Arthrosis of the big toe is a common form of arthrosis of the foot joints. This disease is popularly called “bone” and is often confused with gout, but the cause of the disease has nothing to do with excess uric acid.
The problem is a violation of metabolic and trophic processes in the tissue of hyaline cartilage. During arthrosis, structural changes in the joint lead to partial or complete immobility, which causes difficulty when trying to take even a step. On top of that, in the absence of treatment, an unaesthetic problem of a protruding growth appears and severe pain, which can accompany a person day and night.
Arthrosis of the big toe is a universal human disease, inherent in both men and women, but in the “weaker sex” it manifests itself much more often.
This selective manifestation is the result of a specific set of risk factors.
Risk factors
Despite its clear localization (joints only), arthrosis of the big toe is a multi-cause disease. The manifestation of its symptoms is preceded by a number of reasons. Among them:
- hereditary predisposition;
- domestic and professional injuries (arthrosis of the thumb is a characteristic disease of football players and ballet dancers);
- narrow and uncomfortable shoes;
- excess weight with regular loads on the legs;
- severe hypothermia;
- congenital and acquired leg deformities (flat feet, developmental pathologies);
- problems with the endocrine system, hormonal imbalances and changes (thyroid disease, diabetes, menopause, steroid use, etc.);
- long-term loads on the foot area (with low physical activity);
- age-related changes.
If you notice that you have two or more risk factors for the development of arthrosis of the big toe, you should think about undergoing preventive examinations. We have extensive experience in identifying arthrosis at the earliest stages and treating all stages.
Symptoms of foot osteoarthritis
In the early stages of development of osteoarthritis of the foot, there are no obvious symptoms of the disease. The patient may feel discomfort and heaviness in the legs after prolonged standing or severe exertion.
Characteristic signs of the disease are:
- Pain in the foot;
- Swelling of the joints;
- Rapid fatigue of the lower extremities;
- Crunching when rotating the foot.
Stage 1 osteoarthritis of the foot is not easy to determine. All signs of the disease are not expressed and the person tries not to notice them, attributing fatigue to age. Later, a constant feeling of tired legs and discomfort in the ankle joint appears. Over time, fatigue is accompanied by pain that occurs in the foot while walking. Pain can also be observed at rest. This is grade 2 osteoarthritis of the foot. Treatment must be carried out immediately, otherwise deforming arthrosis may develop. As the disease progresses, the articular cartilage is destroyed and the patient may become disabled.
Osteoarthritis of the toes manifests itself as a crunching sound. When bending and straightening the fingers, a “dry” sound is heard. It appears due to a violation of the structure of cartilage, which produces an insufficient amount of joint fluid. The quality of synovial fluid, which provides “lubrication” to the joints, also deteriorates, which increases the frequency of crunching.
With osteoarthritis of the foot, swelling persists constantly. It increases towards the end of the day and decreases after rest. In many cases, edema of the lower extremities is associated with impaired patency of small blood vessels, and is not directly related to manifestations of osteoarthritis. Rheumatologists at the Yusupov Hospital conduct the following studies to determine the true cause of pain and swelling of the foot:
- X-ray of the foot bones;
- Computed tomography;
- Ultrasonography.
If the ankle joint is affected, arthroscopy may be performed. Laboratory tests allow us to assess the nature and severity of the inflammatory process.
Symptoms
- Rapid fatigue of the legs;
- pain syndrome (pain can be aching or sharp);
- "weather" sensitivity;
- poor circulation in the feet (toes and feet are cold);
- joint stiffness, periodic “crunching”, especially with sudden movements;
- swollen and inflamed tissue around the “bone” of the thumb;
- deformation of the articulation area;
- nodules (Heberden) on the surface of the joint.
This list includes symptoms of different stages of the disease. Depending on the individual characteristics of the patient, they may appear earlier or later, so at the slightest sign of a problem you should consult a specialist.
Be careful! The widespread spread of the disease has given rise to many traditional methods of treating arthrosis; as a result, patients turn to doctors in the later stages.
