Big Toe Arthritis Anyone?

[Marita40]

My broken foot bone--now mostly healed--evidently triggered big toe arthritis. (SIGH: This was the first time I've heard "arthritis" associated with me--freaked me out! ) According to the various doctors I've seen (podiatrist, orthopedic surgeon) the arthritis had been building for some time although I didn't know it and had no pain. Now that the swelling and soreness from the broken foot has subsided the big toe hurts with every step. The orthopedic surgeon said I've lost 70% of movement in it.

Anyone have this? What did you do? Since the docs and I have been mostly concerned with the broken foot I haven't really consulted them specifically about the arthritis. So far I've heard them suggest physical therapy, orthotics, surgery.

 

[Gumby]

The young wife has had it in both feet for the past 15-20 years. It originally came to light because she had shifted her gait due to the arthritis pain, and that shift resulted in a broken bone in her foot. She had surgery on each foot. I'm not sure precisely what they did each time, but I know it had something to do with drilling holes in the joint surface and shortening the bone. The foot on which she had the first surgery about 20 years ago had recently become a problem again. So this past Tuesday (i.e. 3 days ago) she had a joint replacement in that toe. I think it works just like a knee. They saw off the ends of the two bones and insert the metallic joint implant in each. I am hopeful that this will be a more permanent fix for her, and I expect that she'll have the same thing done on the other foot in a few years.

 

[jjquantz]

I've struggled with this for that last 15+ years (I'm 56). I had surgery on both big toes 13 years ago to remove excess bone - this shortened the big toes by more than 1/4 inch each but greatly restored range of motion. After about 8 years, though, the arthritis returned. This time I was fitted with orthotics for my shoes. This provided a lot for relief for about 4 years. However, now the range of motion is sufficiently reduced that the orthotics don't help. I'll be setting up an appointment with the podiatrist in the coming few months.

My advice would be to first get fit with orthotics and then investigate surgery. My bet is that you can get several years of pain relief without any cutting. I was able to run, bike, golf and everything else with the orthotics.

 

[Gumby]

I've struggled with this for that last 15+ years (I'm 56). I had surgery on both big toes 13 years ago to remove excess bone - this shortened the big toes by more than 1/4 inch each but greatly restored range of motion. After about 8 years, though, the arthritis returned. This time I was fitted with orthotics for my shoes. This provided a lot for relief for about 4 years. However, now the range of motion is sufficiently reduced that the orthotics don't help. I'll be setting up an appointment with the podiatrist in the coming few months.

My advice would be to first get fit with orthotics and then investigate surgery. My bet is that you can get several years of pain relief without any cutting. I was able to run, bike, golf and everything else with the orthotics.

I forgot about the orthotics. Like you, they helped the young wife for a few years, but the pain came back.

 

[Ronstar]

I used to have arthritis in several toes - the big toes being the worst. The pain usually occurred on long hikes and runs, and only while hiking or running. Orthotics and staying hydrated seemed to help minimize the pain. But I went on a gluten free diet a few months ago and I haven't had any problems since.

 

[Marita40]

I would be interested in knowing more about the connection of diet (ie. gluten?) and arthritis pain, especially when arthritis (at least what I seem to have in my big toe) seems to be a clear cut physical wear-and-tear bone-on-bone thing. Just wondering how not consuming gluten might help this.

Hmmm. . .ok, I don't yet know anything about orthotics. To whom do I go to investigate this? A good shoe store perhaps? All this is new to me since I've spent most of my life in sandals or cheap gym shoes/work flats. I've never thought twice about my feet. And now!

 

[Ronstar]

I would be interested in knowing more about the connection of diet (ie. gluten?) and arthritis pain, especially when arthritis (at least what I seem to have in my big toe) seems to be a clear cut physical wear-and-tear bone-on-bone thing. Just wondering how not consuming gluten might help this.

Hmmm. . .ok, I don't yet know anything about orthotics. To whom do I go to investigate this? A good shoe store perhaps? All this is new to me since I've spent most of my life in sandals or cheap gym shoes/work flats. I've never thought twice about my feet. And now!

I'm certainly not a doc, but DW (also not a doc) tells me that reducing gluten results in less inflammation. I haven't done much research yet to verify what she's saying, but did find this:
http://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-inflammatory/gluten-free-diet.php

As for orthotics - A good foot doctor will probably be the best for getting you into orthotics. I got mine from a doc, but I also got a pair from REI that are good as well.

