Big toe bursitis

Bursitis of the big toe, or in other words, an inflammatory process of the joint bag, is one of the most common diseases of the musculoskeletal system.

The internal cavity of the joint is lined with a special membrane that produces fluid that ensures painless and easy movement in the joint articulation. Due to various infections and changes, the cavity of the first joint of the metatarsophalangeal section becomes inflamed, which leads to a violation of its direct function and limitation of motor activity.

In medical practice, there was an opinion that bursitis of the big toe develops in those who consume large amounts of salt, but later studies did not confirm this hypothesis. However, situations when the joint bag becomes inflamed due to salt deposits are not so rare. For example, this phenomenon is common with gout, when uric acid salt compounds are deposited in the phalanges of the foot. Inflammation can also develop with a violation of the immune function, or more precisely with rheumatism, rheumatoid arthritis, psoriasis. However, the main cause of the disease is valgus deformity of the feet. This is observed when wearing uncomfortable, narrowed shoes, flat feet, pathology of the muscles and ligaments of the foot, most often this disease occurs in women.

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Causes of Bunion

The causes of bursitis of the big toe are varied, but the main factor that provokes the inflammatory process is excessive accumulation of fluid in the joint bag. Normally, this fluid is in the cavity of each joint, and it is due to its properties that each movement in the joint occurs smoothly. In addition, the pressure on the bone also decreases, which makes movements in the joint painless. If for some reason the fluid in the joint bag begins to accumulate in large quantities, this leads to the development of the inflammatory process. With chronic inflammation and trauma, a seal is formed in the joint bag. Over time, due to this seal, the bone shifts, due to which a lump forms at the site of the articular articulation.

The causes that increase the risk of developing inflammation of the synovial bursa can be classified as follows:

• Due to flat feet.
• With hypermobility of the joint, it mainly occurs when it is weak.
• For diseases of the musculoskeletal system, such as arthritis.
• In case of chronic trauma or long-term non-healing injury to the big toe.
• In case of congenital foot deformity.
• For infections of the joint cavity.
• In case of metabolic disorders.
• For allergies.
• Due to intoxication.
• When the surrounding tissues are inflamed.

To avoid bunion, it is worth thinking about timely prevention of this disease - monitor your lifestyle, diet, wear comfortable shoes, especially if you have to stand on your feet due to work.

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Symptoms of Bunion

Symptoms of bursitis of the big toe are usually difficult to confuse with other diseases of the musculoskeletal system. The first signs indicating inflammation of the joint bag are:

• Deformation of the big toe, formation of a seal in the joint area.
• The appearance of pain in the area of the big toe joint, which intensifies when walking.
• Discomfort and pain when wearing shoes.
• Formation of a callus on the joint seal.
• Impaired sensitivity in the area of the big toe.

The first signs of the disease are difficult to ignore, largely due to this, inflammation of the synovial bag can be determined at the initial stage. A specialist will help to clarify the diagnosis at the initial stage, since inflammation of the joint bag can be similar to arthritis, gout, cerebral palsy, multiple sclerosis, etc. At the early stage of the formation of a painful seal, it is possible to stop the development of the disease and restore the functioning of the joint, and with timely access to a specialist and competent complex therapy, you can achieve complete recovery. Otherwise, the inflammatory process will lead to the development of arthrosis and complete ossification of the articular articulation, and, accordingly, deformation of the foot.

Suppurative bursitis of the big toe

This is an acute inflammatory disease that covers the entire cavity of the joint capsule. The joint capsule or synovial bag is a cavity that covers the head of the joint; inside the cavity there is a small amount of special fluid that promotes normal painless movement in the joint, due to which friction between the bone, muscle tissue and ligaments is reduced.

Synovial fluid can become infected for several reasons - when pathogens enter it through the blood and lymph, as well as through the wound channel of the joint capsule (during ruptures, dissections, gunshot wounds, surgery, etc.). But the presence of foci of purulent inflammation near the joint articulations is especially dangerous, namely:

• purulent arthritis;
• furunculosis;
• erysipelas;
• subcutaneous phlegmon, etc.

The most common pathogens causing inflammation of the synovial bursa are streptococci and staphylococci; less common are cases of infection with E. coli and others.

Purulent bursitis of the big toe is dangerous because during the inflammatory process in the joint cavity, purulent melting of the walls of the joint cavity occurs and purulent exudate penetrates the tissues, which leads to such a complication as phlegmon of the foot. This is an acute surgical disease that requires urgent surgical intervention and complex antibacterial therapy. With timely treatment and compliance with medical prescriptions, rapid restoration of joint functions occurs.

Diagnosis of bunion

Diagnosis of bursitis of the big toe is carried out according to the patient's survey data; at later stages, examination and palpation data are sufficient - the presence of hallux valgus can be noted with the naked eye. But it is also important to conduct an X-ray examination of the diseased joint to determine the degree of deformation and the condition of the adjacent bone system of the foot.

Methods such as CT and ultrasound are prescribed as an additional diagnostic method when there is a suspicion of the presence of related pathologies of the musculoskeletal system. In addition, clinical and biochemical blood tests are mandatory. With their help, you can get accurate information about the state of formed elements of the blood, which are very sensitive to inflammation and other changes in the body, as well as get information about the state of the organs and systems of the human body.

