Overview
This describes arthritic changes to the big toe. It happens in the 1st MTPJ (metatarsophalangeal Joint). This occurs when the cartilage at the ends of the joints starts to wear away. This causes Bones to rub against each other. With no cartilage to protect, pain at the joint develops. Additionally, bone spurs may form at the joint causing further damage.
Causes
-Overuse
-Trauma
-Elevated first ray- This causes jamming at the joint
-Foot deformity
-Improper shoe gear
-Old age
Symptoms
-Pain with range of motion at the joint
-Limitation in range of motion (normal range of motion is 60 degrees of dorsiflexion and 20 degrees of plantarflexion)
-Bone Spurs
-Redness/swelling
-Callus formation
-Pain with physical activity
Treatment
Multiple treatment options exist. Usually, start with x-ray’s to determine the extend of injury and to come up with a treatment plan
Conservative- Rest, Ice, Compression, Wide shoe gear, Nsaids, Topical pain creams, Orthotics
Surgical- For those that have failed conservative therapy surgical options include:
- Cheilectomy- Removal of the bone spur
- Decompression osteotomy
- Joint Fusion
- Joint replacement