Great Toe Pain / Arthritis in Orange County

Hallux Rigidus is arthritis of the big toe joint. It is the most common arthritic condition of the foot, second only to hallux valgus (bunion deformity) as a condition associated with the big toe.  Hallux Rigidus typically develops in adults between the ages of 30 and 60 years of age.​ Our Orange County Podiatrist / Foot and Ankle Surgeon can evaluate and treat your great toe pain / hallux rigidus at our Irvine, CA, Huntington Beach, CA, or Orange, CA offices.

 

Symptoms and Clinical Presentation 

Most patients present with a complaint of pain in the big toe joint while active, especially when pushing off to walk. Others may have swelling and stiffness around the big toe joint, or an inability to bend the toe up or down. A bump, like a bunion or bone spur, can develop on top of the big toe joint and may be aggravated by rubbing against the inside of a shoe. 

​

Causes of Great Toe Pain

Several risk factors for hallux rigidus have been identified. These include an abnormally long or elevated first metatarsal (foot) bone, differences in foot anatomy, prior traumatic injury to the big toe, and family history. Most of these risk factors cause damage to the surfaces of the bone and lead to wear and tear of the joint, which in turn may lead to arthritis. 

 

Treatments of Great Toe Pain in Orange County

Non-surgical management is always the first line treatment for this condition. Your doctor may suggest pain relievers and anti-inflammatory medicines, ice or heat packs, or even injections to reduce pain and stiffness. Changes in footwear may also be suggested, including advice to avoid thin-soled shoes or high heels, wearing wider shoes, or even add shoe inserts that limit the motion at the Great toe joint. While these treatments may help decrease the symptoms, they do not alleviate the condition.

 

Surgical Treatment for Hallux Rigudus in Orange County

Surgical intervention for hallux rigidus is considered with the failure of non-surgical treatments. You and our Orange County Foot and Ankle Surgeon will develop a treatment plan based on the extent of arthritis in the great toe joint and the deformity of the toe. The most commonly performed surgical treatments include: 

 

Cheilectomy 

For the more minor type of hallux rigidus, when the damage is mild to moderate, shaving of the bone spur on top of the metatarsal (cheilectomy) may be sufficient. Removing the bone spur allows more room for the toe to bend and alleviates the pain caused when pushing off the toe. The advantages of this procedure are that it preserves joint motion and maintains joint stability.

 

Fusion (Arthrodesis)

Advanced stages of hallux rigidus, when the joint damage is severe, are often treated by fusing the big toe (arthrodesis). In this procedure, the damaged cartilage is removed and the two bones are fixed together with screws and/or plates to allow them to grow together. The main advantage of this procedure is that it is a very reliable, predictible, and permanent correction, which eliminates the arthritis and pain.. The disadvantage is it may require shoe gear modification and may limit the wearing of high heeled shoes, due to the restriction of movement of the big toe.

 

Interpositional Arthroplasty

For the patient with moderate to severe hallux rigidus who is unwilling to accept the loss of motion at the big toe, an interpositional arthroplasty may be an option. This procedure consists of taking away some of the damaged bone and placing a joint implant within the joint to allow for some motion. While this operation may be effective, it is not as reliable, predictable, or permanent as fusion (arthrodesis). Patients may require a revision to a fusion with the placement of a bone graft if symptoms return.

 

You and our Orange County Podiatrist / Foot and Ankle Surgeon will discuss the surgical options in detail in order to help you determine which procedure is best for your individual situation.

​

Please contact our office in Irvine, Orange, or Huntington Beach in Orange County, CA to make an appointment with our foot and ankle surgeon / podiatrist (Dr. Coyer) to have your great toe pain in Orange County fully evaluated.