Treatment of bunions and big toe pain

    Auteur: Podiatre Montreal

    If you have pain in the big toe joint, you probably have one of three related conditions:

    1. Hallux limitus (pain in the big toe joint caused by excessive pressure)
    2. Hallux rigidus (arthritis in the big toe joint)
    3. The bunions (hallux valgus) (enlargement of the big toe joint)

    On this page you will learn about onions. You can use the links to learn more about hallux limitus and hallux rigidus. All of these problems can usually be treated without surgery, but if left untreated, they will get worse over time. If you are experiencing pain in your big toe joint or if you are seeing changes in that joint, you should call us today to book an appointment at Montreal’s Podiatric Clinic.

    The cause of big toe pain and bunions

    As humans walk, near the end of each step, just before the foot touches the ground, the big toe joint should bend to about 75 degrees. If this natural movement is restricted, pain and deformity may develop.

    Some people have a foot that rolls too much inward (i.e. overpronation) while walking. When the foot is overpronated, the big toe joint is pushed into the ground. This prevents the big toe joint from bending naturally while walking.

    Treatment Objectives: Relieve pain and further joint damage

    If you experience bunions or joint pain in your big toe, you should make an appointment and come see us as soon as possible. Without treatment, these problems only get worse; the bunions get bigger or arthritis develops in the joint. But we can usually eliminate your pain and protect your joint without surgery. Treatment for bunions and hallux limitus varies depending on your foot type, the severity of the deformity, your activity level and your symptoms. At the first sign of a bunion, you should see a doctor as soon as possible to avoid severe deformity or arthritis.

    Early treatment helps prevent future problems.

    The main goal of early treatment is to relieve pressure in the big toe joint and to reverse the progression of joint damage. The main conservative treatments include:

    • Custom-made foot orthotics for bunions and big toe joint pain are prescribed and molded by your doctor and designed to relieve tension in the joint
    • Shoe modifications; including purchasing and fitting footwear appropriate for your foot type (and activity level)
    • The padding / cushions

    Custom-made orthotics can help relieve big toe conditions.

    Custom functional orthotics are useful to control abnormal foot mechanics and prevent surgery.

    Orthotics for big toe joint conditions are prescribed to help relax the big toe joint and help it function in a way that reduces the risk of joint damage. To ensure the best results, we first perform a thorough examination, video motion analysis of how you walk and how the big toe joint behaves. A mold of your foot is then prepared in a very precise position and orthotics are prescribed to ensure optimal joint protection.

    In order to improve the function of the big toe joint, research has shown that orthotics must be made from casts without loading. To do this, the foot must be held in the position that gives the best possible function to the big toe joint.

    In addition, studies have indicated that a very specific type of foot orthosis is the most effective in making the big toe work the way it should. This type of orthosis is called a “strong adherence orthosis” and, as the name suggests, it adheres strongly to the arch of the foot.

    Hallux limitus and bunions are progressive conditions and will worsen over time if not treated properly. The right type of brace can help reduce pain and possibly prevent the progression of your condition.

    What causes pain in the big toe joint?

    When the big toe cannot bend upward, excessive force builds up inside the joint every time you take a step. Blocking” this joint can cause pain in the joint and over time lead to joint damage such as arthritis. This type of pain and damage is called hallux limitus.

    People with hallux limitus will experience pain in the joint when they walk and sometimes after the activity. This condition may be more painful in some shoes than others. There may (or may not) be visible signs of changes to the joint and a bunion may (or may not) develop.

    Pain in the big toe joint, even if there are no visible signs of change, is an indication that the joint may be damaged. This warning sign should not be ignored. Hallux limitus is a progressive deformity and early treatment can help prevent problems.

    What is a bunion?

    In some patients with hallux limitus, the first toe begins to move towards the second toe as a means of relieving excessive force inside the joint. This causes the toe to deviate towards the metatarsal and causes a bump to appear on the big toe joint. This combination of a deviation of the toe and a bump on the outside of the joint is what is commonly known as a “bunion”. This deformity is also known as “hallux valgus”.

    The onion is not hereditary. However, the type of foot is. Shoes generally do not cause bunions, while bad shoes can make them more painful.

    Hallux valgus is a progressive deformity. In many cases, treatment can slow (or even stop) the progression and help prevent joint damage or surgery.

    When does surgery become necessary?

    When you begin to have joint pain or bunions that limit your activities and all conservative treatment options have failed, surgery may be necessary. Joint pain may indicate degeneration of joint cartilage. One of the goals of surgery is to realign the joint in order to prevent the loss of articular cartilage.

    Pain and deformity are significantly reduced in the vast majority of patients who undergo bunion removal. Bunion surgery allows for the realignment of the joint. After surgery, the foot will be able to support the weight of the body in a more normal way and adapted footwear should no longer be necessary. Postoperative orthotics may be recommended to improve foot function and limit the forces on the big toe joint.

    Don’t let your big toe pain get worse. Early treatment can prevent problems in the future. Call today to schedule an appointment at our Montreal clinic.

    Don’t let your big toe pain get worse. Early treatment can prevent problems in the future. Call today to book an appointment at our Montreal clinic.

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      Podiatre Montréal
      1826 Sherbrooke O,
      Montreal, QC H3H 1E4