Arthritis of the Big Toe Joint Hallux Rigidus Treatment Ideas from Podiatrist Larry Huppin
Today I'm talking about arthritis of the bigtoe joint. This is also called hallux rigidus. So essentially what this is, it's arthritisof this joint here. So if you look at a normal step what should happen as we walk is thisjoint bends 60 to 80 degrees. You can imagine, if this joint wears out, which is what arthritisis, how painful that can be. So as you walk forward now, you can no longer bend this joint. Now let's look over at this picture here.So this is what that joint should look like with that cartilage in that joint a hundredtimes smoother than glass. As it starts to wear out, this cartilage gets thinner andthinner to the point where down here we have
hallux rigidus or that there is no cartilageleft and essentially there is no motion left in this joint, or if there is motion it'sjust a few degrees that leads to pain. So when we look at trying to treat this probleminitially, our goal is to eliminate the pain so that people can walk pain free and do theactivities they want to do. In most cases if it is early on, meaning thereis not bad arthritis, we want to do something to enhance the motion in that joint. In thatsituation we might use either a prefabricated or a customer orthotic to try and bring thisbone down a little bit more because whenwe do that, that helps the motion in this joint.But over time if this joint gets bad enough
that it really starts to get quite worn outand there's very little cartilage left, that isn't going to eliminate pain. In order to eliminate pain we have to do somethingto stop motion and there's several ways to do that. First of all, we still want to useeither a prefabricated or custom orthotic to transfer pressure off of this area andget more pressure back here. Custom orthotics tend to work better because they conform closerto the arch but there's also some good overthecounter devices that can work. Actually if you goto our website and do a search for hallux rigidus or big toe arthritis, you'll finda list of overthecounter devices that might
help you. The second thing that we might do is do someshoe changes. You can buy shoes, either athletic shoes or dress shoes or walking shoes thatare rigid on the front. This is called a rocker sole. You can see I cannot really bend thatsole. So as this person starts to walk forward in this type of shoe, the shoe rocks you throughthe step and the toe joint does not have to move. That can be very effective at eliminatingmotion in that joint and eliminating pain. You could also purchase what's called a turftoe plate. It's a rigid plate that goes inside a shoe in order to stop motion. There's evenwomen's dress shoes on the market that come
with platforms, for example. Those have rigidsoles on them. So we'd like to do all of this before consideringsurgery. There are surgical options that can also be done. If it gets too bad where yougot real arthritis in that joint, usually you're considering a fusion of that joint.Usually it's actually a fairly effective surgery, most patients do very well, but we alwaysconsider surgery a very last resort. So if you have pain in your big toe joint, don'tlive with it. It can only get worse. Often we catch it early enough, we can prevent furtherdamage or at least slow the potential for damage. Later on if there is quite a bit ofdamage of the joint, we can still do a lot
to eliminate your pain. So if you're in ourarea, make an appointment to see us. If you're not in our area find a podiatrist that specializesin biomechanics and orthotic therapy. They can usually help you a lot.
How to Best Treat Foot Arthritis with Seattle Podiatrist Larry Huppin
Hi. So today we're going to talk about arthritison top of the foot or what's called midfoot arthritis. That's arthritis in these jointsthrough here. This is the second most common cause that we see causing pain on the topof the foot. The first one is a condition called dorsal compression syndrome, whichjust means that the foot is collapsing down and all these bones get pressed together toomuch but there's no actual damage to the joint. For information on that problem, go to ourwebsite and do a search for quot;dorsal compression syndromequot; or quot;top of foot pain.quot; However, today we're going to talk about arthritisin these joints. So longterm, this foot flattening
out too much can start to damage these joints.As the foot goes down, all these bones get pressed together. Initially it just causespain, but over time, it starts to wear away the cartilage on the inside of these joints,and that can cause a lot of pain. So after that occurs, almost any motion in this areawill start to cause pain. Also, a lot of times people will see a bump, a bone occurring ontop of the foot associated with that arthritis. When we look at treating it, our first goalis to avoid surgery and still eliminate a 100% of the pain. You really should look atsurgery as only the very, very last resort. And in most cases, in fact, in almost allcases, we can treat this without doing surgery.
Our goal here is to limit motion in thesejoints, so what we're going to do is put something under the arch of the foot. We're going totake an orthotic device, put it underneath there, and we're going to try and use thatto stop the motion in that joint. For that to work the best, we want that orthotic toconform extremely close to the arch of the foot. It's called a total contact orthotic.Again, you can look up quot;total contact orthoticquot; on our website. That type of orthotic doesthe best job of limiting motion in this area. If that's not enough, we can actually do someshoe modifications where we put what's called the rocker on the bottom of your shoe to limitthe motion in that foot. This is a big orthotic
that we might use in a men's dress shoe orin anybody's athletic shoe. For women's dress shoes, we can use much, much smaller devices,as we aren't going to a flat or a heel, but the key is that still conforms very closeto the arch of the foot. So if you think you might have arthritis inyour midfoot, what you want to do first is find a podiatrist in your area who specializesin orthotics and biomechanics. If you're in our area, go to our website and you can findcontact information there. If you're not in our area, look for someone who has that specialty. If you want to try and treat this yourself,go to our website and do a search for quot;selftreatment
for midfoot arthritisquot; or quot;selftreatmentfor foot arthritisquot; and you'll find all kinds of hints there, we'll recommend some overthecounterarch supports you can try instead of the custom ones. We'll recommend some types of shoesyou can use and a number of different things you can do initially to try and treat thisproblem.