Pain, stiffness or swelling of the big toe? Mr Mark Davies answers the FAQs...
Mr Mark Davies, SOL Consultant Orthopaedic Foot & Ankle Surgeon
Claremont Clinics: Mondays, Wednesday PM, Thursday AM
What are the symptoms of arthritis of the big toe?
There are 3 main symptoms - pain, stiffness and swelling. As in other arthritic joints, the swelling can be from increased amounts of fluid in the joint and/or excess bone formation. The more the cartilage has been worn away and the more excess bone that is formed, the stiffer the big toe becomes. In some individuals, there is not much stiffness and the pain they experience occurs mainly when the toe is bent upwards when walking. However, in the majority of people, pain occurs with any movement of the joint becoming worse with the amount of time spent on foot.
What is arthritis of the big toe?
Arthritis of the main joint of the big toe is very common. It is a process where the smooth cartilage lining the surfaces of the joint has been worn away so the bare bone rubs with each step. For specialist foot and ankle surgeons, it differs from the term ‘bunion’ which describes a deviation of the big toe away from the midline of the body. In most cases of big toe arthritis, the toe remains relatively straight.
What are the possible causes of arthritis of the big toe?
Studies have shown there are many reasons for bunions and arthritis to the main joint of the big toe. Links have been established with family traits, poor footwear, certain types of arthritis, gout and previous injury.
I have tried simple measures to help with pain such as painkillers, better fitted shoes and advice from podiatrists but they are no longer helpful. What other treatments available?
The surgical treatments available are a cheilectomy, Cartiva or fusion surgery. Specialist foot and ankle surgeons can discuss with you which one would suit your needs best. All 3 treatments are performed as day surgery cases.
What is a cheilectomy?
This surgery aims to treat people with minimal stiffness and pain when bending the toe. The excess bone that is blocking the joint from moving is removed to free the joint motion. In certain cases, this can be performed with newer minimally invasive incisions.
What is Cartiva?
Cartiva is an implant that has been designed to help treat osteoarthritis of the main joint of the big toe. It works by spacing apart the arthritic joint surfaces so they no longer rub together. If the surfaces of the joint stop rubbing, this should provide pain relief.
How do I know Cartiva is safe to implant?
It is made of the same material as a contact lens and therefore is safe for implanting in the body. Sheffield foot and ankle surgeons took part in a multi-national clinical trial that successfully showed the implant to be both safe and effective as a treatment for arthritis.
What is fusion surgery?
Although this treatment is over 100 years old, it remains very effective in providing pain relief for big toe arthritis when the toe is very stiff. The joint edges are removed and the 2 bones are pinned against each other with screws so that the 2 bones are encouraged to heal together as one.
Does fusion surgery prevent me from walking normally?
After successful fusion, your gait improves as the pain has been relieved. The stiffness created by the surgery is often similar to that before the treatment. In some individuals, it can limit the heel height of the shoe.
A private consultation with Mr Davies at Claremont costs £200 if you don't have health insurance. To book an appointment, call our friendly Private Patient Team on 0114 263 2114 or email firstname.lastname@example.org. You will need a referral letter from your GP or you can see one of our Private GPs quickly if you prefer.
Copyright Mark Davies, 2016.