Arthritis in the feet and big toe: what helps
Foot arthritis gets far less attention than knee or hip arthritis, yet it's common. A stiff, painful big toe or an aching, bony midfoot can make walking, running and even choosing shoes a daily problem. There's a fair amount that can help.
How common is foot arthritis?
A review of foot osteoarthritis reported that symptomatic foot arthritis seen on X-ray affects about 17% of adults aged 50 and over. The big toe joint is the most commonly affected, followed by joints in the midfoot (Roddy and Menz, Therapeutic Advances in Musculoskeletal Disease, 2018).
What is big toe arthritis?
Arthritis of the joint at the base of the big toe causes pain and stiffness there, particularly when the toe bends upwards as you push off in walking, climbing stairs or squatting. A bony bump can develop on top of the joint and rub on shoes. When the joint becomes very stiff, it's called hallux rigidus.
What is midfoot arthritis?
Arthritis in the joints across the middle of the foot causes aching on top of the foot, worse with standing and walking, and often a bony prominence on top of the foot that's sensitive to tight shoes or laces.
See our post on pain on top of the foot.
What causes foot arthritis?
Age-related joint changes, previous injuries such as fractures or sprains, foot shape, and in some cases inflammatory arthritis or gout. Tight or narrow footwear doesn't cause arthritis but can make symptoms worse.
What helps big toe arthritis?
The review notes some evidence for physical therapy, rocker-sole shoes and foot orthoses for pain relief in big toe arthritis. In practice: choose shoes with a stiff sole and a slight rocker, which reduce how much the toe has to bend; avoid high heels and flexible, thin-soled shoes; and consider a stiff insert or orthosis. A podiatrist can help with footwear and orthoses.
What helps midfoot arthritis?
The review found some evidence for prefabricated foot orthoses in midfoot arthritis. Supportive, cushioned shoes with adjustable fastening, lacing that avoids pressure over the bony area, and pacing standing time all help.
Do exercises help foot arthritis?
Yes, as part of a plan. Gentle big toe mobility, calf stretching and strengthening, strengthening the small muscles of the foot (towel scrunches, toe spreading, short foot exercises), and general lower limb strength help you walk more comfortably.
Can I keep running or walking?
Usually, with adjustments. Stiffer, more cushioned or rocker-soled shoes can make running more comfortable for big toe arthritis. Walking is encouraged. Cycling and swimming are alternatives on bad days.
Do injections or surgery help?
A corticosteroid injection can relieve a flare. When conservative measures fail, surgical options for big toe arthritis range from removing bone spurs to fusing the joint. These are discussed with a foot and ankle surgeon.
Is it arthritis or gout?
Gout typically causes sudden, severe pain with redness, heat and swelling, often in the big toe joint, coming on over hours, often overnight. It needs a GP for diagnosis and treatment. Osteoarthritis pain comes on gradually and fluctuates with activity.
What about arthritis in the ankle?
Ankle arthritis is less common and usually follows a previous injury, such as a fracture or repeated sprains. It causes deep ankle pain and stiffness and is managed with similar principles: supportive footwear, bracing, strengthening and activity changes.
Does weight matter?
Extra body weight increases the load through the feet with every step. Weight loss, where relevant, can reduce foot pain.
What shoes are best for foot arthritis?
Look for a firm, cushioned sole, a slight rocker at the front, a roomy toe box, and laces or straps that let you adjust the fit around a bony midfoot. Avoid thin, very flexible soles and high heels. Try shoes on later in the day when feet are slightly larger.
Can I still go barefoot?
Short periods on soft surfaces are usually fine. On hard floors, supportive house shoes or slippers with a firm sole are often more comfortable while symptoms are active.
How can an osteopath help?
We assess the foot, ankle, knee and hip, as problems higher up can affect how you load your feet. We provide hands-on treatment for stiffness and an exercise plan, and refer you to a podiatrist for footwear and orthoses, or to your GP if gout or inflammatory arthritis is suspected.
When should foot pain be checked?
See a doctor promptly for a hot, red, very painful joint, fever, a foot wound if you have diabetes, or sudden swelling after an injury. Book in for foot pain that's limiting walking or not improving with footwear changes.
See our posts on arthritis in the hands and joint supplements, or our foot pain guide. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
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Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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