Arthritis toe pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Many forms of arthritis can affect the toe(s).

The most common type is called osteoarthritis. Osteoarthritis causes wearing away of cartilage in the joints. The pain and swelling worsens while standing or walking, and stiffness usually occurs after periods of rest. The great toe may be affected. When osteoarthritis affects the toe and is accompanied by bursitis, the condition is referred to as a bunion. If the same condition occurs on the fifth toe side, it is called a "bunionette."

Gout is another form of arthritis that also leads to toe involvement. Excess uric acid crystals collect in and around the joint of the big toe. The big toe joint is commonly the focal point due to the presence of concomitant osteoarthritis. This often leads to severe pain in the big toe. Men are more likely to develop gouty arthritis than women. Pseudogout, a cousin to gout, may also affect the toes.

Another type of arthritis that affects the foot and toes is rheumatoid arthritis. People who suffer from rheumatoid arthritis often develop severe forefoot problems such as bunions, hammer toes, claw toes, and others.

The various spondyloarthropathies such as psoriatic arthritis, the arthritis of inflammatory bowel disease, and Reiter’s disease are other forms of inflammatory arthritis that affect the toes. When the toes become inflamed they swell up and look like little sausages. This is called “dactylitis.”

Pain between the toes can be due to either bursitis or benign nerve tumors called Morton's neuromas.

Conservative treatment of the arthritic foot includes proper footwear and orthotics. Arthritis footwear should provide the following benefits:

• High, wide toe box (high and wide space in the toe area)
• Removable insoles for fitting flexibility and the option to insert orthotics if necessary.
• Rocker Soles designed to aid with walking and to reduce stress and pain at the ball-of-the-foot.

Arthritic footwear should also accommodate swelling of the foot. Orthotics designed to provide comfort, support and extra cushioning are also recommended. Orthotics made with a material called Plastazote are often recommended because they mold to the feet to provide customized comfort. The proper footwear and orthotics will reduce foot stress to provide a comfortable and healthy environment for the foot.

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