Arthritis in big toe also known as hallux rigidus is a common condition causing pain and reduced movement. Cortisone injection for big toe joint is helpful if other treatments for arthritis fail. When should you consider a cortisone shot for the big toe?

Symptoms of arthritis in big toe

When the big toe doesn’t bend as much, the joint jams causing pain and swelling. We often call this condition hallux rigidus. Sharp pain is felt at the top of the joint as the joint jams together and causes bony spurs. Over time, arthritis can move to the bottom of the joint causing a deep ache at the end of the day.

Generally, the big toe joint is stiff to move and tender to touch.

Imaging in the form of an X-ray or ultrasound can show the arthritis changes such as narrowed joint space, bony spurs, and inflammation.

Why do some people develop arthritis in big toe? 

We see big toe arthritis in people with abnormal mechanics of the foot. In particular, a long or elevated big toe can lead to abnormal forces on the joint and early arthritis. Other factors leading to arthritis include a past break or injury, wearing poorly-fitting shoes, or arthritis disorders such as gout.

What treatments are available for big toe arthritis? 

Generally, simple treatments for big toe arthritis are effective at reducing pain.

Firstly, changing footwear to a stiff or rocker-soled shoe can help. Silicon gel pads can cushion pressure on shoes.  Orthotics can improve the mechanics of the foot. Secondly, anti-inflammatory treatment such as ice and topical Voltarol gel reduces swelling. Sometimes, anti-inflammatory tablets such as ibuprofen are also needed. Finally, calf stretching and strengthening exercises can help with reducing the abnormal forces on the joint.

In cases that fail simple treatment, a cortisone injection in big toe joint may help.

Cortisone injection in big toe joint: Is it useful? 

big toe injection under ultrasound

Cortisone injections are a strong way of reducing inflammation and pain in the joint. Generally, we do injections with ultrasound to make them more accurate. It is important for people to understand that a cortisone injection in big toe only lasts for a few months. However, in some cases, the pain-relieving effect can last for much longer. Also, we should limit the number of cortisone injections into a joint.

This blog on cortisone injection discusses pros and cons of a cortisone injection for joints in the body.

Are there other injection options apart from cortisone injection in big toe joint? 

Platelet-rich plasma injections

Yes. We sometimes use hyaluronic acid or platelet-rich plasma in degenerative joints when cortisone has been used or is not indicated. You should speak to your doctor about these other options.

Generally, we suggest. hyaluronic acid injection as these injections are less expensive and only require one injection.

Surgery should be reserved for cases that fail other treatments.

Final word from Sportdoctorlondon about a cortisone injection in big toe

Big toe arthritis is common as we get older. Generally, we suggest trying simple treatments first including seeing a podiatrist. In difficult cases, we try an ultrasound-guided cortisone injection in big toe followed by hyaluronic acid or PRP.

Other foot and ankle conditions:

Dr. Masci is a specialist sport doctor in London. 

He specialises in muscle, tendon and joint injuries.

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