Osteo in big toe

[chinalil]

After many pilgrimages and at the age of 77 (just completed the Camino de Torres from Salamanca) I have developed OE in my big toe. Am having physio, ice, ultrasound and manipulation, am not walking long distances atm, am cycling instead. Any suggestions on how to manage this condition. Thank you.

 

[dougfitz]

developed OE in my big toe.

What is OE?

In the main, for medical conditions, it would be usual to recommend speaking to the treating medical staff, not seeking the opinions of forum members. Even were there to be a fellow sufferer, they might be able to share their experience, but it would be unlikely they would be qualified to give you advice on this.

 

[Kgaynor]

I’m wondering if the original poster means osteoarthritis?

I agree, I wouldn’t take any serious advice here other than to commiserate on having the same condition.

 

[C clearly]

The OP is getting medical advice. I think there is still room for some discussion of the experience and management tips.

I am interested in the OP's experience, as I also get twinges in my big toe and wonder how it might affect my Camino walking. How did this come on? What type of shoes do you typically use? (I now use very cushioned running shoes with thick soles.) I also wear an old pair of the same shoes around the house instead of slippers, since the hard floors aggravate my feet. (Something to do with losing the padding fat on the feet, in old age. I guess that fat all migrates upward to my midsection.)

 

[kmrice]

You might discuss a course of prednisone with your physician.

 

[Shazzza]

After many pilgrimages and at the age of 77 (just completed the Camino de Torres from Salamanca) I have developed OE in my big toe. Am having physio, ice, ultrasound and manipulation, am not walking long distances atm, am cycling instead. Any suggestions on how to manage this condition. Thank you.

I have the same issue and found really great, light yet stiff hiking boots works well for me! Zero pain. Bonus is zero knee pain (caused by tight IT band) The boots are a bit overkill perhaps on some trails but when I tried a more flex hiking shoe, I felt it in that toe joint and knee. My boots are Oboz. Love love love them! I’m also trying Lowa. Good luck dialing that in! Docs wanted to operate on my toe joint but I’m avoiding that at all costs.

 

[chinacat]

You might discuss a course of prednisone with your physician.

This is a good example of the inadvisability of posting medical advice on here.
Steroids would only decrease the strength of bones and joints (as well as causing thinning of the skin, increasing the possibility of Type 2 diabetes, etc etc etc. They have many drawbacks for health.)

Anti-inflammatories include Curcumin, (in turmeric) Ginger, Rosemary, Green tea … all everyday herbs/spices

 

[Jill PetersGee]

After many pilgrimages and at the age of 77 (just completed the Camino de Torres from Salamanca) I have developed OE in my big toe. Am having physio, ice, ultrasound and manipulation, am not walking long distances atm, am cycling instead. Any suggestions on how to manage this condition. Thank you.

I am a physician and also just finished my 2nd camino. I had problems with a bunion and arthritis in 2019 that made the camino very painful. My daughter joined me in Sarria and brought my stiff soled hoka sneakers that allowed me to finish. This year similar problem in the opposite foot (surgery fixed the right side). Started in SJPDP, What seems to help is a relatively rigid and inflexible sole on your shoe or boot. You can buy carbide insoles also called insoles for “turf toe” These prevent the toe from moving. If you have a bunion, Hanwag makes a bunion hiking shoe and boot on a bunion last. You can google to find a store near you. I have used all three of these with good results.

 

[kmrice]

No medical advice was posted by me. My advice was to discuss prednisone with his physician. To the extent that it is permissible to discuss the drawbacks of prednisone I think it should also be ok for me to mention that prednisone can be effective with certain arthritic conditions. While I rely on the advice of my physicians I find it helpful to have some familiarity with my condition and possible remedies when I visit.

 

[Rebecca Rushton]

I don't mind chiming in here with some pretty general info (btw, I'm a podiatrist).

A stiff big toe knuckle, often but not always the result of osteoarthritis (OA), is called hallux limitus/rigidus (hallux = big toe).

When you toe-off (propulsion), that big toe knuckle has to bend so you can transfer your weight to the other foot. Without it, your gait has to change - you compensate by either out-toeing and rolling off the inside of your foot so the big toe doesn't have to bend; or you toe-off through the lesser toes and reduce the force going through that joint as it bends.

Most shoes are designed to allow the forefoot to bend - it's a normal and efficient way to walk, and the way the foot was designed to function. But it doesn't help if you have painful OA in that joint. So many get relief with shoes that have one or more of the following features:

• Relatively stiff sole at the forefoot - I say relatively because this is not a desirable feature for a normally-functioning and asymptomatic big toe knuckle, so you'll find them hard to come by. Basically it doesn't let the forefoot bend as much/as easy.
• Rockersole - A rounded sole so you can transfer weight from heel to toe and over to the opposite leg by rolling through, all while your foot sits flat in the shoe.
• Thicker sole (usually rockersoles are thicker, and the thickness generally means stiffer, but not always)

Or you can see a podiatrist (at least in my part of the world - Australia) and potentially get a carbon fibre plate fitted to the shoe which doesn't allow either just the big toe or the whole forefoot, to bend. This forces you to compensate in one way or another. This sometimes goes smoothly but sometimes aggravates other problems because of the compensation.