Stages of arthrosis of the big toe
1st stage. It may be asymptomatic at first. The feet quickly get tired, cold, and periodic “aches” and “torsion” appear in the joint of the big toe. Gradually, the general discomfort is replaced by limited mobility of the joint when walking and periodic aching pain.
Stage 2. A characteristic symptom is the appearance of callus growths on the outer part of the foot, due to forced redistribution of the load. The pain intensifies and accompanies every movement of the leg, becoming continuous over time. The joint swells and surrounding tissues become inflamed.
Stage 3. The pain becomes unbearable, accompanying the patient even at rest. A joint deformity occurs: the metatarsophalangeal joint of the big toe grows, the toe itself moves into the plane of the foot and down. The period of complete destruction of the joint and fusion of bones into a fixed joint is sometimes identified as the 4th stage of the disease.
Attention! Timely detection of the disease at the 1st stage of arthrosis allows you to stop the development of the pathological process.
Degrees of foot arthrosis
There are 3 degrees of arthrosis, varying in depth of pathology and intensity of symptoms of the disease.
Arthrosis of the foot of the 1st degree is characterized by the absence of pronounced morphological changes in the form of destruction of articular tissues. There are no external signs of deformation. However, already at this stage the nutrition of the articular cartilage with synovial fluid is disrupted, and inflammation appears. Subjective symptoms at this stage are mild. The patient may notice fatigue when walking, aching pain with prolonged exercise.
Arthrosis of the foot of the 2nd degree is characterized by the appearance of morphological signs: the structure of the cartilage is disrupted, the synovial surfaces begin to collapse, and the joint space narrows. Joint function suffers. Pain in the legs becomes constant, more intense, and does not go away with rest or after rest.
Arthrosis of the foot of the 3rd degree is an advanced pathological process; this stage of the disease is characterized by extensive destruction of structures, the appearance of bone growths, and noticeable deformation of the foot. The range of motion in the joint is lost until complete immobility. Pain in the legs becomes so pronounced that a person strives to free the leg as much as possible from the load and transfer the weight to the healthy side, which leads to lameness.
Treatment of arthrosis
Depending on the stage, symptoms and causes, conservative or surgical methods are used to treat arthrosis of the thumb. In some cases, these areas are used comprehensively.
Conservative treatment
It is based on symptomatic treatment and supportive therapy aimed at eliminating the symptoms of arthrosis and regenerating damaged cartilage tissue (stopping destruction).
Treatment order:
- anesthesia;
- elimination of inflammation;
- improved blood circulation;
- cartilage regeneration.
Typical techniques:
- Drug treatment involves the balanced use of injectable and oral drugs, as well as local agents to achieve the main therapeutic goals: pain relief (analgesic group - analgin, spasmalgon, etc.), relief of inflammation (non-steroidal and steroid drugs), regeneration of cartilage tissue (use of chondroprotectors and supporting substances), improving blood circulation.
- Manual therapy and exercise therapy to restore the anatomically correct position of the joint elements and prevent subsequent deformation.
- Physiotherapy methods are aimed at treating arthrosis of the thumb using UHF, laser and magnetic therapy, electrophoresis, etc. The methods actively restore blood circulation, trigger the processes of regeneration of cartilage tissue and gradually relieve pain.
- Use of orthopedic devices (insoles - arch supports, special shoes, etc.).
In parallel with a set of conservative techniques, work is being done to address the causes of arthrosis (excess weight is eliminated, orthopedic shoes are prescribed, etc.).
Surgery
If conservative treatment methods are unable to cope with the restoration of normal motor activity of the joint and the pain syndrome is not relieved, a decision is made on surgical intervention. As a rule, this situation occurs at the 3rd stage of development of arthrosis of the big toe and is accompanied by:
- complete or almost complete destruction of the cartilage tissue of the joint;
- continuous pain;
- poor sensitivity to medications.
Until recently, the basis of surgical treatment was the traditional approach using either radical techniques:
- resection arthroplasty – resection of deformed areas of the joint;
- arthrodesis – treatment of pain syndrome by immobilization of the joint;
Other methods of surgical treatment are currently used:
- arthroscopy – joint sanitation: removal of the damaged meniscus, particles of destroyed cartilage tissue from the cavity of the joint capsule;
- cheilectomy – removal of deforming growths on the surface of the phalanges of the finger and articular capsule.
