Bursitis of the big toe or in other words, an inflammatory process of the bag replacement is one of the most common diseases of the locomotor system.
Inside of the joint cavity is lined with a special membrane that produces a fluid that provides a painless and easy move. Because of multiple infections and changes in the cavity of the first metatarsophalangeal joint of the Department of inflammation, which leads to the violation of his direct functions and the limitation of physical activity.
In medical practice it was considered that the bursitis of the big toe develops in those who consume large amounts of salt, but in later studies, this hypothesis was not confirmed. However, the situation in which the joint capsule is inflamed because of the salt deposits, are not uncommon. For example, it is common to drop, when the feet are deposited the salt of the compound of uric acid. Also, the inflammation can develop in violation of the functions of the immune system, and more specifically for rheumatism, rheumatoid arthritis, psoriasis. However, the main reason for diseases – flat feet. This can be seen when wearing shoes uncomfortable, flat feet, diseases of the muscles and ligaments of the feet, most often this disease occurs in women.
The causes of the disease of the big toe is very varied, but the main factor that triggers the inflammatory process is an excessive accumulation of fluid in the bag of the joint. Normal this liquid in the cavity of each joint, thanks to its properties of each movement in the joint is smooth. In addition, the pressure on the bone is also reduced, making movement in the joint is painless. If for any reason the liquid in the bag joint begins to accumulate in large quantity, which leads to the development of the inflammatory process. In the chronic inflammation and trauma in a bag set is made of seal. Over time, this seal bone is varied, from the place of articulation of the hinge formed of shocks.
The causes that increase the risk of developing inflammation of the synovial bags can be classified as follows:
To prevent the disease of the big toe, it is necessary to think in timely prevention of this disease is to follow a way of life, food, wear comfortable shoes, especially if they are in service and have to stand on his feet.
The symptoms of the disease of the big toe, it is usually difficult to confuse with other diseases of the musculoskeletal system. The first signs of inflammation of the bag replacement is:
The first symptoms are hard to ignore, largely because of this inflammation of the shoulder Bursa can be defined in a first phase. To clarify the diagnosis in the initial phase will help to a specialist such as inflammation of the joint capsule may be similar to that of arthritis, gout, cerebral palsy, multiple sclerosis, etc. In a first phase in the formation of the painful compression it is possible to stop the progression of the disease and restore the structure and subject to timely appeal to the specialist and competent comprehensive treatment can achieve full recovery. Otherwise, the inflammatory process will result in the development of osteoarthritis, and, in consequence, the deformation of the foot.
This is an acute inflammatory disease covering the entire cavity of the joint of the capsule. Joint capsule or synovial bag is the cavity, which covers the head of the joint within the cavity is a small amount of liquid special, which contributes to normal movement without pain in the joint, which reduces friction between the bones, muscle tissue and ligaments.
Set of fluids can be infected for various reasons – if you get into it of infectious agents through the blood and lymph and through the wound channel in the capsule of the joint (wear and tear, cuts, bullet wounds, surgical intervention, etc.). But the special danger is the presence of foci of inflammation purulent in the vicinity of the articulating joint, that is to say:
The most frequent causative agents of the inflammation of the synovial bags – streptococci and staphylococci, less frequently, there are cases of infection by E. coli.
Purulent bursitis of the big toe is dangerous because in the course of the inflammatory process in the whole of the cavity is the fusion of the walls of the joint cavity and purulent exudate penetrates into the tissues, which leads to such complications as phlegmon of the foot. This is an acute surgical illness that requires emergency surgery and complex antibacterial therapy. With timely treatment to the doctor and adherence to medical prescriptions, there is a rapid restoration of the function of the joint.
Pain in the joints of the toes
The diagnosis of the disease of the big toe is carried out in accordance with the survey of the patient, in the later stages is enough data inspection and palpation – the naked eye will note the presence of hallux valgus. But it is also important to perform an x-ray of the patient's joint to determine the degree of deformation and condition of the adjoining bone of the foot.
Methods such as CT and ultrasound named as an additional diagnostic method when there is a suspicion of the presence of other pathologies of the locomotor system. In addition, compulsory to appoint clinical and biochemical analysis of blood. Can be used to get the accurate information about the situation of the formed elements of the blood, which are very sensitive to inflammation and other changes in the body, and also to get information about the status of the devices and systems of the human body.