When the diagnosis is confirmed by diagnostics, it is necessary to start treatment as soon as possible. At an early stage, the disease can be completely eradicated, restoring the functionality of the joint. Diagnosis at a late stage complicates further treatment, but if all rules are followed and appropriate orthopedic treatment is given, the outcome of the disease is favorable.

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Treatment of bunion of the big toe

Treatment of bursitis of the big toe can be both conservative and surgical (in case of purulent bursitis and in cases where very severe pain occurs when walking). Treatment of this disease is within the competence of a traumatologist-orthopedist, surgeon. The effectiveness of treatment depends on the time of contacting a doctor. Acute bursitis is treated on an outpatient basis, and complicated chronic bursitis requires treatment in a hospital setting.

• If severe pain occurs in a sore joint, you need to immobilize the sore joint (using a bandage or any fixator), apply a bag of ice or snow to the sore joint through a cloth, bandage the foot with an elastic bandage, and keep the limb itself elevated, placing the foot on a pillow.
• To prevent complications of acute inflammation, anti-inflammatory and pain-relieving drugs are prescribed (Ibuprofen, Diclofenac, Nise, Analgin, Butadion, Ketoral, etc.). For purulent bursitis, antibacterial agents are prescribed, but only after bacterial culture of the joint fluid and identification of the pathogen.
• In the non-acute phase, physiotherapy procedures and UHF are prescribed.

In the chronic form of inflammation of the synovial bag, surgical intervention is indicated. The surgeon dissects the joint bag, removes adhesions and growths inside it, after which the cavity is washed with an antiseptic solution, antibiotics, anti-inflammatory and painkillers are prescribed at the same time. The process of restoring movement in the joint can take several months.

Bunion Surgery

Surgery for bunion is performed in cases where other treatment options have been ineffective, pain in the joint prevents full movement, or persistent foot deformity has developed that interferes with walking. Surgery is also prescribed in cases where the disease becomes chronic.

Before the operation, the doctor evaluates the general physical condition of the patient, the condition of the leg, X-ray data, venous and arterial blood circulation. It is also worth considering possible complications that may accompany the postoperative period. This is the development of tumors, infections, bleeding, displacement or shortening of the toe, recurrence of inflammation. The risk group includes patients who have poor health, inadequate or excessive nutrition, diabetes, smoke or abuse alcohol.

Before the operation, either general anesthesia or local anesthesia is administered, depending on the complexity of the patient's condition. After the anesthesia, the doctor cuts the joint capsule near the big toe. Then part of the phalanx is removed (osteotomy), its head is formed so that the phalanx is in the correct position. In severe cases, the phalanx is fixed with surgical steel pins to support and form the bone. After that, the wound is sutured and a bandage is applied to it. In general, the operation lasts 30-120 minutes, depending on the complexity of the case.

Surgery for bunion of the big toe allows you to restore mobility in the joint and reduce pain when walking. Full recovery occurs 8 weeks after surgery.

Prevention of bunion

Prevention of bursitis of the big toe concerns almost everyone - in pursuit of fashionable shoes, not everyone cares about their comfort. Shoes with heels, shoes with a narrowed toe, when worn often, contribute to the deformation of the bones of the foot. Pressure on the joint of the big toe is constantly maintained, which leads to the formation of a callus and a change in the position of the phalanx. In the future, the displacement interferes with walking, there is very severe pain in the foot, joint.

To prevent the development of bursitis of the big toe, you need to choose comfortable shoes, especially if your job requires you to spend a lot of time standing. In extreme cases, have a spare set of shoes with a wide toe. It is also useful to massage the foot, in particular, massage the joint of the big toe. If the fact of inflammation is confirmed, then you should immediately give up narrow shoes and wear a special retainer-pad. The retainer is placed between the first and second toes, which prevents the first phalanx from changing position and makes the load on the joint bag much less, and also reduces pain when walking.

Prevention of big toe bursitis and its timely detection allow early control over the further development of the disease and eliminate the need for surgical intervention.

Prognosis of bunion

The prognosis for bursitis of the big toe with timely diagnosis and treatment is favorable, but at a later stage, when the hallux valgus has already formed. This is dangerous because such a complication as arthritis can develop, and this will lead to limited joint function and pain when moving. Arthritis leads to gait and posture disorders, and this will lead to inflammation of the overlying joints. In case of infection of the synovial fluid through the wound canal in the area of the articular articulation and the development of purulent bursitis, the recovery process takes longer, since surgical intervention will be required.

In severe cases of bunion, osteotomy is performed – bone reconstruction of the foot bones aimed at changing the position of the metatarsal bone and the phalanx of the first toe. But this is an extreme treatment method when other treatment options are ineffective.

You can lean on the metatarsus of the foot already in the third week after the operation, and the restoration of motor functions occurs in 6-8 weeks. Within 8-12 weeks, the process of full recovery is completed, but you should not forget about preventive measures - wear comfortable shoes with a wide toe, use special fixators and orthopedic insoles.

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