Sometimes when you walk, run, or ascend stairs do you experience a sharp, stabbing pain in the ball of your great toe. Does it ache and/or burn at the end of a long day? This could signal early degeneration of the joint. The ball of the great toe is quite complex, involving motion of the great toe over the round head of the 1st metatarsal, and two bones (sesamoids) on the bottom of the joint that move in unison with the great toe.

In some people, genetics, prior injury, or poor mechanics of the foot can lead to degeneration of this joint.  In some cases the great toe can jam into the top of the joint, resulting in progressive loss of cartilage within the joint, bone spur formation, and inflammation.

The severity of pain can vary, and is not always related to the severity of arthritis.  Moreover, x-rays do not always correlate with the severity of arthritis.  The complex series of events that lead to the arthritis are treatable, with conservative options including anti-inflammatory medications, custom orthotics to improve the mechanics of the joint, periodic steroid injection, possible use of topical anti-inflammatory medications, use of stiff soled shoes, and finally surgery.

When conservative options fail to reduce the pain, surgery is sometimes required.  One simple fact that should be known is that the arthritic changes that take place in the joint will not reduce with time.  Unless something is done to reduce the pressures within the joint, the arthritic damage will progress over time.  That leaves the patient with a choice.  Do I pursue surgery now in effort to preserve the joint, or leave the joint as is, knowing the arthritis will get worse with time?   If you choose to wait, the joint surfaces will have to be removed in order to remove the pain.  When the arthritis is more advanced, surgical options include fusing the joint together, where the two bones grow together and no longer move, or replacing the joint with an artificial implant.  Both options bear advantages and disadvantages, but possess good success rates in alleviating the pain of the arthritis.

If you experience pain in the ball of your great toe, or any other foot pain, we are the experts you need.  In the Owensboro, Western Kentucky, or TriState area, Dr. Block and staff at the Bluegrass Foot Center-your source for all your foot and ankle problems!


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