|
Hallux Limitus
Stiffness of the big toe joint is termed Hallux Limitus. Hallux is the medical term for the big toe. When the big toe possesses no motion, it is termed Hallux Rigidus.
To confuse the topic, the big toe joint may appear to have normal
motion, but this motion can be limited when weight is on the foot and
during the normal standing and walking. This is termed functional
Hallux limitus, because it occurs during the normal functioning of the
foot while walking. As with many conditions that affect the foot,
functional conditions progress to structural deformities. As the
condition progresses, a degenerative type of arthritis develops in the
big toe joint. Diagnosis The
most common cause of Hallux limitus is an abnormal alignment of the
long bone behind the big toe joint called the first metatarsal bone. In
this condition, the first metatarsal bone is elevated relative to the
other metatarsal bones that lie behind the other toes. When this is the
case, the big toe joint cannot move smoothly and jamming occurs at the
joint. A variety of symptoms can begin to occur. One common problem
that occurs is pain in the bottom of the big toe where a central callus
can develop. The pain and callus develop because the big toe does not
bend upward enough as the bottom of the toe is jammed into the ground.
People who have diabetes must watch this area carefully because the
pressure can cause the development of an ulceration that can become infected. Another
consequence of the jamming of the big toe joint is the development of
bone spurs on the top of the joint. This bump on the top of the big toe
joint can become painful as a result of shoe pressure. Pain within the
joint is a common result of the limitation of movement of the big toe
joint. With time, the big toe joint becomes stiff and painful to move.
As the joint continues to degenerate more bone spurring occurs. If the
condition is left untreated complete destruction of the joint can
occur. Diagnosis is made by performing a
physical exam of the foot and the use of x-rays. In early stages of the
condition x-rays may be normal. In later stages of the condition,
narrowing of the joint and/or bone spurs may be evident. Treatment Initial treatment consists of using oral anti-inflammatory medications, cortisone injections and/or functional orthotics.
Oral medications and cortisone injections are useful in treating the
pain associated with the condition, but will not stop the process
because they do not address the underlying cause of the condition.
Functional orthotics, however, are designed to treat the cause of the
condition. These devices will generally fit into normal shoes and
correct the underlying functional problem with the joint. Orthotics
will not reverse what damage may have occurred, but can slow or halt
the on-going damage to the joint.If the
condition progresses to the point of spurring around the joint, surgery
may be indicated. Depending upon the degree of degeneration of the
joint, surgery may consist of simply removing the bone spurs around the
joint or may require a total joint replacement (See surgery of Hallux limitus). Following surgery, the use of a functional orthotic is useful to improve the joint function. If
a painful callous exits on the bottom of the big toe it will frequently
resolve and the pain subside with the use of functional orthotics
and/or surgery to improve the motion of the joint.
Back to Top
|