- osteotomy – shortening, corrective osteotomy of the proximal phalanx of the finger or 1st metatarsal bone, removal of deforming growths on the surface of the phalanges of the finger and articular capsule.
Radiographs of the feet: a.
arthrosis of the first metatarsophalangeal joint (MTP) degree 2, b. metatarsophalangeal joint after osteotomy of the phalanx of the big toe and the first metatarsal bone.
Such interventions are effective for arthrosis of 1-2 degrees, so in the world of restorative medicine there is a shift towards the treatment of arthrosis with endoprosthetics.
a.b.
appearance of the foot with arthrosis of the first PFJ, c.
X-ray of the foot with arthrosis of the big toe . Radiographs of the foot after arthroplasty of the big toe joint.
We have been performing endoprosthetics
of the first metatarsophalangeal joint
for 7 years (complete or partial replacement of damaged parts of the joint with endoprosthesis components).Many years of experience working with small joints allows us to perform similar tasks of any complexity with excellent and good results in the long term.
How to treat arthrosis of the foot joints
The original method of kinesitherapy used at the Center is aimed at restoring the physiological functions of the joints and activating the body’s own resources.
This happens due to a number of factors:
- Activation of muscle function;
- Relieving spasm and, as a result, restoring blood flow;
- Improved nutrition of cartilage tissue as a result of regular, proper exercise;
- Elimination of tissue dystrophy;
- Preventing or stopping the destruction of cartilage;
- Preventing the progression of arthrosis.
Before prescribing treatment, the doctor conducts a complete diagnostic examination of the patient. A manual examination and myofascial testing are required to determine the degree of joint mobility impairment and characteristic pain sensations. As additional methods, the doctor may prescribe an X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) of the joint. These studies reveal morphological changes characteristic of stages 2 and 3 of the disease: narrowing of the joint space, deformation and destruction of bone and cartilage tissue, and the appearance of bone growths.
Having studied the results obtained, the doctor determines the degree of arthrosis, because the proposed treatment plan depends on it.
Despite the fact that the general principles of therapy are the same for all stages of the disease, the intensity of the therapeutic effect and its effectiveness largely depend on how advanced the pathological process is.
How to treat arthrosis of the 1st degree?
At this stage of the disease there are no noticeable morphological changes, but there are only prerequisites for their possible appearance in the future, which can be easily corrected.
To treat the first manifestations of the disease and prevent severe complications, an individual kinesitherapy program is drawn up, taking into account the characteristics and needs of the patient. The absence of severe pain and noticeable limitation of mobility at this stage allows you to choose active tactics and create an intensive program of exercises performed both on a gymnastic mat without additional equipment, and on special simulators.
How to treat arthrosis of the 2nd degree?
Treatment of arthrosis at stage 2 requires greater care and caution on the part of the attending physician in order to prevent the appearance of pain during the process of kinesitherapy.
The exercises are performed on the Bubnovsky multifunctional block simulator, which allows you to specifically engage the desired muscle group without provoking pain. Each lesson is supervised by a kinesiotherapist, and the technique of performing the exercises is supervised by experienced instructors.
Treatment started at the second stage helps improve impaired joint movement, relieve pain, as well as stop the progression of arthrosis and prevent a deterioration in the patient’s quality of life.
How to treat grade 3 arthrosis?
Unfortunately, at this stage of the disease, morphological changes reach significant severity and become irreversible, so a complete recovery of the patient is impossible.
Often patients suffering from grade 3 arthrosis come to the Center after surgery. However, surgery itself does not restore joint function. Proper and complete rehabilitation is necessary, including individually selected physical activity and additional procedures: massage, physiotherapy, thermal effects.
The prescribed program includes exercises and procedures that are most effective and safe at this stage. Thanks to a competent combination of these drugs with physical activity, the maximum therapeutic effect and prevention of the progression and complications of arthrosis are achieved.