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Saturday, September 01, 2007

Hallux Rigidus - How can I avoid surgery?

"Hi Gary: I have a rather severe case of hallux rigidus. Surgery is the only thing, I am told, that can help it. Pain is unbearable at times….however, I run daily and while I am running there is not much pain at all. Devil’s Claw (Phyteuma) has been suggested…I really do not want to have surgery. The manipulation you suggest seems like excruciating pain….but I would be willing to try it if it meant not having surgery. I have worn very high heels the majority of my adult life which probably has contributed to the severity of this. Also, I fractured the ankle on the same foot several years ago and think I may have also injured the toe and not realized it at the time. What do you suggest?"

"Hi Gary,
I am a very serious runner and have this Hallux Rigidus. I have had it for a couple of years. it is pretty much the same as when it first became noticeable. There is some soreness and swelling around the toe joint so there has been some bone growth. I can still run but am interested in your thoughts about manipulating the toe and getting blood to flow around the area as a means of making it better. Please provide me with some more council/insight on this.
Gary Moller comments:
Cath & Max,
Please read this earlier article if you have not already and search for related articles using the search functions on this website.
The pain of manipulation is intense. some would even say it is agonising; but it does work in most cases (I have not had a single failure yet). Without knowing the severity of your hallux rigidus, please bear in mind that you must make the final judgment as to what to do. If there is significant bone growth around the margins, this must be taken into account and worked around.

Here is what I would do:
  • Start taking a quality supplement of glucosamine and chondroitin with MSM, plus 1-2,000mg of natural vitamin C and fish oil with natural vitamin E daily for several days before undertaking a course of manipulation by a trained therapist. These supplements are beneficial for joint health and have a natural anti inflammatory effect.
  • Commence a course of manipulation having been prepared for considerable pain and discomfort over ensuing days.
  • Repeat the manipulation every 4-5 days even if the toe is still tender.
  • Take some additional MSM on the day of the manipulation and for a couple of days after along with the glucosamine, vitamin C etc.
  • Repeat the manipulation every 4-5 days for at least 21 days by which time there should have been a significant improvement in function and reduction in pain.
  • Make sure that all of your shoes have ample toe room and there is no slamming of the foot up against the shoe.
  • Get about bare foot as much as possible and wear flexible shoes. Walk barefoot on grass and on sand at every opportunity.
  • Get your toes pulled and feet massaged at regular intervals, especially if you are doing a lot of walking and running. This will prevent a recurrence.


Anonymous said...

Hello Sir,
I found your web site because I was looking up a "problem toe" for my friend Patrice. It sounds like she might have: hallux rigidus but I'm not sure about that.
When she was a very young girl, under 4 yrs old, living in Germany, her mom couldn't afford shoes every time her foot grew, so by the time she was 4, she was wearing smaller shoes than she should have been wearing. When at 4 she was adopted, her new family bought her the correct size shoes but also had to send her to some sort of foot therapy because of problems with her rt foot and big toe. Anyway, she is a petite woman today, 5' 3" and her foot size ranges between a 6 1/2 - 7, depending on the shoe. So I dont think that her feet are too small, but it seems like her toes are sort of "jammed" together.

That said, here is her problem.

Her big toe has always been a problem. Its hard for her to find shoes that fit because of that toe. Now, that toe has developed a bone spur and the dr.'s say she would need surgery to take care of it. She doesn't want to go that route, so her I am writing you for your professional advise. What could she do to take care of that problem without surgery? Herbal medicine? Massage therapy? etc.

If you need any other questions answered, please just email me and ask me. I will gladly do my best to answer them, and if I dont know, I'll ask her.
Thanks for taking the time to read this and respond.


Gary Moller said...

Unfortunately the damage you describe may be more or less permanent. If the bony spur is so prominent such that it is causing discomfort and making finding a comfortable pair of shoes difficult then surgery is probably the best option and will give much wanted relief after the initial pain of the surgery.
Bone responds to pressure and running by growing. Hence the reason why surgery may be the best option. Adopting a lifestyle that is pretty much barefoot is an option; but probably impractical for her.
These problems are most common in women and serves as a reminder to all parents of the importance of giving children's feet the space they need to grow.
Even tight socks and heavy bedding can deform wee toes.