The appearance of a suspicious lump on the leg rarely goes unnoticed, because any attempt to walk without taking off shoes causes discomfort for the patient. But in most cases, seeing a doctor is postponed for months, or even years. It’s a pity, because going to the doctor in the early stages of arthrosis of the big toe allows you to “freeze” the disease and delay the appearance of irreversible foot deformities.
First, baths and applying onions in a sock are used, then, when the disease does not respond, ointments are used, and only then, exhausted by constant pain, the patient turns to an orthopedist or rheumatologist. What kind of diagnosis is this, how to treat arthrosis of the toe, how to recognize its first signs and what could be the consequences of postponing a visit to the doctor?
Arthrosis of the toe joints - what is it?
Osteoarthritis of the interphalangeal and metatarsal joints of the legs is a chronic degenerative disease that begins with the destruction of cartilage tissue and can disfigure the patient’s fingers and feet beyond recognition. Regardless of the causes of this condition, it leads to complete degeneration of cartilage and its replacement by bone growths - osteophytes.
Since the foot and toes - the load-bearing supports of the human body - are subject to enormous stress, arthrosis of the toes is extremely common. According to some estimates, it affects up to 10% of the human population over 60 years of age. It’s not surprising, because the foot doesn’t rest even when we sit!
Typically, the disease begins in the big toe or little toe and primarily affects the metatarsophalangeal joint. Osteoarthritis of the second or third finger is less common. In recent years, there has been a trend towards “rejuvenation” of the disease - arthrosis of the big toe is increasingly found in patients aged 30-35 years.
How to prevent the disease
Basic preventive measures help prevent swelling in the toes. You just need to take care of your body and try to avoid the possibility of injury. The key to good foot health will be personal hygiene, which should be present in every person's life on an ongoing basis.
Particular attention should be paid to the choice of comfortable, high-quality shoes, which should be made from natural materials, and also have a not very high heel and a comfortable sole. In addition, you can use special orthopedic shoes or insoles. If fungal or other diseases are detected, treatment should be started immediately.
You should also monitor your diet so that it is complete and includes all the necessary microelements obtained from foods. It is necessary to reduce the amount of salt consumed, as it prevents excess water from leaving the body, which causes edema. It is also better to abstain from drinking alcohol or reduce it to a minimum.
Swelling of the fingers is easy to treat and is often completely eliminated, but only if treatment was provided in a timely manner. By following basic rules, you can prevent the formation of edema and also maintain your health.
Causes of arthrosis of the toes
Joint diseases, incl. arthrosis of the joints of the toes must be considered comprehensively - often the prerequisites and triggers of the disease include several factors at once. These factors lead to disruption of phosphorus-calcium metabolism, starvation of cartilage tissue, and its loosening.
Common causes of osteoarthritis of the toes include:
- injuries to the fingers, foot or joints located above (frequent and severe bruises of the little finger, left without treatment, can also provoke arthrosis);
- congenital abnormalities of the foot, postural disorders (flat feet, club feet, lordosis, kyphosis, etc.);
- wearing uncomfortable shoes (tight, constricting, not warm enough, worn out or high-heeled, or otherwise leading to an unphysiological position of the foot);
- hypothermia (local or general);
- excessive load on the legs (“standing” profession, excess weight, active sports, habit of uncomfortable posture);
- diseases of the peripheral arteries of the lower extremities (varicose veins, thrombosis and others);
- metabolic disorders (diabetes mellitus);
- endocrine diseases, hormonal imbalances, menopause or pregnancy;
- the presence of infectious agents in the body;
- genetic predisposition associated with the density of cartilage tissue, metabolic characteristics, and the anatomical structure of the limbs;
- the presence of arthritis and arthrosis of other joints, especially with systemic diseases;
- smoking and other bad habits;
- stress - physical, mental or emotional stress;
- elderly age.
The exact causes can only be determined after a series of tests, x-rays, and in some cases, an MRI. Acute inflammation in arthrosis of the toes usually occurs after active physical activity, and also if particles of osteophytes break off and enter the joint capsule, injuring it during movement.
Pain after injury
If discomfort appears after wearing open shoes, you need to check your feet for bites, minor scratches and other injuries, changes in the shape or color of the nails. Often, infections cause inflammation and swelling. Most often, the tips of the toes hurt. If the pain is mild, you can first consult a therapist. If the finger is very swollen, red or blue, or occupies an unnatural position, this may indicate a serious injury: a fracture, dislocation, or severe bruise. In this case, you need to contact a traumatologist.
Symptoms of osteoarthritis of the toes
An alarming signal for the patient, as a rule, is pain and fatigue in the legs. At first, they are mistaken for ordinary fatigue at the end of the day, the consequences of uncomfortable shoes, and a sedentary lifestyle. Discomfort is observed while walking; in the mornings, patients are bothered by stiffness of the toes and the entire foot, a feeling of numbness, and crunching. The pain increases after physical activity and subsides at night, but as arthrosis of the toes progresses, it becomes around the clock.
Also among the first symptoms to appear:
- swelling, sometimes up to the ankle;
- hyperemia and hyperthermia (redness and increased skin temperature) as symptoms of the inflammatory process;
- frequent appearance of corns and calluses in the same places where they were not observed before;
- growing limitation of mobility in the joint (the joint space seems to be “overgrown” with osteophytes and the heads of the subchondral bones can no longer slide in the joint);
- audible rough crunching sound when walking;
- sometimes the patient can independently palpate osteophytes - hard tubercles under the skin.
