Toe osteoarthritis (metatarsal-phalangeal joint)

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How is MTP joint OA treated?

Non-surgical management

In the majority of cases, the symptoms of MTP joint OA can be managed effectively by non-invasive measures as described below:

Footwear. The most effective measure is wearing appropriate footwear including wearing wider fitting shoes.

Orthotics. Appropriately supportive insoles can improve symptoms.

Exercises. Regular exercises to maintain flexibility to the ankle and foot:

Using painkillers when needed. Over-the-counter analgesia is available through pharmacies when needed. Paracetamol is most commonly prescribed. Anti-inflammatories, such as Ibuprofen, can be used, but as there is little or no inflammation involved in osteoarthritis these are best avoided without discussing with your GP. Side effects are even more common than with paracetamol so please ensure to take appropriate medical advice. There is a good booklet on the Versus Arthritis website with information about the various drug options.

Corticosteroid injection therapy. For individuals with relatively early-stage MTP joint OA who continue to suffer disabling symptoms in spite of a course of other non-surgical measures as management (outlined above), or for patients who are unable to commence a supervised exercise program due to pain levels, a corticosteroid injection can may be offered as the next line of treatment. You can read more about local corticosteroid injections here.

Surgical management

MTP joint debridement, fusion or MTP joint replacement surgery can be effective options for patients with advanced-stage MTP joint OA who:

    • Have trialled a course of non-surgical management without success
    • Have consistent, disabling pain significantly limiting mobility
    • Have a satisfactory Body Mass Index (BMI) or have made lifestyle changes to lose excess bodyweight

It normally takes 6-8 weeks following foot surgery for patients to resume wearing normal footwear.