THE big toe (hallux) takes on considerable load throughout our daily lives, bearing all of our weight when running, walking and standing.

For this reason it is the most common site for arthritis in the foot due to wear and tear.

The joint at the base of the big toe — the metatarsophalangeal joint — is the most affected area, and the medical term for this condition is Hallux rigidus (HR). The condition can also occur as a result of an injury, such as stubbing a toe or other types of inflammatory disease like rheumatoid arthritis and gout.

HR results in stiffness, pain and bony prominences or spurs which may rub in shoes. Often the toe will become deformed with a lip of bone overlying the surface and callus on the skin underneath the foot. This occurs due to poor function.

Treatment

Pain relievers and anti-inflammatory medication such as ibuprofen may help to reduce the swelling.

Natural anti-inflammatories like turmeric tea can work very well with this condition. If the condition is acute, ice packs can be applied to the area four times daily for 10 minutes.

It is important to wear a shoe with a large toe box that has good support at the ankle. The sole needs to be stiff to reduce the amount of flexibility and bend in the big toe.

In cases where palliative care is not effective, surgical intervention may be indicated. Depending on the severity of the HR and the age of the patient, the orthopaedic surgeons usually carry out one of three procedures:

1. Arthroplasty, which is a joint replacement.

2. Arthrodesis, which is the fusion of the joint.

3. Cheilectomy, which is the removal of the spurs and other parts of the bone to allow greater movement.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.