Final piece of advice: Some people have plenty of range in that big toe knuckle but because of how their feet work, that range is unavailable when they walk (functional hallux limitus). There's no OA but it can be painful. This often requires foot orthoses with specific design features to facilitate the function of this joint.

I do hope I haven't overstepped the mark. Please take this as general advice and seek the professional opinion of a podiatrist who can look at your foot structure and function to tailor advice and treatment recommendations specific to your needs.

All the best @chinalil!

 

[Jill PetersGee]

I don't mind chiming in here with some pretty general info (btw, I'm a podiatrist).

A stiff big toe knuckle, often but not always the result of osteoarthritis (OA), is called hallux limitus/rigidus (hallux = big toe).

When you toe-off (propulsion), that big toe knuckle has to bend so you can transfer your weight to the other foot. Without it, your gait has to change - you compensate by either out-toeing and rolling off the inside of your foot so the big toe doesn't have to bend; or you toe-off through the lesser toes and reduce the force going through that joint as it bends.

Most shoes are designed to allow the forefoot to bend - it's a normal and efficient way to walk, and the way the foot was designed to function. But it doesn't help if you have painful OA in that joint. So many get relief with shoes that have one or more of the following features:

• Relatively stiff sole at the forefoot - I say relatively because this is not a desirable feature for a normally-functioning and asymptomatic big toe knuckle, so you'll find them hard to come by. Basically it doesn't let the forefoot bend as much/as easy.
• Rockersole - A rounded sole so you can transfer weight from heel to toe and over to the opposite leg by rolling through, all while your foot sits flat in the shoe.
• Thicker sole (usually rockersoles are thicker, and the thickness generally means stiffer, but not always)

Or you can see a podiatrist (at least in my part of the world - Australia) and potentially get a carbon fibre plate fitted to the shoe which doesn't allow either just the big toe or the whole forefoot, to bend. This forces you to compensate in one way or another. This sometimes goes smoothly but sometimes aggravates other problems because of the compensation.

Final piece of advice: Some people have plenty of range in that big toe knuckle but because of how their feet work, that range is unavailable when they walk (functional hallux limitus). There's no OA but it can be painful. This often requires foot orthoses with specific design features to facilitate the function of this joint.

I do hope I haven't overstepped the mark. Please take this as general advice and seek the professional opinion of a podiatrist who can look at your foot structure and function to tailor advice and treatment recommendations specific to your needs.

All the best @chinalil!

Excellent advice! My trial and error approach cost $60 for insoles, $280 for hanwag shoes, $170 plus for multiple attempts at shoes that were comfortable. A podiatrist and evaluation will save time and money!

 

[chinalil]

The OP is getting medical advice. I think there is still room for some discussion of the experience and management tips.

I am interested in the OP's experience, as I also get twinges in my big toe and wonder how it might affect my Camino walking. How did this come on? What type of shoes do you typically use? (I now use very cushioned running shoes with thick soles.) I also wear an old pair of the same shoes around the house instead of slippers, since the hard floors aggravate my feet. (Something to do with losing the padding fat on the feet, in old age. I guess that fat all migrates upward to my midsection.)

Yes, I meant osteoarthritis. Yes, I have started getting medical advice and imho the more information I gather about any condition the more informed I will be. It came on rather suddenly when I returned home to Australia after walking the Camino de Torres and a section of the Pilgrims' Walk in UK. So quite a bit of walking and carrying a back pack of some 10.5kgs. I have done similar pilgrimages for the last 10 years, sometimes twice a year with no sore toe!
For hiking I wear Scarpa Kailesh Trek GTX but they hurt now. I normally wear high heels, flats, trainers (fashion) but my physio said no and I do too! I am a cyclist fortunately, nothing hurts when I do that!!
ATM I am wearing Brooks cross trainers, everywhere!!! Even in the house since I read your post, what a difference. Thank you! My toe prefers this cushioning. And yes, going shoeless aggravates it too. I have made an appointment to see my doctor and a podiatrist to follow up. Thank you very much C Clearly for your comments!

 

[chinalil]

Excellent advice! My trial and error approach cost $60 for insoles, $280 for hanwag shoes, $170 plus for multiple attempts at shoes that were comfortable. A podiatrist and evaluation will save time and money!

I’m wondering if the original poster means osteoarthritis?

I agree, I wouldn’t take any serious advice here other than to commiserate on having the same condition.

Yep, mistake!!

 

[chinalil]

I have the same issue and found really great, light yet stiff hiking boots works well for me! Zero pain. Bonus is zero knee pain (caused by tight IT band) The boots are a bit overkill perhaps on some trails but when I tried a more flex hiking shoe, I felt it in that toe joint and knee. My boots are Oboz. Love love love them! I’m also trying Lowa. Good luck dialing that in! Docs wanted to operate on my toe joint but I’m avoiding that at all costs.

