Swollen, painful big toe joints

mally

Hi, I have oa in my big toes and hands. My toes have been bad for about 10 years now. They are now virtually rigid.........I forget the term used. At the minute they are very swollen, red and painful to the extent that I am considering working part time instead of full. I haven't changed any of my shoes and I have a severe allergy to anti inflammatories.

Is this swelling a sign that the arthritis is progressing even further? My GP has given me strong painkillers but they make me even tireder than the psin from the arthritis does. Every step is agony at the minute.

What I would like to know is what causes my joints to swell up like this. The swelling has been getting worse for a month or so.

stickywicket

Mally, I saw your post last night but just didn't know how to answer it. The simple, brutal answer to 'what causes my joints to swell?' is arthritis. It's what it does. Is it progressing? I don't know. It might be because it can do that too. It's certainly having a bite at you right now. That might or might not ease off. Who knows?

You say you are allergic to anti-inflamms. Does that include the ointments? If not one might help but do check first with your GP or pharmacist.

dreamdaisy

This sounds very much to me as though your OA is having a bite at you - it tends to dislike cold weather and reacts by playing up. It's not fun, is it? DD

Chris01

I have no idea why it is causing swelling, but I can understand difficulty it must be causing for you for walking. The current treatment for severe osteoarthritis of the big toe is arthrodesis, or fusion, in which a metal strip is inserted into the joint between the two bones and fuses the bones together with screws so that they no longer rub against each other. This is usually ­performed on younger people.
Sorry can’t help you at the moment, but in future could you consider orthotics, if you’ve not already. Shoe orthotics may help correct abnormalities of the foot or problems with the way you walk that could be contributing to the problem. Consider thick-soled shoe or one with a rocker bottom (like an orthopedic clog), which allows the foot to roll forward as you walk, so that your big toe doesn't bend sharply.
To reduce inflammation, experts suggests a contrast bath three times a day: Immerse the affected foot in water as cold as you can stand for 30 seconds, then in water as warm as you can stand for the same amount of time, alternating cold and warm baths for a total of five minutes (ending with cold water). This might be able to help with swelling too; especially when you mentioned you’re allergic to anti-inflammatory agents. How you’re managing your OA otherwise?

Chris.

mally

Thanks all. I've been googling swelling of osteoarthritic joints and found sites that claimed that inflammation isn't common with oa so wondered why mine were swollen and sore. Usually I only get apin when I walk but at the minute it's when I'm wearing any for of outside footwear

I'm taking tramadol for the pain, Chris. I also use Phorpain Max strength cream which does ease it until I put my shoes on! I'm awaiting an appointment with biomechanics to see if anything can be done by them. I wear arch supports but I'm not sure that they are doing much. My podiatrist has mentioned fusion but my GP is against it because of my age (he says I'm young to have it at 53 and the "relatively big chance that I'll end up hobbling through it".

I'm on 2 weeks annual leave at the minute and I'm having hernia surgery on 13th Feb so will have to do very little for a while after that. I'm hoping that the oa will settle in that time. Otherwise I'm going to have to go back part time as I'm on my feet all day and it's just so tiring.

dreamdaisy

It is not unknown on here for OA-ers to take an anti-inflammatory medication alongside their pain relief. My knees would swell enormously with fluid due to my auto-immune arthritis, now they are comparatively tiny because that is well controlled but I still find that a diclo or two can ease the discomfort of my OA. I hope you stick to reputable sites when researching - there is a whole load of utter rubbish out there in cyber-world and it's human nature to take it all at face value. Good luck with the hernia surgery, I hope that remedies that problem. DD

AnnaMilton

Hi Mally, I have to agree with your GP here. Standard of care for a painful big toe is conservative care first. Medications, physical therapy, and orthotics are the main stays of non-operative care. Fusion takes long time to recover but they’re permanent. Many doctors believe surgery is the last resort in this case, if everything else fails. The advantage of the surgery is a stable joint that stops hurting. The disadvantage is an immobile joint that doesn't move. You will be unable to push off with the big toe when you take a step. You need to do a lot of research and learn the pros and cons of the procedures and how they would affect your lifestyle.

Anna.

stickywicket

Good luck with the hernia op. I do hope that the respite from work and from standing so much will help your toes too.

mally

Thanks again, all. I am hoping it will help, Stickywicket.

Anna, I can't push off with my big toe as it is. It's been too painful to do that for some time now. Consequently, I've been getting back and ankle pain which my GP said may develop into more arthritis in time! I also have inflammation on the other side of my feet. We can't win, can we? I'm certainly in no hurry for surgery and if things settle down while I'm recuperating from my hernia surgery I'll be happy.

dreamdaisy

This is how OA spreads - it occurs somewhere forcing us to alter how we hold ourselves and move, thus putting pressure onto other joints so they have extra stress, again forcing us to change how we hold ourselves, etc. etc. etc. - degeneration and progression writ large. The surgery may help to slow the process but let's get the hernia op done and dusted first, yes? I wish you well with that. DD