Stepping into Winter: Tackling Big Toe Arthritis at Thames Foot Clinic

Introduction to Big Toe Arthritis (Hallus Limitus)

As we wave goodbye to the warm days and welcome the chilly winds of winter, our footwear changes too. The open-toe sandals are replaced by warm, closed-toe shoes and boots. However, this switch might bring along an unwelcome guest – pain in the big toe. If you’ve noticed a sharp or aching pain in your big toe, it could be a sign of arthritis. At Thames Foot Clinic, under the expert guidance of Sally Feeney, our Consultant Podiatry Surgeon, we’re here to help you understand and manage this condition better as we stride into winter.

What is Big Toe Arthritis?

Big Toe Arthritis, known in the medical community as Hallux Limitus / Rigidus, is a form of degenerative arthritis that specifically targets the main joint where the big toe attaches to the foot. This condition is more than a mere inconvenience; it’s a progressive ailment that, over time, can significantly impair mobility and diminish the quality of life. The journey from the first twinge of pain to severe discomfort can be a slow yet relentless progression, making every step a painful endeavour.
The anatomy of our feet is both intricate and robust, bearing the brunt of our daily activities. The big toe, being a crucial part of this system, plays a vital role in maintaining balance, enabling a normal gait, and bearing weight especially during walking or running. When arthritis settles in, the smooth cartilage that cushions the joint wears away, leading to a painful bone-on-bone contact. This can cause significant discomfort, stiffness, and sometimes an overgrowth of bone (exostosis / bone spurs) which further exacerbates the problem.
The etiology of Hallux Rigidus is varied, encompassing a range of factors from genetic predispositions, previous injuries, to abnormalities in foot anatomy. Some individuals may have a family history of arthritis or possess a foot structure that’s more susceptible to wear and tear. Previous injuries like fractures or severe sprains can also precipitate the onset of Big Toe Arthritis.
The saga of discomfort often escalates during the colder months. This could be attributed to a multitude of factors. One plausible explanation is the switch to tighter, less forgiving footwear which may exert more pressure on the toe joint. Furthermore, subjectively it is thought that colder temperatures can cause joint stiffness and potentially exacerbate the symptoms of arthritis.

Spotting the Symptoms Early

The symptoms of Big Toe Arthritis can range from a mild discomfort to a sharp pain, especially when you walk or move the toe. Catching these signs early can make a big difference. Simple actions like choosing comfortable footwear with enough room for your toes, avoiding activities that make the pain worse, and doing gentle stretches can help ease the discomfort. Over-the-counter painkillers like paracetamol or ibuprofen may provide relief, but it’s wise to consult with a healthcare professional before taking any medication
At Thames Foot Clinic, we pride ourselves on providing a holistic and patient-centric approach towards alleviating Big Toe Arthritis. Our goal is to ensure an enhanced quality of life, minimising discomfort, and promoting optimum foot health. The treatment spectrum is broad and appropriate treatment is determined based on the severity and progression of the arthritis:

Advanced Non-Surgical Treatments:

Steroid injections into the joint are a good way of providing pain relief for a period of time.

Conservative Treatments:

Our primary objective is to manage and mitigate the symptoms of Big Toe Arthritis sans surgical intervention. Our conservative treatment regimen encompasses:


• Exercises: Prescribed exercises aimed at maintaining joint flexibility and promoting mobility, thereby reducing stiffness and discomfort.
• Custom-Made Insoles: Bespoke insoles are crafted to provide adequate support to your foot, alleviate pressure on the affected joint, and promote an anatomically correct foot posture.
• Footwear Advice: Guidance on selecting footwear that provides proper support, accommodates the insoles, and doesn’t exacerbate the condition.
• Medication Management: Based on individual tolerance and the extent of pain, medications may be advised to control discomfort and inflammation.

Surgical Interventions:

In instances where the arthritis has advanced to the moderated / severe stage or when prior treatments have not yielded the desired relief, surgical intervention might be contemplated. The surgical treatment spectrum includes:

• Joint Debridement: Procedures to meticulously clean out the joint, removing debris and any bone spurs that might be causing discomfort.
• Bone Realignment / shortening:  When appropriate, surgical realignment or shortening of the 1st metatarsal can help decompress the joint and reduce pain in most cases. This can help promote a more natural joint function.
• Joint fusion or joint replacement: In cases of severe pain the arthritic joint can be removed and the bones fused together to eliminate the pain. Alternatively, in some cases, the joint can be replaced which also alleviates pain and maintains some movement.

Finding Support

Living with Big Toe Arthritis can be tough, but you don’t have to face it alone. There are many support groups and organisations in the UK dedicated to helping people with arthritis. They offer information, advice, and support to help you manage your condition

Your comfort and mobility are our priority at Thames Foot Clinic. We offer a range of treatments for Big Toe Arthritis, from conservative management to surgical interventions. Our goal is to help you understand your condition, explore your treatment options, and find a solution that suits you. So, don’t let Big Toe Arthritis keep you on the back foot this winter. Reach out to us, and let’s take the next step towards comfort and mobility together.
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