Hallux rigidus, or arthritis, of the great toe is often mistaken as bunion pain. Classical bunions consist of the great toe bent in relation to the foot. Arthritis of the great toe is more painful and the toe is straight. There can be a combination of the 2, but for this discussion the great toe is straight.
There are many reasons for this painful deformity. I am a believer that most of our physical problems are a result of genetics. If your ancestors had this problem then you may also get the same problem. It can begin at any age but usually starts later in life. If there is no history of injury, then there is a continued stress to the joint from abnormal position of the 2 bones that make up this joint. The joint is made up from the 1st metatarsal and the 1st proximal phalanx. The usual cause of the problem is while walking the metatarsal bone is higher than the toe, and when we push off, the great toe jams into the metatarsal. Over time arthritis can form in the joint. It may start as a bone spur or thinning of the cartilage. This will be painful especially when the bone rubs on the shoe.
We begin treatment of bunion arthritis by changing the way you walk by using an orthotic to raise the toe and shoe recommendations. At times we may use cortisone injections to reduce inflammation. Surgical intervention begins when it becomes too painful to walk.
