When it comes to a number of slow-moving conditions tied to aging or natural degeneration, watchful waiting is sometimes all that is recommended. The problem may not be symptomatic yet, or it may not seem to warrant a surgical correction at this time, so little is done for the problem. Unfortunately, watchful waiting may not be the best option if the problem progresses and becomes more challenging to treat down the road. Heading the issue off earlier may prove superior than watchful waiting with minor issues.
Big Toe Osteoarthritis Surgery
According to researchers out of Finland, that may be the case when it comes to big toe osteoarthritis. The team wanted to take a closer look at the treatment protocols for big toe osteoarthritis, a condition that affects roughly 8% of individuals over the age of 50. A fusion surgery is typically recommended when surgery enters the picture, but oftentimes patients are told to simply try to stay active and practice watchful waiting. Researchers wanted to understand if watchful waiting truly was helpful when it comes to pain management from the condition.
For the study, 90 individuals with big toe osteoarthritis were split into two groups, a watchful waiting group and a surgical correction group. At a one-year follow-up, surgery was significantly more effective than watchful waiting in reducing walking-related pain. Pain went down from a score of 6 (on a 0 to 10 point scale) to 1.3 in the surgery group. In the watchful waiting group, pain scores remained unchanged at 5.7. Perhaps most notably, by the end of the year, 64% of patients in the watchful waiting group had requested and received surgery.
“Fusion surgery has long been considered the standard treatment for osteoarthritis in the first metatarsophalangeal joint, but only now has it’s superiority over watchful waiting been demonstrated in a study from which reliable conclusions can be drawn,” said the study’s principal investigator, Lic Med, Mikko Miettinen from HUS.
Surgery is oftentimes viewed as a last resort, but perhaps it doesn’t have to be. If earlier surgery can deliver results, and if the alternative leads to a desire for surgery in about two-thirds of cases, then perhaps having the big toe joint surgically addressed sooner rather than later can provide optimal treatment results.
Of course, this is just one small study, and you’d be wise to have a conversation with an orthopedic specialist based on your specific toe concerns, but know that putting off surgery isn’t always the right answer, especially if surgery is likely in the cards eventually.
To learn more about big toe osteoarthritis or other conditions that affect the toes and feet, connect with Dr. Silverman and his team today!