 

[John Galt III]

I had a pair of orthotics made for me decades ago when I suddenly developed foot pain. They were very expensive and insurance did not cover them. I think they were $325 for one pair. I walked across an electronic pad in the podiatrist's office with both feet to record my foot pattern/pressure pattern. I only had to wear them about 2 weeks and the pain went away. I stopped using the orthotics then and the pain never returned until recently. I tried the same orhthotics again, which I had stashed away, and they are not making the pain go away this time. Maybe because my feet are not the same shape, and I need new orthotics. Might be something for me to check out in 2016.

 

[splitwdw]

I had a pair of orthotics made for me decades ago when I suddenly developed foot pain.

What was causing the pain?

 

[JPatrick]

The painful big toe also is a symptom of gout. Whether it is or not, you will find lots of diet advice to reduce the pain. Who knows, it may help what ails you.

 

[Marita40]

I'm going to make an appointment with another orthopedic surgeon to evaluate the toe specifically. It is definitely not gout btw. Yes, orthotics may be an answer for awhile. I have been reading up on the different types of surgery available and they all sound rather miserable. I have bone spurs that will need shaving off but I understand they are likely to come back. The other surgery appears to be fusing the toe to another. Yikes.
This has been an odd year for me--58 years old and the first health issues ever seem to have emerged all at once. I am a HUGE walker and am even planning to hike the Camino in two years. But now this.

 

[John Galt III]

What was causing the pain?

My memory of it is vague. I may have gotten new shoes which caused the pain. Or maybe I had started jogging. But I think it just came out of nowhere. The podiatrist said I had a structural weakness in one (both?) feet that would lead to fatigue and irritation of a certain tendon under certain conditions. Apparently the foot (feet?) needed to be be supported with the arch supports (orthotics) to be relieved from the constant stress from walking, in order to completely heal. Once healed, all was well. Until now! My research now points to plantar fasciitis. I will try my existing arch supports again for a week and see what happens.

 

[molly312]

Get checked for gout.

 

[splitwdw]

...Until now! My research now points to plantar fasciitis. I will try my existing arch supports again for a week and see what happens.

Plantar fasciitis causes heel pain so if that's where the pain is it's a good chance that's what it is. Though it could be something else like a heel spur. Some people think the two go hand in hand but they don't. Anyway, there's a discussion on this forum about the different things that worked for people. I've had it twice. The first time I went to my family doctor. I got an injection in the heel and it was extremely painful but fixed it. A few years later I got it again. The injection hurt so much I put off going to the doctor for months. This time I went to a podiatrist. He used ultra sound to fix it. There are exercises and sometimes a night splint will help.

 

[Fedup]

I gave my husband strongly mixture of fresh turmeric and honey, it healed his plantar fasciitis. He used to run and got hurt every few months and couldn't run. This was over 2-year period. He went to the doctor and had some brace for a few weeks but didn't fix the problem until the turmeric. Now he takes turmeric daily. It helps to wart off Alzheimer's too.


Sent from my iPad using Early Retirement Forum

 

[Marita40]

Molly, as I stated gout has already been ruled out in my case.

 

[John Galt III]

Plantar fasciitis causes heel pain so if that's where the pain is it's a good chance that's what it is. Though it could be something else like a heel spur. Some people think the two go hand in hand but they don't. Anyway, there's a discussion on this forum about the different things that worked for people. I've had it twice. The first time I went to my family doctor. I got an injection in the heel and it was extremely painful but fixed it. A few years later I got it again. The injection hurt so much I put off going to the doctor for months. This time I went to a podiatrist. He used ultra sound to fix it. There are exercises and sometimes a night splint will help.

I'm glad Marita started this thread. Splitdw, the current pain is only in the left foot, and is under the arch, at the highest point, in the middle. I thought plantar fasciitis was associated with arch pain. I have had heel pain before, but it has gone away on its own, thank God. I just put two old arch supports in my shoes today, to see what happens. I bought them at *Foot Locker* for $39 long ago, and are brand name is Spenco. How would ultrasound do anything for it? Do the high frequency waves do anything to the tissues in the foot?

 

[Ian S]

I have severe arthritis in my right big toe - it's called Hallux Rigidus. My orthopedic surgeon said to first try orthotics, then injections then surgery. My insurance covered an expensive pair of custom orthotics and although they helped, I was disappointed. Just on a lark, I tried these Hallux Rigidus Full Length Insoles, Pair :: Insoles :: Shop now with FootSmart and have been quite happy with them (nearly 2 years now.) I suspect I'll eventually have to have surgery to fuse the toe bones. There is also a facebook group for those with Hallux Rigidus. Good luck.

 

[Marita40]

Thanks for this recommendation Ian. I will look into these. Like you I suspect I will need surgery eventually. The question is when. All this has come as kind of a shock to me since I had no pain with this arthritis at all until the foot break. Now there is a big bony mass on the top and side of the big toe. Just amazes me that this can come on so suddenly. BTW, it was the second metatarsal that broke, not the big toe.

