toe Joint are common with Hallux Rigidus (arthritis) and can be removed with surgery.. Dr. Neal Blitz / www.BunionSurgeryNY.com

Big toe arthritis can be quite debilitating, especially in the advanced stages.   Arthritis of the big toe joint (medically called hallux rigidus) is the result of erosion of articular cartilage and the formation of bone spurs.  The joint eventually becomes very stiff.  Symptoms wax and wane and can become a constant.  


Most people will “get away with” a few simple treatments and as symptoms progress will advance onto more invasive measures.

 Big toe arthritis surgery often become inevitable when with progressing symptoms and when supportive treatments have failed.  While there are a multiple of treatments, below are a list of the most popular treatments for big toe arthritis:


1. Anti-inflammatory Medications.  Because everyday walking taxes the big toe joint, anti-inflammatory pain medication is a cornerstone of treatment.  The medication will not reverse or halt the progression of the arthritis, but will temper or alleviate the symptoms.  Patients may respond well to medication, however, the effect seems to lessen as the arthritis progresses.  


2. Cortisone Injections.  Delivery of a potent anti-inflammatory (Cortisone) directly into the big joint can have a powerful effect on quieting down symptoms.  The effect can provide a sustained period of pain relief.  However, injections directly into the joint should be used sparingly as they can further promote progression of the arthritis.

 Intra-articular injections are often tried before surgery is considered.  


3. Bone Spur Removal.  Often big toe arthritis develops motion-blocking bone spurs on the the top of the joint, and this is a natural mechanism where the body attempts to auto-fuse the joint.  The bone spurs (medically called exostosis) are often painful with direct pressure from shoes.

 Surgery to remove the bone spurs (called Cheilectomy) can have tremendous impact on the symptoms and dramatically reduce pain.  The bone spurs may grow back over time and the procedure can be repeated depending on symptoms.   As a NYC foot surgeon, I find bone spur removal to be a great operation for most cases of arthritis because the surgery alleviates pain while still allowing motion of the joint.  


4. Big Toe Joint Fusion.  Advanced stages of big toe joint arthritis where the joint is deemed unsalvageable or “too far gone” can be treated with surgery to fuse the joint.  A big joint fusion will permanently cure the arthritis pain, however, it comes at the expense of not being able to move that joint anymore.  In many cases, patients elect to undergo this when the big toe joint is already near motionless, and therefore, are not particularly affected by the fusion.   


Other treatments

Of course there are a variety of the other treatments, not mentioned here, that may also be helpful for big toe arthritis.

 When it comes to non-operative treatments, patients often try several treatments at one time. When it comes to surgery, there are a handful of procedures that can be used depending on the extent of the arthritis, with the most popular listed above.

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