Arthritis in big toe

palo

Spent 3 hours in A & E yesterday as GP thought I had sceptic arthritis in my toe, she had been treating me for gout.

X-rays showed osteo-arthritis. Has anyone got any advice for how to manage it. I have osteo-arthritis in hands already and am ok managing that.

Have been unable to weight bear for about 5 weeks and walk with a limp at best as too painful to put full weight on foot, sometimes can't manage walking at all.

Thanks in advance. Must have drank 2 litres of cherry juice in the week she treated me for gout!!!

dreamdaisy

Hello Palo, I am sorry to read your latest news. There's no secret to treating OA of the toe, it's just the same as treating it elsewhere albeit it's in a more awkward place. Pain relief, maybe an anti-inflammatory medication, rest and soaking your feet in warm water with some added Epsom salts may help to bring about further temporary relief. How are things otherwise? DD

palo

dreamdaisy wrote:

Hello Palo, I am sorry to read your latest news. There's no secret to treating OA of the toe, it's just the same as treating it elsewhere albeit it's in a more awkward place. Pain relief, maybe an anti-inflammatory medication, rest and soaking your feet in warm water with some added Epsom salts may help to bring about further temporary relief. How are things otherwise? DD

TBH feeling quite low, the only good news this year has been that my lump on my leg was not cancer. Otherwise been unable to walk for over a month and feeling as though I am losing the battle these days to remain functional..

dreamdaisy

We have to force ourselves to keep moving, no matter how much it hurts, otherwise our muscles atrophy and, believe it or not that makes things worse. My toes are affected by my PsA, my ankles and hips by OA, my knees by both. They are bone-on-bone now, have been for years. I suppose I am lucky in that I am in my 22nd year of this, I've gone from one affected joint to around forty (my upper body isn't unaffected) but have had time to adjust. I have never shied away from using aids and that has made a big difference in the physical ability I have left - you may or may not know that I began working with a personal trainer and that has helped matters no end. Has it reduced my pain levels? No, and it's caused muscular pain too, but it has improved my stamina and that in itself helps me deal better with it.

As a result of working with her I have been able to drop my anti-depressants to 10mgs per day instead of 20, a small but important thing. DD

mamadeesix

I have hallux rigidus, which is usually a form of OA, in my big toes. Don't know if this is it's own thing, or part of the bigger picture of an auto-immune thing for me, but anyway....

I am familiar with big toe pain. I did get prescription, custom made inserts for my work-out shoes. That does help. I suppose it would help more if I switched them out and wore them in other shoes, but they don't always fit.

And while it is important to keep moving.....at least with hallux rigidus, there are certain things I stay away from. Lunges for instance. Anything that hyper flexes my toes will cause trouble for me during and especially after the fact. High heels are also troublesome. Also, I have to be careful to find shoes that don't rub on the top of my big toe joint.

So far, haven't really found any pain med that works well. Mostly takes the edge off.

palo

mamadeesix wrote:

I have hallux rigidus, which is usually a form of OA, in my big toes. Don't know if this is it's own thing, or part of the bigger picture of an auto-immune thing for me, but anyway....

I am familiar with big toe pain. I did get prescription, custom made inserts for my work-out shoes. That does help. I suppose it would help more if I switched them out and wore them in other shoes, but they don't always fit.

And while it is important to keep moving.....at least with hallux rigidus, there are certain things I stay away from. Lunges for instance. Anything that hyper flexes my toes will cause trouble for me during and especially after the fact. High heels are also troublesome. Also, I have to be careful to find shoes that don't rub on the top of my big toe joint.

So far, haven't really found any pain med that works well. Mostly takes the edge off.

Thank you. I am avoiding pain killers, I can't have anti-inflammatory painkillers (contra-indicated with other drugs I take) the only ones I can take are paracetemol, oramorph or tramadol.

Now that I know what I am dealing with just did a foot bath, and will be trying hot wax baths too, which I am sure will help.

The hospital said I should get GP to refer back for ortho elective (?) to discuss surgical options etc, but can't face going back to GP today, will see tomorrow.

I am getting over yesterday now, that was the biggest scare I've ever had, more so than the cancer scare earlier this year...

Will start my yoga again too.

stickywicket

Palo, we know you have a great deal to contend with, arthritis being but one thing, and you do so bravely and uncomplainingly.

I'm glad the leg problem was not as serious as feared but, of course, more rubbish rocks up all the time.

I'm sorry, I can't remember if you've seen an orthotist or not. (Your GP can refer you.) Orthotic insoles might help to some extent if worn with sensible shoes such as trainers but an orthotist might have other suggestions worth listening to.