You might discuss a course of prednisone with your physician.

Thank you very much for your comment, I shall discuss this with my physician.

 

[katevos]

No medical advice was posted by me. My advice was to discuss prednisone with his physician. To the extent that it is permissible to discuss the drawbacks of prednisone I think it should also be ok for me to mention that prednisone can be effective with certain arthritic conditions. While I rely on the advice of my physicians I find it helpful to have some familiarity with my condition and possible remedies when I visit.

I just saw my orthopedist for an injection in my back. He is very athletic. We discussed my pack and some current neck issues that I am using Pt for. I also recently had oral surgery( been a couple of rough health months!) and was put on a short dose of prednisone to aide in healing( though normally I hate the stuff because of the side effects. Don’t know if it helped my gums that much, but it really helped my neck issue! )Anyway the orthopedist felt that it would be a good idea to have some to take in an emergency and wrote a prescription. I am grateful! Hope not to need it but have arthritis in my feet and a bunion. In any event I have been aware of the dangers of prednisone and other steroids but my understanding that short term use is safe.

 

[Kgaynor]

Yep, mistake!!

?

 

[C clearly]

I’m wondering if the original poster means osteoarthritis?

Yep, mistake!!

?

I think she meant to say that yes, she meant osteoarthritis (and not "OE").

 

[Kgaynor]

Ahhhhh thank you. I was scratching my head trying to understand.

 

[dougfitz]

Any suggestions on how to manage this condition. Thank you.

I note you are from Australia. If you are planning to walk or ride in Europe, certain pain management and complementary medicines that you would normally have available at home will either not be available at all (modified release paracetamol) or only available from a pharmacy (many if not most supplements available in Australia in supermarkets). I did find re-hydration salts and some mineral supplements at supermarkets, and some multi-vitamins that I don't take, but the range appeared much more limited compared to supermarkets here.

 

[camino07]

Yes, I meant osteoarthritis. Yes, I have started getting medical advice and imho the more information I gather about any condition the more informed I will be. It came on rather suddenly when I returned home to Australia after walking the Camino de Torres and a section of the Pilgrims' Walk in UK. So quite a bit of walking and carrying a back pack of some 10.5kgs. I have done similar pilgrimages for the last 10 years, sometimes twice a year with no sore toe!
For hiking I wear Scarpa Kailesh Trek GTX but they hurt now. I normally wear high heels, flats, trainers (fashion) but my physio said no and I do too! I am a cyclist fortunately, nothing hurts when I do that!!
ATM I am wearing Brooks cross trainers, everywhere!!! Even in the house since I read your post, what a difference. Thank you! My toe prefers this cushioning. And yes, going shoeless aggravates it too. I have made an appointment to see my doctor and a podiatrist to follow up. Thank you very much C Clearly for your comments!

Maybe try Hoka Speedgoats next Camino . I felt it was like walking on a cloud ,even on the cobblestones.

 

[chinalil]

Maybe try Hoka Speedgoats next Camino . I felt it was like walking on a cloud ,even on the cobblestones.

Thank you very much for the complete name….I recall u telling me about them

 

[C clearly]

Maybe try Hoka Speedgoats

Or try the New Balance More shoe - similar thick rocker sole, as the Hoka's have, but the NB comes wider.

 

[chinalil]

Thank you all very much for your valuable and informative comments regarding my ‘big toe’ condition and shoe choices, my dream would b to return to wearing my Scarpa boots but atm it’s more the spongy, flexible sole that’s required. Iowa, Hoka and New Balance to name a few of the suggestions. I am now m a much better position when heading off to the next practitioner which is today. @Rebecca Rushton, the podiatrist’s remarks are very helpful from a “technical” point of view and no, imho in no way did u “overstep the mark”.
Additionally, it’s now perfectly clear to me that OA means osteoarthritis!!
Very grateful to u for spending time to respond

 

[Shazzza]

I am a physician and also just finished my 2nd camino. I had problems with a bunion and arthritis in 2019 that made the camino very painful. My daughter joined me in Sarria and brought my stiff soled hoka sneakers that allowed me to finish. This year similar problem in the opposite foot (surgery fixed the right side). Started in SJPDP, What seems to help is a relatively rigid and inflexible sole on your shoe or boot. You can buy carbide insoles also called insoles for “turf toe” These prevent the toe from moving. If you have a bunion, Hanwag makes a bunion hiking shoe and boot on a bunion last. You can google to find a store near you. I have used all three of these with good results.

Oooh! Carbide! I’ll check those out. The super feet I tried def don’t keep things from moving. I posted about a stiff hiking boot I use by Oboz and I love them except I just realized they are a snowshoeing/snowboarding boot! No wonder they are stiff. Def overkill but they work! I’ll try the carbide insole with a hiking boot to see what happens. Thank you for your post!!