Therapy of hallux rigidus

introduction

Hallux rigidus is an increasing wear and tear of the metatarsophalangeal joint of the big toe. Of the Articular cartilage wears out with age and causes pain, especially when walking and, if the disease is advanced, also at rest. Osteoarthritis can also be due to a rheumatic disease arise or form as a result of a misalignment of the joint. The pain can become one Loss of movement up to one Joint stiffening to lead. There are also signs of inflammation such as Redness and swelling on. Wearing shoes is becoming increasingly uncomfortable and can cause additional pain for the patient. The complaints are frequent worse in colder temperatures.

Conservative therapy

Conservative treatment has that Aim to stop the process from proceeding and finally to avoid osteoarthritis of the metatarsophalangeal joint of the big toe. The patient should be able to walk symptom-free for as long as possible.

A medical therapy with anti-inflammatory drugs intended inflammatory processeswhich can arise from the wear and tear of the cartilage coating of the joint, can be avoided or their progression can be stopped. Inflammation manifests itself as swelling, redness, overheating and pain in the affected joint. Medication can contain symptoms and prevent them from spreading to surrounding tissues. Various pain-relieving medications can be taken against the pain. Also Pain relieving and at the same time cooling ointments can be applied to the affected joint and relieve the discomfort.

Physical therapy measures aim to relieve pain and promote the healing process. With regular and professional use, they can give the patient symptom-free times and avoid chronic pain. Cold therapy in particular has proven to be a healing measure for inflammatory processes. In the case of cold applications in the form of ice and cooling compresses, it should be noted that the Skin not in direct contact with the cold stands. The cold can also cause burns, which can damage the blood vessels and the skin and are often noticed too late by the patient.

Various other options offer conservative treatment for hallux rigidus Injection method. Among other things, local anesthetics can be injected into the affected joint. They have a dampening effect on the nerve endings and significantly reduce pain, as pain is no longer transmitted via the nerves located there. The joint in question can eventually recover and the healing process is further promoted. Possible drugs that are suitable for injections are, in addition to conventional anti-inflammatory drugs, homeopathic drugs, cortex and hyaluronic acid. Inflammatory processes can be caused by using injections Orthokine be alleviated. Orthokines are the body's own hormone-like substances that counteract and stop inflammatory reactions. In inflammatory processes In joints, it is particularly important that the inflammation does not spread to the cartilage. The cartilage has a protective function and protects the bones from wear and tear. Orthokines can therefore also protect the cartilage coating on the joint surfaces from infection.

In addition to drug therapy, physiotherapy should also be carried out regularly. It is often necessary to relieve the pain beforehand so that the exercises can be carried out without pain. The goal of physiotherapy is to use targeted exercises to reduce the symptoms and, in particular, to keep the joint flexible. In the case of underlying rheumatic diseases in particular, it is particularly important to counteract a stiffening of the joint.

Operative therapy

If the conservative treatments are unsuccessful, the only option for the patient is often an operation to treat the hallux rigidus. There are different operations to treat the disease. she is depending on the extent of the discomfort and the age of the patient.

A Cheilotomy is performed when touching the metatarsophalangeal joint bony extensions have formed. As they can often be very painful, they are removed by surgery. This procedure can be performed when the joint is largely intact. The big toe can then be moved freely and without pain.
In addition, if the disease progresses and worsens, another operation can be considered, in which the joint will ultimately be replaced by a prosthesis can be replaced. However, this is only possible if the bone has not been manipulated too much beforehand.

Another method, the Osteotomy, the metatarsal is shortened. This relieves the stress on the joint surfaces and prevents hallux rigidus from progressing.

Another surgical treatment is that stiffening (Arthrodesis) of the metatarsophalangeal joint of the big toe. It is used in young and active people. The joint is stiffened so that the big toe positioned facing up inwards becomes. This enables pain-free unrolling and harmless strain.

Furthermore, there is also a endoprosthetic replacement possible. The joint of the big toe is similar to a knee joint prosthesis by a Metal prosthesis replaced. An intact and stable bone is a prerequisite for this surgical procedure. However, this operation is controversial. The big toe is exposed to great stress. Doctors therefore have to bear in mind that a prosthesis loosens after a short time and can in turn lead to subsequent problems.

insoles

Orthopedic aids such as insoles for hallux rigidus are used particularly often. The right footwear is particularly important in order to properly distribute the load on the damaged joint and thereby prevent the condition from worsening. The shoes should correspond to the shape of the foot and provide a good stable hold so that misalignments are not favored. At a present hallux rigidus can he stiffened front part of the shoe so that rolling does not cause pain for the patient and the joint is spared.

Additionally offer special insoles the possibility of relieving the big toe by strengthening it underneath and raising the joint. Special rubber inserts can be attached to the outside of the big toe and worn in the shoe without any problems. They absorb shocks and support the stability of the joint. Insoles are also prescribed after partial stiffening of the metatarsophalangeal joint of the big toe so that it is immobilized and the load is redistributed. They have a plantar flap that sits under and supports the big toe. The Insoles are specially made from a footprint and aligned in such a way that they can really develop their effect and significantly alleviate the patient's symptoms.