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Sunday, July 06, 2008

Hallux rigidus - metatarsal-phalangeal-joint pain (Turf Toe) - Treatment Advice

Dear Gary
I just found your webpage online as I was researching Hallux Rigidus.

I have already been to an orthopedic surgeon and was looking for a foot and ankle specialist next. I tried the ice, rest, and motrin remedy without success. I have also recently received a cortisone injection into the MTP joint on my right foot with some acute relief. Unfortunately I still have pain on a daily basis and my workouts and running have suffered.

I am a nurse so therefore am on my feet most of the day. I only wear heels when I go out socially. At this point I am still taking Ibuprofen for pain, icing my foot and taking Fish Oils in the amount of 2000-4000mg/day.

I am hoping you can offer me some additional advice or relief so I can be pain free and can get back to my usual pattern of exercise.

Sincerely, Jana
Gary Moller comments:
Please have a look at my video about this topic here. You will need to find an experienced massage therapist near you who can do this procedure.

Before doing this, I recommend that you address any possible underlying nutritional deficiency that may be contributing to the development of the disorder and its failure to recover through natural healing processes that would have been the norm when you were younger.

For, example; if you have been on a low fat diet (most women are) and working indoors and not getting a lot of sunlight, then it is highly likely the you have steadily run out of the fat soluble vitamins, essential fatty acids, many minerals and even some essential amino acids. Deficiency in even one of these nutrients and the bones and cartilages soften and healing will be compromised. If you work night shifts as a nurse, it is also possible that you have disturbed your circadian cycles which may mean that you are not producing enough growth hormone each night for repair and regeneration. This one reason why shift workers score so poorly on just about every population health measure one cares to look at.

Big toes can be "canaries in the coal mine" and may indicate the very early signs of the body declining in health for whatever reason. This can explain why treating the toe in isolation of the whole person may be doomed to fail.

So, the first step is to complete the Active Elements Assessment. When you do so, please detail your health and injury history, exercise and occupation background. List all medications and supplements you are taking and explain why and for how long. Please include a list of everything that you have drunk and eaten over the previous 24 hours.

If you are able to purchase a set of Salter 9106 Body Composition Analysis Weighing Scales from a store near you, or off my website store (Currently on Special), then you will be able to send me the breakdown of your fat, bone, water and muscle. This is extremely useful information for me to work with.

I will then get back to you with a number of recommendations, bearing in mind the limitations of dealing with you remotely. Please ensure that you continue to consult your doctor as you go.

Do you have a question?
Email Gary: gary at (Replace the "at" with @ and remove spaces). Please include any relevant background information to your question.


pandoraholic said...

I had hallux rigidus and know how excrutiating the pain is and took votaren on a daily basis for that pain. I was sent to a surgeon at the hospital and took the plunge and had an operation where he took away the arthritis causing this pain and fused the joint. The pain disappeared. the downside being that I can no longer wear high heels and found the most comfortable footwear on a daily basis are Birkenstock sandals. I am not able to stand on tip toes on that foot but to be free of the pain is worth it.

Gary Moller said...

Thanks for the comments Lorraine. When conservative measures have been exhausted, surgery then comes in as a reasonable option for serious consideration. The reason for caution is that there is no going back.
I am pleased that it worked so well for you.

Unknown said...

I had gone to the doctor for years with my big toe pain--but no help (wear a pad underneath), mainly because it is an HMO.

Then the bone spur became too large and painful to ignore. I found an orthopedic surgeon (young, athletic) who would remove just the bone spur, sort of clean up the joint, but not put the pin in. (The older, more-experienced surgeon I consulted would ONLY do the pin surgery.) My surgeon figured I still have the pin option later--and some of his other patients, including runners, were very happy having just had the spur removed.

That was 5 years ago, I have virtually no pain, some balance issues (minor compensation)--but have retained some movement in the joint, which comes in useful for my daily, intense yoga practice! [I'm 60 years old, and it was probably from dancing and genetics....]

Unknown said...

Dr.Big Toe is a great product for turf toe.