The diagnosis confirmation of the diagnosis of the disease as soon as possible to begin the treatment. In a first phase, the disease can be eradicated by the restoration of the functionality of the joint. Diagnosis at a late stage makes it difficult to follow the treatment, but subject to all the rules and appropriate orthopaedic treatment of the disease outcome is favorable.
The treatment of the disease of the big toe can be both conservative and operative. The treatment of this disease in the competence of the surgeon. The effectiveness of the treatment depends on the time to seek medical attention. Acute bursitis is treated on an outpatient basis, and complicated by chronic require treatment in the hospital.
In the chronic inflammation of the synovial bags, surgery is indicated. The surgeon examines the joint of the capsule, removal of adhesions and growths inside of her, after which the cavity is washed with antiseptic solution, simultaneously prescribe antibiotics, anti-inflammatory and pain medications. The recovery process of movement of the joints can take several months.
Surgery of the disease of the big toe is carried out in cases where other treatment options have failed, the pain in the joint does not give a complete move or a fixed deformity of the foot, which prevents walking. Also, the operation is assigned in cases in which the disease becomes chronic.
Before the surgery the doctor assesses the General physical condition of the patient, the condition of the feet, x-rays, venous and arterial circulation. It's also worth bearing in mind the possible complications that may accompany a postoperative period. This is the development of tumors, infections, occurrence of bleeding, displacement or shortening of the tip of the recurrence of the inflammation. The group of risk includes patients who have poor health, insufficient or excessive diet, have diabetes, smoke or abuse alcohol.
Before the surgery will General anesthesia or with local anesthesia, depending on the complexity of the patient's condition. After the anesthesia, the doctor examines the whole of the capsule near the big toe. Then delete the part of the phalanx (an osteotomy), the head is formed so that the falange was in the correct position. In severe cases, the maintenance and the formation of the bone of the phalange is fixed pins surgical steel. Then, the wound is sutured and it is in the armband. In General, the operation lasts 30-120 minutes, depending on the complexity of the case.
Surgery of the disease of the big toe that allows you to restore joint mobility and reduce the pain when walking. Complete recovery occurs within 8 weeks after the surgery.
Prevention of the disease of the big toe applies to almost all – in the pursuit of fashion, shoes, not all the attention on your comfort. Heel shoes, shoes with a toe-shaped, with frequent door, contributes to the deformation of the bones of the foot. The pressure on the big toe joint is constantly maintained, which leads to the formation of calluses and changing the position of the phalanges. In addition, the compensation is to bother to go, there is a sharp pain in the foot joint.
To avoid the development of the disease of the big toe, you have to choose comfortable shoes, especially if on duty, has to spend much time in standing position. In extreme cases, have a replacement set of shoes with a wide toe box. It is also useful to massage the feet, in particular, massage the big toe joint. If the fact of inflammation is confirmed, you must leave immediately the strait of shoes and wear special retainer-gasket. The retention is placed between the first and second fingers, which makes the first phalange to change the position and makes the load on the joint of the capsule is much smaller, and also reduces the pain when walking.
Prevention of the disease of the big toe and its timely detection to provide early, take control of the development of the disease, and avoid surgical intervention.
The prognosis of the disease of the big toe with timely diagnosis and treatment is favorable, but at a later time, when already formed deformation. This is dangerous because it can develop complications, such as arthritis, and this will lead to the limitation of joint and pain during movement. Arthritis leads to an alteration of gait and posture, and that will lead to inflammation of the overlying joints. In the case of the infection of synovial fluid through the wound channel in the region of the hinge joint, and the development of purulent diseases, the recovery process takes more time because you need surgery.
In severe forms of the disease of the big toe bone is carried out the reconstruction of the bones of the foot aimed at changing the position of the bones of the metatarsus and phalanges of the first toe. But this is an extreme method of treatment when other treatment options are ineffective.
Rely on the cane foot, the third week after the surgery, and the recovery of motor function occurs within 6-8 weeks. In 8-12 weeks the process of complete recovery has been completed, but we should not forget about preventive measures is to wear comfortable shoes with large toe box, to use the clamps, and special orthotics.