Do I Need Surgery for Arthritis in my Big Toe Joint?

Today I had a question from an active 28 year-old named Jennifer. She has a very active 3 year old son she chases about, but she gets pain and stiffness in the big toe joint. She says its worse when she crawls around on the floor kneeling, squatting, and playing with her little boy. She says he's into everything, but she loves watching him learn.

She thought she had a bunion and went to see a foot doctor who told her it was arthritis. And she needed foot surgery right away. Although this assessment was close, it was wrong.

She came in to see me for a second opinion.

Now, I will admit that she does have a little arthritis in the big toe joints. I will admit that one is worse than the other. I will even admit that I (or any foot surgeon) could make it look different on xrays. Maybe even look better on xray. But no guarantee it would feel better. At least not by New Years.

Jennifer has a condition called hallux limitus or hallux rigidus. This happens when there is restricted motion and the big toe doesn't bend up as far as it should. Because of this, the joint starts jamming and develops arthritis. Eventually, bone spurs start to develop on top of the joint. With time it will get worse. The cartilage can even get worn away over time.

Someone recommended that she have joint replacement surgery to put an implant in to replace the worn joint. Good idea, but not when she is committed to taking care of a 3 year old. I recommended she get some super-stiff Dansko Clogs from ZUMFOOT. With these she can walk without pain because the big toe won't be forced to bend and thus it won't jam anymore.

For her this was a good solution. She can can now walk without pain and wait until the timing is better. It won't get worse fast, and she can wait until the little one starts school.

Eventually she will have surgery. But I truly believe that unless the condition is going to get significantly worse, you should have foot surgery when it fits your lifestyle best.

Foot surgery can help many conditions, but the amount of disruption to your daily routine is elective...just like the surgery.


Dr. Christopher Segler is an award winning foot and ankle surgeon with a podiatry practice in Chattanooga. He is the inventor of a patented surgical instrument designed to simplify bunion surgery and flatfoot surgery. He publishes articles teaching other surgeons about his techniques and how to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.anklecenter.com.