Five Tips to Manage Toe Arthritis
Your big toe plays an important role in your ability to walk, stand, and participate in many daily activities. When you walk, your big toe absorbs forces equal to almost twice your weight, making it vulnerable to damage from overuse.
When toe arthritis strikes, it typically causes pain in your big toe joint, especially when you push off to walk. The condition, also called hallux rigidus, results from wear and tear of the cartilage in your toe joints.
The inflammation and stiffness associated with toe arthritis can make it painful to walk, stand, and perform weight-bearing activities like climbing stairs. Treating toe arthritis can help delay disease progression, reduce symptoms, and minimize the risk of developing secondary symptoms like ankle pain that result from an abnormal gait.
Our board-certified podiatrist, Francine Rhinehart, DPM, is a toe arthritis specialist. Dr. Rhinehart provides professional diagnosis and treatment at our practice in Dallas, Texas. Based on a thorough physical examination, medical history, and the results of diagnostic tests like X-rays, Dr. Rhinehart recommends the most appropriate treatment for your symptoms.
Dr. Rhinehart generally advises conservative treatment before pursuing invasive measures. Here are five tips she recommends for managing toe arthritis before considering surgery.
1. Use nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) include over-the-counter medications like aspirin, ibuprofen, and naproxen and prescription drugs like celecoxib, diclofenac, and nabumetone. These drugs are used to relieve inflammation, pain, and stiffness caused by arthritis.
NSAIDs prevent enzymes called cyclooxygenases from producing hormone-like compounds called prostaglandins. Prostaglandins are a major source of pain and inflammation in your body.
While NSAIDs are typically taken in oral form, they’re also available as topical treatments applied directly to the skin over the painful joint. If your toe is the only joint affected by arthritis, topical NSAIDs may be appropriate because they avoid exposing your body to the side effects of NSAIDs. With long-term use, side effects of NSAIDs can include ulcers, high blood pressure, and kidney damage.
2. Perform toe-stretching exercises
Toe-stretching exercises can improve flexibility, extend range of motion, and reduce pain. When performed in the early stages of toe arthritis, toe stretches may help slow the disease progression.
Dr. Rhinehart prescribes a regime of toe exercises personalized to your condition. In addition to toe stretches, your plan may include movements to strengthen the muscles that support proper foot and lower limb alignment.
3. Modify shoe choices
In addition to pain and inflammation, toe arthritis can cause cartilage degeneration and bone spurs at the base of your big toe. A bump, like a callus or bunion, can develop on the top of your foot, making some shoes uncomfortable to wear.
With toe arthritis, it’s important to shop for a proper fit. Cushion, arch support, and a rigid sole can promote stability and soften the impact forces on your toe.
To reduce pain and inflammation from toe arthritis, avoid shoes with a narrow toe box, which can cause friction against any bumps, calluses, or bunions. Heels that are 2 inches or higher can increase pressure on the big toe and contribute to toe arthritis by positioning your foot at an unnatural angle.
Having your foot measured before purchasing shoes can help you achieve the correct fit.
If you have toe arthritis, look for the following characteristics when shopping for shoes:
- Wide toe box to allow toes to accommodate bunions, deformed joints, and hammertoes
- Square or round toe box
- Wide, rigid sole that only bends where your foot bends (at the toes)
- Stable heel counter (the back of the shoe that cups your heel) to provide stability and prevent friction
- Removable insoles to allow for the insertion of customized orthotics
- Extra or added depth to avoid friction on the top of your toes
- Heel height no more than 2 inches
4. Wear custom orthotics
Orthotics are heel or shoe inserts that can help relieve foot pain. Custom orthotics are custom-made based on molds or digital images of your feet.
In addition to being manufactured to meet the exact size and shape of your foot, custom orthotics are also produced to treat your specific diagnosis, joint deformity, and type of arthritis.
5. Consider SupartzⓇ injections
Supartz is a solution of sodium hyaluronate that’s administered in a treatment called viscosupplementation. Supartz is a gel-like substance similar to the fluid that surrounds your joints. It is designed to provide shock-absorbing protection and lubrication to the treated joint.
Supartz is administered as an injection directly into the arthritic toe joint. It’s typically administered as a series of weekly treatments over 3-5 weeks. When successful, pain relief can last up to 12 months for some patients.
Find out more about options for treating toe arthritis, because early intervention can slow disease progression and help you achieve a better outcome. Call our office or book online to schedule a consultation.