I'm pleased you're feeling a bit better today. Sometimes we live right on the edge, barely aware of it until the slight breeze of yet another diagnosis threatens to blow us over the cliff top. I hope the improved mood continues but, if not, there is no shame in a course of anti-depressants. Or in talking to us.

palo

stickywicket wrote:

Palo, we know you have a great deal to contend with, arthritis being but one thing, and you do so bravely and uncomplainingly.

I'm glad the leg problem was not as serious as feared but, of course, more rubbish rocks up all the time.

I'm sorry, I can't remember if you've seen an orthotist or not. (Your GP can refer you.) Orthotic insoles might help to some extent if worn with sensible shoes such as trainers but an orthotist might have other suggestions worth listening to.

I'm pleased you're feeling a bit better today. Sometimes we live right on the edge, barely aware of it until the slight breeze of yet another diagnosis threatens to blow us over the cliff top. I hope the improved mood continues but, if not, there is no shame in a course of anti-depressants. Or in talking to us.

Thank you SW.

Am seeing GP today, only the locum is available and not until this afternoon. A year ago after the arthritis was diagnosed in my hands I asked if they would xray my feet as I was sure it was in there as well and they flatly refused, do you think I should raise this now, if they had, we would not have had this latest incident and could have saved me the weeks of pain and immobility leading up to Tuesday?

Yes, it is like lliving on the knife edge, everything planned and managed just so and anything more is just enough to bring it all down. I have no reserves unfortunately my body is pushed to its max as it is and there is just no give in it...

My mood is better and back to being more combative again, needs must.

Hope you are as well as can be.

dreamdaisy

I'm not sure how having an Xray taken a year ago would have prevented this happening, when we have OA affecting a joint it alters how we stand, move, sit etc. thus putting other joints under stress, throwing them off kilter and causing more trouble. Xrays are diagnostic, not preventative and are not to be done lightly - there's a reason the technicians disappear behind the screen, the dentist and assistant leave the room.

One medical condition often leads to others, to my way of thinking when the body's defences are breached that weakens the whole structure. My defences were never completed thanks to my genes, when you realise as a child you're on a hiding to nothing it simplifiers matters - well it has for me. My life has been a constant succession of creeks and in the early days there was not a paddle to be had. Over the years the development in meds has supplied at least half a paddle every now and then for which I am grateful. Fighting back all the time is wearying and every now and again a rest from the battle is no bad thing as long as one resumes the cudgels: I will not let my beasts beat me, they try to have their way every now and again (as they are at the moment) but they can dream on if they think they are going to win. DD

palo

dreamdaisy wrote:

I'm not sure how having an Xray taken a year ago would have prevented this happening, when we have OA affecting a joint it alters how we stand, move, sit etc. thus putting other joints under stress, throwing them off kilter and causing more trouble. Xrays are diagnostic, not preventative and are not to be done lightly - there's a reason the technicians disappear behind the screen, the dentist and assistant leave the room.

One medical condition often leads to others, to my way of thinking when the body's defences are breached that weakens the whole structure. My defences were never completed thanks to my genes, when you realise as a child you're on a hiding to nothing it simplifiers matters - well it has for me. My life has been a constant succession of creeks and in the early days there was not a paddle to be had. Over the years the development in meds has supplied at least half a paddle every now and then for which I am grateful. Fighting back all the time is wearying and every now and again a rest from the battle is no bad thing as long as one resumes the cudgels: I will not let my beasts beat me, they try to have their way every now and again (as they are at the moment) but they can dream on if they think they are going to win. DD

Since OA doesnt form overnight, it would have shown last year surely, that was my point and I would have managed it from then having a diagnosis?

dreamdaisy

Ah, I see, I apologise for misunderstanding. I remain unsure, however, what you could have done differently to stop it from happening. The major problem with arthritis of any kind is that it is both degenerative and progressive, one of the heavily disguised blessings of the auto-immune kinds is that the meds slow those processes by suppressing the immune system but OA works differently. I didn't even know I had OA until it was diagnosed in 2011, I have no idea how long it had been chuntering away but in my case preventing it was never on the cards.

I don't think there is anything you could have done to prevent what has happened but that won't stop you thinking that there was. Do what you can now to prevent it going further and let's hope that helps matters. DD

stickywicket

I think I agree with DD in that, even if you'd known you had OA in the toe, what could you have done about it? A few exercises maybe, ensuring your shoes were always strong and supportive but nothing else, I'd have thought. Ask for an x-ray by all means but I'm not sure what good it will do other than (and this is a very long shot) potentially ruling out (or in) an autoimmune type of arthritis. I read somewhere on the ARUK site that the changes from RA show first in the feet. As DD says, though, x-rays do carry radiation risks which is why they're not too gung-ho with them.

