Big toe/ first MTP joint arthritis

What big toe arthritis?

Stiffness of the big toes is a gradual process due to arthritis affecting the big toe joint and wearing down of the cartilage. Hallux Rigidus and hallux limitus cause the joint to become enlarged with bone growth and gradual stiffness ensues.

The difference between hallux rigidus and hallux limitus is that hallux limitus is slightly early arthritis. Otherwise, they both have the same causes and can be treated with the same path. 

Causes of big toe joint stiffness:

There are many causes of  big toe joint stiffness. Our patients generally tell us of an injury, stubbing or an old fracture that occurred often decades ago which gradually results in stiffness and pain. The enlargement of the joint results in difficulty with getting into comfortable shoes and women cannot wear high heels any more.

Other causes of big toe stiffness can be genetic or biomechanical as result of poor foot posture and mechanical dysfunction.

Systemic diseases such as gout and rheumatoid diseases can also damage the joint and result in Hallux Rigidus.

Symptoms of big toe arthritis:

  • Pain and stiffness in the big toe that is worse during activity and cold weathers
  • Swelling and inflammation around the joint
  • As the condition worsens, you may experience loss of movement
  • Bone growth on the joint can occur

Diagnosing big toe arthritis:

Diagnosing first MTP joint arthritis begins with a specialist examining your feet and lower limbs. Our specialists will asses the movement available in your big toe joints and any change in shape. The quality of big toe joint movement will also be assessed.

X-rays may be needed to diagnose arthritis which will allow examination of the joint. In particular, the available joint space giving an indication of cartilage present, as well as osteophytes/bone spurs.

For subtle cases of arthritis, an MRI may be requested to look at soft tissue inflammation and lesions on the cartilage that may not be visible on the bone.

Treatment for big toe arthritis:

Following an assessment and possible X-rays, your specialist may advise on one or a combination of the following treatments:

Surgery for Big toe arthritis:

Should conservative treatments not be beneficial then your specialist may advise on surgery, this could include:

  • Cheilectomy procedure
  • First MTP joint fusion
  • First MTP joint surgery with implant

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