Medically referred to as hallux limitus (limited arthritis) and Hallux rigidus (severe arthritis), arthritis of the big toe joint is a condition where the cartilage of the big toe joint becomes eroded, leading to limitation of motion and eventually rigidity. This results in a painful, enlarged, and/or inflamed big toe joint.
The two most common causes of arthritis of the big toe joint are biomechanical and traumatic arthritis. Inflammatory arthritis (i.e., rheumatoid) can occur but tends affect the rest of the body. Gouty arthritis is most common cause of arthritis in the big toe joint. Traumatic arthritis occurs after the joint is injured and not treated immediately, leading to more sever issues. Fractures that involve the joint, injuries to the cartilage, and sprains and strains can develop into arthritis. Biomechanical arthritis occurs from structural problems within the foot that lead to premature ‘wear and tear’ on the joint. Shoe gear can also play a role in arthritis development. Arthritis usually develops slowly over time until the flare-ups and pain reach a point where treatment is necessary to return to comfort.
Patients affected by arthritis of the big toe joint have varying degrees of symptoms depending on the severity of their arthritis. Usually, the big toe joint hurts with regular activity (i.e., walking and running), and the pain varies from superficial and achy to sharp and intense. Additionally, grinding sensations (known as crepitus) can be felt with movement of the affected big toe joint. Irritation from footwear can cause redness and swelling. If untreated, joint motion can become limited as time goes on, leading to extremely limited movement or ability to flex the toe.
There are two kinds of procedures to repair arthritis of the big toe joint: those that spare the joint (joint sparing procedures) or those that remove the joint (joint destructive procedures).
Sparing procedures surgically modifies or cleans up the joint in order to alleviate pain and maintain continued motion. Destructive procedures involve removing the joint and performing a fusion (locking the bone in place) or a joint replacement (utilizing artificial joint to allow motion). The severity of the arthritis determines whether the joint could be salvaged or not.
Recovery after big toe joint arthritis surgery is varies depending on the method chosen to fix the problem. Minor procedures (i.e., bone spur removal) allow patients to walk in a regular shoe in one to two weeks. If bone cuts are performed, patients have more restrictions and may be walking in a surgical shoe for six weeks or so.