What is Hallux Rigidus?
The most common place where arthritis is located in the foot is the center of the big toe. This joint is called the metatarsophalangeal joint or MTP joint. This joint is very important as it bends every time you take a step. If this joint becomes stiff, walking becomes very painful and difficult. The metatarsophalangeal joint, like any other joint, ends in bones covered with a flat articular cartilage. If there is wear and tear or damage to the joint cartilage, the painful bone endings rub together. A bone spur, or overgrowth, may develop at the top of the bone. This overgrowth prevents your toe from bending as much as it needs to when you walk. Conclusion; It is a rigid toe toe or hallux rigidus.
Hallux rigidus,mostly develops in adults between the ages of 30-60. No one knows why this development occurs in some people and not in others. This may result in injury to the toe and destruction of joint cartilage, or it may be caused by differences in foot anatomy that increase stress on the joint.
Signs and symptoms
- Pain in your MTP joint when you are active, especially when you step on your toeswhile walking,
- Swelling around the joint,
- Bunion developing on the top of the foot or a callus-like protrusion,
- Hardness in the big toe, in curling it up and down.
Diagnosing the problem
If you have difficulty bending your toe up and down, or if you are stepping on the outside of your foot while walking due to pain in your toe, go to see your doctor. If hallux valgus is detected early, it is easy to treat. If you wait until you see a bump on the top of your foot, a bone spur will have already developed and this will be even more difficult to treat. Your doctor will examine your foot and look for evidence of a bone spur. Move your finger around By lowering it, he will see how much movement can be painless. X-rays can show the size and location of any bone spurs, as well as the degree of degeneration in the joint space and cartilage tissue.
Nonoperative treatment options
Painkillers and ibuprofen. Anti-inflammatory drugs, such as , help reduce swelling and relieve pain. Applying ice packs and contrast baths (described below) are also helpful in reducing inflammation and controlling symptoms for a short time. But all these are not enough to stop the progression of the situation. Wearing wide toe shoes will reduce the pressure on the toes and you will probably have to give up high heels. Your doctor may recommend specially designed shoes with hard soles, such as rockers or rollers (with external wheels on the sole), and possibly even a steel or metal sole support in the middle. Contrast bath; It is a bath used by alternating cold and hot water to reduce inflammation. For this; You need two buckets, one with as much cold water as you can stand and the other with as much hot water as you can tolerate. Dip your feet into the bucket of cold water for thirty seconds, then immediately move to the bucket of hot water and hold there for thirty seconds. Continue this process for five minutes, alternating between hot and cold and finally leaving it in cold. You can take contrast baths no more than three times a day. However, avoid exaggerated water temperatures when your feet are in the water, especially when your feet are not very sensitive to hot and cold.
Surgery options
Cheilectomy
This surgery mostly involves damage, It is recommended if it is mild or moderate. The surgery essentially involves removing the bone spur that has become part of the foot bone. like this; The toe finger has a place where it can bend easily. The incision is made above the top of the foot. The finger and the operated area may remain swollen for several months after the surgery. Finally, two weeks after surgery, you should wear wooden-soled sandals. However, in most patients this period is much longer. It may be a long time.
Arthrodesis
In cases of very severe damage to the cartilage tissue, welding the bones together (arthrodesis) is often recommended. Damaged cartilage tissue is removed and the joint is fixed in a permanent position using pins, screws, or plate. Bones gradually develop together. This kind of surgery; It means you can no longer bend your finger. However, this surgery; It is the most reliable way to relieve pain in such severe cases.
Arthroplasty
Older patients, where many functional demands are placed on the feet; They may be candidates for joint replacement surgery. In this surgery, the joint surface is removed and an artificial joint is implanted. This surgery option can relieve pain and preserve joint movement.
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