ARTHRITIS OF THE BIG TOE
(Hallux Limitus/Rigidus)

What is Arthritis?

Arthritis is inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. Arthritis has multiple causes; just as a sore throat may have its origin in a variety of diseases, so joint inflammation and arthritis are associated with many different illnesses.

Arthritis is a disabling and occasionally crippling disease. It afflicts almost 40 million Americans. In some forms, it appears to have hereditary tendencies. While the prevalence of arthritis increases with age, all people from infancy to middle age are potential victims. People over 50 are most prone to arthritis. Arthritic feet can result in loss of mobility and independence, but early diagnosis and proper medical care can help significantly.

Causes

Besides heredity, arthritic symptoms may arise in a number of ways:

  • Through injuries (particularly in athletes and industrial workers), especially if the injuries have been ignored, which injuries of the feet tend to be.
  • Through bacterial and viral infections that strike the joints. The same organisms that are present in pneumonia, gonorrhea, staph infections, and Lyme disease can cause inflammation.
  • In conjunction with bowel disorders such as colitis and ileitis, frequently resulting in arthritic conditions in the joints of the ankles and toes. Such inflammatory bowel diseases seem distant from arthritis, but treating them can relieve arthritic pain.
  • Using drugs. Both prescription drugs and illegal street drugs can induce arthritis.
  • As part of a congenital autoimmune disease syndrome of undetermined origin. For instance, recent research has suggested that a defective gene may play a role in osteoarthritis.
Hallux Limitus & Rigidus – Arthritis of the Big Toe

Hallux Rigidus and Hallux Limitus are terms that refer to different stages of the same foot problem. Hallux refers to the big toe. Limitus refers to decreased motion of the joint. There is less than normal motion available. This is the early stage. Rigidus denotes a joint that is rigid. Very little, if any, motion is available. This is the later stage.

Hallux Rigidus/Limitus involves the 1st metatarso-phalangeal joint. This joint is located at the base of the big toe. Hallux Rigidus/Limitus causes pain and stiffness in the big toe, and with time it becomes increasingly harder to bend the toe. This is a progressive condition during which the toe’s motion decreases as time goes on. In the early stages motion of the big toe is only limited. At this point the disorder is called Hallux Limitus. As the problem advances, the big toe’s motion gradually decreases until it becomes rigid or frozen. At this point the disorder is referred to as Hallux Rigidus. As motion becomes progressively limited the pain increases, especially when the big toe is extended or pushed up. This condition is frequently seen in younger adults and can occur secondary to athletic sports or injury. Often times a relatively minor injury to the area in high school can precipitate an early painful and limited joint. Essentially this condition is a type of osteoarthritis, which may be post-traumatic arthritis to this specific joint. There is an early type of Hallux Limitus which does not show any x-ray signs, but there is limitation of motion dorsally, especially when the foot is weight bearing. This is referred to as Functional Hallux Limitus.

When to See Your Podiatrist

Because arthritis can affect the structure and function of your feet, it is important to see a doctor of podiatric medicine if any of the following symptoms occur in the feet:

  • Swelling in one or more joints
  • Recurring pain or tenderness in any joint
  • Redness or heat in a joint
  • Limitation in motion of joint
  • Early morning stiffness
  • Skin changes, including rashes and growths

Information courtesy of the American Podiatric Medical Association (www.apma.org) and Our Health Network (ourhealthnetwork.com)

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