Symptoms arthritis in toe
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.
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The primary symptom of toe arthritis is pain. The pain may be accompanied by swelling, redness, heart, and deformity.
Examples of arthritis conditions that cause toe problems are:
Bunions. A bunion is a deformity that usually occurs at the head of the big toe. Most often it occurs due to osteoarthritis affecting the first metatarsal phalangeal joint, accompanied by adjacent bursitis. A bunion may also develop in the bone that joins the little toe to the foot (the fifth metatarsal bone), in which case it is known as a bunionette.
A bunion typically develops in this fashion:
A bunion begins to form when the big or little toe is forced in toward the rest of the toes, causing the head of the metatarsal bone to stick out and rub against the side of the shoe. Bursitis develops. The underlying tissue becomes inflamed, and a painful bump forms.
As this bony growth develops, the bunion is formed as the big toe is forced to grow at an increased angle towards the rest of the toes. This leads to a condition called hallux valgus, where the bone and joint of the big toe shift and grow inward.
Bunions can be caused by a number of conditions:
• Narrow high-heeled shoes with pointed toes
• Injury to the joint
• Genetics (10% to 15% of the time)
Pressure and pain from bunions can be relieved by wearing appropriate shoes, such as the following:
• Soft, wide, low-heeled lace-up leather shoes.
• Athletic shoes with soft toe boxes.
• Open shoes or sandals with straps that dont touch the irritated area.
A moleskin pad can protect the protrusion. In some cases, an orthotic can help redistribute weight and take pressure off the bunion. Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may offer some pain relief.
If discomfort persists, surgery may be necessary.
A hammertoe is a deformity of the toe joint in which the toe bends up slightly and then curls downward, resting on its tip. When forced into this position long enough, the tendons of the toe contract and it stiffens into a hammer- or claw-like shape.
Hammertoe is most common in the second toe but may develop in any or all of the three middle toes if they are pushed forward and do not have enough room to lie flat in the shoe. The risk is increased when the toes are already crowded by the pressure of a cxoncomitant bunion. Prolonged bedrest, diabetes, and various diseases that affect the nerves and muscles put people at risk.
At first, pain with a hammertoe can be relieved by putting a toe pad, which are sold in drug stores, into the shoe. To help prevent and ease existing discomfort from hammertoes, shoes should have a deep, wide toe area. As the tendon becomes tighter and the toe stiffens, other treatments, including exercises, splints, and custom-made shoe inserts may help redistribute weight and ease the position of the toe.
Surgery may be needed in some severe cases.
Podagra is a condition where the first metatarsal phalangeal joint (MTP) becomes inflamed. This condition may be seen in gout and pseudogout. Characteristically, the pain, swelling, and redness are extreme and the patient cannot bear weight on the foot. The treatment will involve anti-inflammatory drugs and steroid injections.
Dactylitis or sausage toe is another form of toe arthritis seen in condition such as psoriatic arthritis and Reiter’s disease. The toe becomes swollen and painful due to a combination of inflammation of the joint as well as the tendon.
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