Please let s know how you get on today. A locum can sometimes provide a fresh viewpoint which can be a positive thing.

palo

Thank you for your responses.

The locum was clueless and wanted me to take gout treatment despite the fact that that diagnosis is under question and requires a blood test to confirm and they can't do that until this flare settles if it is gout. Catch 22. I'm not keen to take drugs just in case I have something!!

He did do the ortho referral though so will wait and see.

I am getting use to using a stick now in the mean-time...

stickywicket

I know very little about gout. Why can't a blood test be done while you're flaring? To the uninitiated it would seem the obvious time to do it.

dreamdaisy

It would make our lives so much easier if there was some degree of consistency in how things are diagnosed but, as usual, we are at the mercy of opinions and practise. My husband has the occasional blast of gout for which he takes naproxen and pain relief (exactly as used to treat OA) but it was not diagnosed by a blood test and it clears within a week. He doesn't know he's born. DD

dreamdaisy

Hello, how are you feeling about things now? Is there any improvement in your toe? DD

palo

dreamdaisy wrote:

Hello, how are you feeling about things now? Is there any improvement in your toe? DD

Thank you for the enquiry DD.

I am still in pain, but reconciled to it more now and getting much more proficient with the walking stick and taking painkillers as well. I have spent 19 years trying to reduce the amount of drugs I take so it is still a bitter pill to have to take regular painkillers now but so be it...

I have a referral for ortho triage, which I can ring tomorrow and hope to progress. I hope I can see someone who can help with solutions re podiatry adjustments etc

I have an appointment tomorrow for ortho review of my latest x-rays of my hands, for which I expect no more help, as the physio asked me last time what I expected him to do about it...

My gout (if I have it) appears to be getting better as the foot/toe is less swollen now, although it still looks mis-shapen.

So progressing. Thank you

dreamdaisy

If you have been resting a little more then the swelling has probably died down which will make things look better. Using a stick will ease the strain on the affected side, I hope you are holding it in the opposite hand and have it correctly adjusted for height. Are you able to take anti-inflammatory medications? I apologise for not remembering but it is hard to recall the exact details of everyone . . . . :oops: DD

palo

dreamdaisy wrote:

If you have been resting a little more then the swelling has probably died down which will make things look better. Using a stick will ease the strain on the affected side, I hope you are holding it in the opposite hand and have it correctly adjusted for height. Are you able to take anti-inflammatory medications? I apologise for not remembering but it is hard to recall the exact details of everyone . . . . :oops: DD

My (hand) physio adjusted it for me last year when my sciatica was playing up, so yes using in left hand as right toe/foot is painful.

I can't take anti-inflammatories. or muscle relaxants - which is most aggravating, but c'est la vie.

Thank you

Airwave!

We have moratorium on x rays for fingers, toes, ribs, lower back etc, basically they (NHS) can't afford them. Wheat bags get the warmth into your pain spots and aren't so messy, don't forget a half an inch of water in the bottom of an old mug in the microwave, the wheat soaks the steam up.

I'm on my eighth pair of (Mountain Warehouse) walking shoes (six months use), I wear nothing else and transfer the built up insoles into the next pair, you need removeable ones. Skechers are comfortable but most of the insoles are sewn in. The inserts are supposed to last two years, thats debatable.

Surgery-often successful but you dont always get what you want as regards results but if you need it then you need it!

I just stubbed my toes on a step, can't think of a more painful or stupid thing to do, they're black and blue!

palo

Airwave! wrote:

We have moratorium on x rays for fingers, toes, ribs, lower back etc, basically they (NHS) can't afford them. Wheat bags get the warmth into your pain spots and aren't so messy, don't forget a half an inch of water in the bottom of an old mug in the microwave, the wheat soaks the steam up.

I'm on my eighth pair of (Mountain Warehouse) walking shoes (six months use), I wear nothing else and transfer the built up insoles into the next pair, you need removeable ones. Skechers are comfortable but most of the insoles are sewn in. The inserts are supposed to last two years, thats debatable.

Surgery-often successful but you dont always get what you want as regards results but if you need it then you need it!

I just stubbed my toes on a step, can't think of a more painful or stupid thing to do, they're black and blue!

Thank you for the suggestions, am looking up sketchers. I know what you mean about stubbing toes, why is it that it is always the most painful part of the body that keeps getting bashed!!!