San Antonio Podiatrist Discusses Help for Painful Stiff Big Toe Joints

SAN ANTONIO, April 4, 2019 (Newswire.com) - San Antonio Podiatrist, Dr. Ed Davis states, "Big toe joints that become stiff and painful can really slow people down and prevent enjoyment of physical activities." The condition that leads to stiffness and arthritis of big toe joints is known as hallux rigidus. The hallux is the big toe. Rigidus means, well, rigid. Effective treatments are now available, according to Dr. Davis.

Treatments for hallux rigidus have included use of shoes with rocker soles, soles that are convex and allow one to push forward without having to bend the big toe joint, physical therapy, anti-inflammatory drugs and occasionally cortisone injections.  Prescription foot orthotics can be used to improve function of the big toe joint.

Application of modern technology to the problem of painful stiff big toe joints or hallux rigidus can restore function and relieve pain.

Eddie Davis DPM FACFAS, DPM

Surgical treatment for hallux rigidus may be considered if conservative care is not enough to restore good pain-free joint function. The choice of surgical procedures depends on the severity or stage of the disease. There are 4 recognized stages of hallux rigidus and treatments are specific for each stage.

Stage one hallux rigidus is treated conservatively as is early stage 2. Late stage 2 may be treated via a procedure called a “cheilectomy” in which arthritic “spurs” are removed from the top of the joint in order to allow more motion. This can be a very successful procedure when used correctly, that is, when used in stage 2 where there is still good cartilage in the joint.

More advanced stages of hallux rigidus such as stage 3 and stage 4 required more complex surgery to restore motion to the joint. A common recommendation provided by some surgeons included fusion of the big toe joint or arthrodesis. A joint which is fused is no longer a joint so it cannot hurt. There are several potentially significant disadvantages to fusion: 1) It can take up to 3 months for a fusion to occur which is a long recovery period, 2) Fusion of the big toe joint changes the way one walks and changes in walking can affect the knees, hips and back, 3) The technology to restore normal or close to normal big toe joint function exists.

The set of procedures known as implant arthroplasty involve reconstruction of the big toe joint with use of an implant. Implants are essentially devices which are additions to existing tissues or devices which substitute for poorly functioning or diseased tissues. Implants to restore motion to the big toe joint have existed in various forms since the late 1970s. Some implant designs have been successful and others not. One challenge that foot surgeons have had was not only to know which designs were best but which implant designs would work best for a particular patient. Some surgeons, frustrated by lack of such knowledge abandoned use of implants and favored joint fusion.

Knowledge of biomechanics, how joints and body parts work, is essential to understand how and why joint reconstruction with implants work. Application of biomechanics to the specific needs of a patient leads to successful implant arthroplasty for the big toe joint. A number of implants exist on the market today for treatment of severe hallux rigidus, including some newer ones such as CartivaTM ArthrosurfaceTM, and PrimusTM by Integra. Proud device manufacturers introduce such products with fanfare and prospective patients hope that the latest device is the one for them. The reality is that there is no one ideal implant for everyone. Patients need to choose carefully to find a foot surgeon who is not “married” to one product but has experience with multiple procedures, multiple implants and understands the complex biomechanics of the foot.

Reconstruction or repair of hallux rigidus is based on application of a system of repair that may include use of an implant. It is how a system which is unique to the needs of a patient is applied that leads to treatment success.

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Dr. Ed Davis is a Podiatrist located in San Antonio, Texas. He is Board Certified in Foot Surgery by the American Board of Foot and Ankle Surgery. He can be contacted at (210)490-3668 or at 109 Gallery Circle, Suite 119, San Antonio, Texas 78258.