I am often asked ‘what is the most common condition you see?’

To be honest it has to be plantar fasciitis, of which we have spoken about many times before. The second most common condition that graces Sussex Foot Centre is pain and swelling focal to the big toe joint. This joint is called the 1st, metatartoso-phalangeal joint. It sounds fancy but it isn’t! It’s the joint between the metatarsal and the phalanx, which put even simpler, is the toe. This joint takes a vast amount of load and if the foot is functioning properly can take three times our body weight through the joint.

There are many reasons why patients get pain and swelling on the big toe joint but many of them are still theories. These theories are heavily disputed and argued within the literature with no-one taking a prominent position.

The picture below shows the long bone as the 1st metatarsal and the phalanx, with a ‘black blob’ in the middle, this blackness is swelling and therefore inflammatory fluid. It is this that comes as a result of overload to the joint. In this example, the joint became overloaded as a result of the patient training for the London marathon.

Ultrasound showing selling on the big toe joint
Ultrasound showing selling on the big toe joint

But how do we treat it?

The best way to treat this condition is a good orthotic, in a good shoe. The idea is to take pressure away from the joint, this will be tried for a good few weeks. Should this fail, then a small injection of cortisone works very well.

I’ll keep you posted with how this Patient’s treatment continues…

If you have any questions or would like to book an appointment, get in touch with us on 01444 453874 or on our contact page!

Jonathan Collins Specialist Podiatrist

We are trusted by our clients

Amy's been extremely helpful, informative and lovely to talk to during my foot appointment the last few visits. 100% recommend their services.
Darryl Rebbetts
Darryl Rebbetts
26/10/2022
Have had scan and chiropodist treatments and both were carried out with care and I was informed what would be done. I would highly recommend the Sussex foot centre for treatments.
Sheila Stobbs
Sheila Stobbs
15/10/2022
I was misdiagnosed by my GP after injuring myself long distance walking. Now I not only know what's wrong with me, but also how to remedy it so I can walk again. Great attention to detail. Thank you 😊
Liz Platt
Liz Platt
09/10/2022
Fantastic experience with the whole practice, there’s no where I’d trust more. Originally I went to have one issue sorted out, and have found another to be dealt with alongside. A practice where you feel listened to and taken seriously. Thanks again!
Nikki Martin
Nikki Martin
07/10/2022
Had an appointment with Jon Collins about a sore heel. Had a scan on both heels, which was followed by a detailed analysis of the results and an explanation (in layman's terms) what the issue was. Very impressed with his knowledge, how it was imparted and happy with our agreed action plan.
Jonathan Whitnall
Jonathan Whitnall
25/09/2022
Over the last 4 years or so, I have visited a number of professionals including physiotherapists, chiropractors and osteopaths. I was experiencing recurring injuries in my left knee and hip from sports and from attempting to walk mid-distances. The pain was starting to flare in my back too. I was following the physiotherapists’ advice religiously and attending appointments regularly. However, the programme of exercises tended to make the pain worse rather than better. To add to my frustration, I was also misdiagnosed with a hip condition. In the back of my mind, I always felt there was something biomechanically incorrect in the way I move but I was reassured that was not the case until…..I booked an appointment with Jon at Sussex Foot Centre for a gait assessment. Jon quickly recognised the issue with my feet and their incorrect positioning. I was prescribed custom orthotics and after a few months of perfecting these, Jon then created my semi-permanent pair of orthotics. I have been walking further than I have done and am now back on the courts playing tennis, which I love, and never thought I would be able to do again. The whole team at Sussex Foot Centre are very helpful and efficient. My treatment is ongoing so as long as Jon is a podiatrist, I am his patient :) Thank you for everything!
Katherine Morley
Katherine Morley
22/09/2022
I had nail surgery last October and after all this time I can say it was worth it. Jon didn’t rush me into it and gave me all options available, in the end I decided to go for the surgery and Jon made it so easy and everything was explained to me before, during and afterwards. Any questions I had were always answered by Jon or one of his team and put my mind at rest (I’m a bit of a worrier). Can’t thank them enough for helping with something that I had tried to ignore for years.
Gavin Robertson
Gavin Robertson
01/09/2022
I highly recommend Sussex foot centre. I booked an appointment for the shoe insoles and Jon was very helpful and professional. He provided a great solution for me and I feel much better since I wear my new insoles. The entire team is also very nice and helpful with booking the appointments around my work schedule.
Michał Piotrowski
Michał Piotrowski
22/07/2022
After the NHS screwed up my ingrown toenail operation twice this year I decided to go private and it was the best decision. I was seen really quickly and toes healed within a couple of weeks, highly recommend sussex foot centre.
Lauryn Spink
Lauryn Spink
22/07/2022