 

[marko]

The painful big toe also is a symptom of gout. Whether it is or not, you will find lots of diet advice to reduce the pain. Who knows, it may help what ails you.

+1 That was my first thought as well.

I've had gout since I was a teenager; some attacks lasting weeks.

I once investigated having the whole toe and joint removed. Dr didn't think it was a good idea. Diet, meds and care made it go away.

 

[MichaelB]

I would be interested in knowing more about the connection of diet (ie. gluten?) and arthritis pain, especially when arthritis (at least what I seem to have in my big toe) seems to be a clear cut physical wear-and-tear bone-on-bone thing. Just wondering how not consuming gluten might help this.

The literature on alternative medicine is not rigorous in its analysis of food and arthritis, and gluten has been accused of being a prominent cause of just about everything. Tomatoes, white potatoes, and corn do cause inflammation, gluten might, yeast might also. The easiest way to tell is to take them out of your diet, then bring them back in one at a time. Just walking across the room will tell you if there's an impact.

 

[Ian S]

Thanks for this recommendation Ian. I will look into these. Like you I suspect I will need surgery eventually. The question is when. All this has come as kind of a shock to me since I had no pain with this arthritis at all until the foot break. Now there is a big bony mass on the top and side of the big toe. Just amazes me that this can come on so suddenly. BTW, it was the second metatarsal that broke, not the big toe.

In my case. the orthopedic surgeon thought it might have been the result of a long forgotten stubbing of the big toe which started the arthritic development. Arthritis runs in my family so maybe not that surprising. If you try those orthotics from Footsmart, you'll have to use them with soft inserts (what came with the shoes worked for me) as they are a hard and stiff fiberglass material. I had to increase my shoe size a half size and an extra wide but YMMV. Footsmart also sells a padded version of that orthotic but I tried it and didn't care for it so much. Just by luck, I also found that Skechers Shape Ups were pretty good without the orthotic but they have a "rocker" sole which I found problematic on anything other than a flat surface. They also did not last long so I didn't replace them when they fell apart.

 

[splitwdw]

I'm glad Marita started this thread. Splitdw, the current pain is only in the left foot, and is under the arch, at the highest point, in the middle. I thought plantar fasciitis was associated with arch pain. I have had heel pain before, but it has gone away on its own, thank God. I just put two old arch supports in my shoes today, to see what happens. I bought them at *Foot Locker* for $39 long ago, and are brand name is Spenco. How would ultrasound do anything for it? Do the high frequency waves do anything to the tissues in the foot?

Most of the time the pain is in the heel but can be on the arch. There's a pretty good description on Footsmart and a series of questions to sort of self evaluate. Plantar Fasciitis: Symptoms, Treatment, Causes, and Prevention | FootSmart My family doctor pinched my foot near my heel and I can tell you that hurts if you've got plantar fasciitis. Footsmart is where I bought my night splint. I bought the hard frame one. It's kind of like a plastic splint with Velcro straps. Do not know how the ultrasound works. The podiatrist used it on my heel (only 1 time for about 10 minutes) and when I had a frozen shoulder the physical therapist used ultrasound on my back and shoulder. Worked for me.

 

[Bir48die]

It's all very simple. As we age and use our joints repetitively when we get trauma in an area it will many times turn to arthritis. I have an ankle that I've sprained so many times that it has resulted in ongoing pain. Many parts of my foot have transient pain. Where I've broken my thumb twice is now sore all the time.

I have been to many doctors and outside of orthodics there's really not much to do outside of high dose IBP or Tylenol. I've been checked for gout due to pain and past kidney stones. Actually has ended up as pseudogout.

It suck as finger joints are starting to inflame. I do not attribute any of this to Gluten. I'm 60 and very active but my philosophy is you're damned if you do and damned if you don't. I'd have less pain if I sat on the couch but then I'd die from something else.

 

[Ronnieboy]

I had severe big toe pain in the joint of my right foot a number of years ago (10?). Testing my uric acid levels (it was barely outside the range of normal, something like 7.3 on a normal scale of 4.6-7.2) so I was told 'gout', I was doubtful as I was barely above a seemingly large range and I didn't consume foods/beverages high in purines (alcohol, seafood and organ meats). I took some allopurinol regularly and would use colchicine for flareups.

Little over a year ago, I had what I thought was a flare and it wouldn't go away with the colchine, I then developed a rash on my body. Going to the dermatologist I was diagnosed with psoriasis. After topical steroids didn't help much, went on a biologic and not only did that clear up the rash after a number of months, but the joint pain was gone in about 2 days. It seems it might have been psoriatic arthritis all along