Previously comfortable shoes become tight for the patient, it becomes more difficult to stand, and changes in gait appear. With arthrosis of the joint of the big toe, as people say, “the bone begins to bulge” on the inside of the foot, at the base of the first toe. Similar thickenings in the joint area can be observed on other fingers, incl. between the phalanges.
Weather-sensitive patients complain that before the weather changes, the joint begins to ache, twist, and ache.
Symptoms may vary depending on the stage of arthrosis of the toes. Stage 1 is characterized by aching pain and an increase in the size of the affected joints, however, due to smoothed symptoms, it may remain unnoticeable. For the 2nd - increased pain, crunching, inflammation. For the 3rd - deformation and inflexibility of the joints, displacement of the fingers.
Diagnostics
Diagnosis of diseases accompanied by pain in the toes is carried out by orthopedic traumatologists. If necessary, rheumatologists, surgeons, dermatologists, and other specialists are involved in the examination. The examination plan includes:
- Survey.
The doctor finds out the time and circumstances of the appearance of pain and other signs, establishes the connection of pain with external circumstances, studies life history, family history. - Physical examination.
During the examination, the specialist evaluates the appearance of the foot and fingers, determines the presence of deformities, swelling, local hyperthermia, and discoloration of the skin. Examines range of motion, sensitivity, pulsation of arteries. - X-ray of the toes.
Visualizes dislocations, fractures, areas of restructuring or destruction of bones and joints, degenerative and inflammatory changes. - Dermatoscopy.
It is carried out to differentiate callus and onychogryphosis from other diseases, to exclude the mycotic or viral nature of the lesion. According to indications, it is supplemented with other dermatological techniques. - Ultrasound.
Performed for vascular diseases. Duplex scanning and ultrasound scanning allow us to study the condition and patency of the arteries, and the speed of blood flow. - Laboratory research
. Recommended for confirming inflammatory processes, detecting markers of rheumatic diseases, and studying flora.
Examination by a traumatologist-orthopedist
Treatment of arthrosis of the toes
Based on the tests performed, the observing doctor draws up an individual treatment strategy, which depends on the stage of the disease, the presence of concomitant health problems, age, weight, lifestyle and anatomical characteristics of the patient. The general course of treatment for arthrosis of the toe joints may include taking chondroprotectors and vitamin-mineral complexes, diet adjustments, therapeutic exercises, and teaching the patient an orthopedic regimen. At stages 2 and 3, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), painkillers, hormonal corticosteroid injections, and physical therapy is indicated. If a joint completely loses its functions, endoprosthetics (usually of the metatarsophalangeal joints) may be prescribed.
At the 1st stage of arthrosis of the joint of the big toe, complete recovery is still possible - the main thing is to consult a doctor in time. At the 3rd stage, as a rule, surgical intervention is indicated - without it, the patient’s quality of life and level of activity drop significantly, and unremitting pain leads to sleep disturbances and decreased mood.
For successful treatment of arthrosis of the toe joints, it is important to follow three principles:
- Seeing a doctor earlier increases the chances of recovery or stable remission.
- Treatment is carried out continuously, over a long period of time.
- Outpatient therapy occurs with regular consultations with the attending physician. Don't self-medicate!
Treatment of arthrosis of the toes with medications
For moderate symptoms, in the drug treatment of arthrosis of the toes, preference is given to local NSAIDs in the form of ointments, creams, and gels. In advanced cases with severe pain, anti-inflammatory drugs together with analgesics can be injected directly into the diseased joint. For systemic joint damage or as part of complex therapy, NSAIDs are also prescribed in the form of tablets or intramuscular injections. This allows you to quickly relieve swelling, improve nutrition of the tissues around the joint, and facilitate warm-up. In addition to relieving symptoms and treating toe joints, the use of any non-steroidal anti-inflammatory drugs slows down cartilage degeneration.
Ointments in the treatment of arthrosis of the toes with medications can be used daily. Short courses of NSAIDs in tablets aimed at relieving an acute inflammatory process are prescribed by a doctor. If taken for a long time, they can lead to stomach ulcers.
If more serious therapy is required to relieve inflammation, the doctor may prescribe hormonal injections with glucocorticosteroids (their use on their own is extremely dangerous!). Analgesics (systemic or local) are used to relieve pain and are selected taking into account its intensity. The main treatment for arthrosis of the big toe is usually supplemented with vasodilators, which improve the nutrition of periarticular tissues and serve to prevent foot diseases (for example, fungal).
It is also recommended to take lifelong dietary supplements based on cartilage tissue components - glucosamine and chondroitin (for at least 3-6 months a year). Effective at stages 1 and 2.
Forms
In normal condition, the metatarsal bones are parallel to each other. Under the influence of certain reasons, the first metatarsal bone deviates outward and because of this, a protruding small bump appears on the foot, ligaments and tendons lose their elasticity, and their dysfunction develops.
The disease goes through several stages:
- Early.
At this stage, the deviation of the big toe is less than 15 degrees.
- Average.
The deviation of the first finger to the side is from 15 to 20 degrees. At the same time, deformation of the second finger is observed. It rises above the thumb and becomes shaped like a hammer.
- Heavy.
The thumb deflection is 30 degrees. All the toes are already deformed, and a large bone growth is observed at the base of the first phalanx. In places where there is a lot of stress on the foot, rough calluses appear.