Arthritis in big toe, also known as hallux rigidus, is a common condition causing pain and reduced movement. Cortisone shot in big toe joint is helpful if other treatments for arthritis fail. So, when should you consider a steroid injection in big toe joint?
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 with 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 significant toe arthritis in people with abnormal mechanics of the foot. In particular, a long or elevated big toe can lead to irregular forces on the joint and early arthritis. Other factors leading to arthritis include a past break or injury, wearing poorly-fitting shoes, or other 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. Also, 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. Thirdly, calf stretching and strengthening exercises can help lower the joint’s abnormal forces. Finally, a steroid injection in big toe joint may help in cases that fail simple treatment.
Cortisone shot in big toe joint: Is it helpful?
Steroid injection in big toe joint is a powerful way of reducing inflammation and pain in the joint.
Generally, we do injections with ultrasound to make them more accurate. People must understand that a cortisone shot in the big toe joint only lasts a few months. However, in some cases, the pain-relieving effect can stay for much longer. Also, we should limit the number of cortisone injections into one joint.
This blog on cortisone injection discusses the pros and cons of a cortisone injections for joints in the body.
Are there other injection options besides a cortisone shot in the big toe joint?
Yes. We sometimes use hyaluronic acid or platelet-rich plasma in degenerative joints when cortisone has been used or is not indicated. It would be best to speak to your doctor about these other options.
Generally, for big toe arthritis, we suggest hyaluronic acid as these injections are less expensive and only require one shot. PRP injections usually require 2-3 injections over a few months.
Surgery should be reserved for cases that fail other treatments.
Final word from Sportdoctorlondon about a cortisone shot in big toe
Big toe arthritis is common as we get older. Generally, we suggest trying simple treatments first, including seeing a podiatrist. In complex cases, we try an ultrasound-guided cortisone injection in big toe, followed by hyaluronic acid or PRP.
My osteoarthritis ln my big toe joint
is becoming unbearable an been waiting for NHS since July last year. I need price for private injection please.
Hi Julie,
Many thanks for your email.
Please contact my admin staff on admin@sportdoctorlondon.com for costs and options for an ultrasound-guided injection. Lorenzo
I can’t have cortisone injections because my body stopped producing its own cortisol after too many injections so my doctor sent me for guided ketorolac injections in my big toe joints on both feet. I have arthritis and huge bunions. I was also injected with ketorolac in both feet in a joint at the top of feet. This is the 5th day and I don’t have any relief. I actually have more pain. On the left foot I am very sore on my big toe and the bone that runs from the toe up through the foot. There is mild swelling but no redness and no fever. It is so painful I’m wondering if it could be infected. It’s very painful to walk. Is this something that’s usual after this type of injection or should I be concerned. It’s gotten more painful since yesterday. Ice packs don’t work and pain clean 10% diclofenac and 10% gabapentin in a base doesn’t help at all. I would appreciate any advice you can give.
I don’t have any experience with ketorolac injections. And I don’t use them for joint arthritis. One option is hyaluronic acid but these injections should only be done under ultrasound guidance.
https://sportdoctorlondon.com/hyaluronic-acid-injection/
Me too I thought it was a bunion my dad doctor said wear and taurine. I had it for a while it used to get sore when I ran or was in my feet all day. 3 weeks ago it got more sire than it ever did before so I went back to my foot doctor after a few days ot still hurt he game me cortisone it seems to get better than the next week it started hurting again off and on some days worse but a week later it still hurts again not always bad pain but the sorness never went totally away this sucks.