Patients present all the time to Podiatrists to help them with pain in their big toe joints. This pain can be traumatic (like sesamoid fractures), or arthritis (some version of hallux rigidus), or due to the simple malposition of the joint. I believe you should try various treatments first before leaping into a surgical fix. I do see surgeries occasionally fail since the wrong surgery was done. You can look at a foot and see a bunion deformity, as in the photo above. You can assume normally correctly that fixing the bunion will eliminate the painful process. But, not always is this the case. Typically, do 5 common treatments for the painful foot before you have the surgery. This can take you 3-4 months. If all your pain is gone by these treatments, I find patients can make a better informed consent on still having that surgery in the future.
So, to the title of this blog post I go. What do I mean? In general, we want the big toe to keep moving. Most sports medicine podiatrists agree with this concept. But, during painful episodes, you need to stop the painful motion for awhile. That is paramount to understand. You are only stopping the painful motion, even in the face of arthritis, for awhile and not permanently. Many of my patients therefore need two sets of orthotic devices: one that stops motion, and one that allows motion. Do not stop motion forever if it can be avoided.
Key Words:
Big Toe Pain
Bunions
Hallux Rigidus
This is astonishing. I've always struggled between choosing to limit vs allow motion and when not provide the patient with both options for when each is most appropriate. Thanks!
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