How Rheumatoid Arthritis Causes Trigger Toe - Symptoms and Treatment

Trigger Toe: A Lesser-Known Symptom of Rheumatoid Arthritis' Progressive Damage

Rheumatoid arthritis patients know all too well how the disease causes swollen, painful joints over time. But some may not realize that RA can also affect smaller joints like those in the hands and feet, leading to a condition called trigger toe.

Trigger toe stems from the same mechanisms as the more widely recognized trigger finger. Just as injury and inflammation constrict tendons in the hands, the toes can develop nodules that catch or “trigger” during bending. For those with RA, trigger digit issues often arise as one of the many progressive symptoms.

Let’s explore what causes trigger toe, how it relates to RA disease activity, and ways patients can seek diagnosis and relief for this aggravating complication. Understanding trigger toe provides one more reason to stick with RA treatments and protect the joints from irreversible damage.

What Is Trigger Toe?

Trigger toe refers to a catching or locking sensation when bending one of the toes. It stems from a nodule or thickening that forms in the tendon sheath, constricting tendon gliding.

As with trigger finger, sudden stopping of the tendon causes pain and difficulty moving the affected toe. Triggering often happens when walking or standing up. Some also feel soreness or stiffness at rest.

While trigger digit issues most often strike the thumb, middle, and ring fingers, they also frequently affect the second and third toes. The abnormal bump puts pressure on surrounding nerves as well, amplifying discomfort.

Trigger Toe and Rheumatoid Arthritis

For rheumatoid arthritis patients, inflammation within the joint linings (synovium) prompts a cascade of immune reactions. This leads to swelling, stiffness, and damage to cartilage and tendons over time.

Erosion of bone and cartilage in the feet combined with synovial proliferation in the toes contributes to trigger digit formation. Nodules grow in areas of repeat friction and inflammation.

Those living with RA face higher risks for developing trigger toe, especially with moderate to severe disease activity. Triggering andLocked joints signal that treatment escalation may be needed to prevent irreversible joint changes.

Warning Signs of Trigger Toe

How can you tell if toe triggering and stiffness is setting in? Warning signs include:

• A popping, clicking or catching feeling when bending the toes
• Pain and soreness when walking or moving the feet
• Swelling, redness or nodules on the tendons
• Toes stuck in a bent or straight position
• Numbness or tingling in the affected toes
• Trouble fitting into shoes due to swollen toes

Prompt attention at the first symptoms of trigger toe is advisable, as prolonged issues can worsen pain and mobility. Catching it early provides more options for effective conservative treatment.

Diagnosing Trigger Toe

To diagnose trigger toe, rheumatologists will first perform a physical exam of the feet. They will check for areas of swelling, test toe bending and extension, and identify any nodules along the tendons.

Applying light pressure to feel for clicking or triggering helps pinpoint involved tendons. Doctors also assess for pain, stiffness, and loss of flexibility indicative of synovitis.

If the cause is uncertain, doctors may run imaging tests like ultrasound or MRI scans to visualize soft tissue structures in the foot. This helps differentiate inflammatory arthritis from other possible causes of triggering.

Treating Trigger Toe in Rheumatoid Arthritis

Trigger toe arising from RA inflammation should be treated as a sign of active disease requiring management change. DMARD medications may need adjusting to reduce joint swelling and damage.

For immediate relief, splinting or taping the toe to limit motion can help calm symptoms. Custom orthotics absorb pressure on tender spots to ease friction and irritation. Steroid injections directly into the tendon sheath reduce inflammation.

Topical anti-inflammatory gels, mild pain medication, and physical therapy exercises to stretch the toes and feet also aid recovery. Padded toe separators realign the digits to prevent rubbing and aggravation.

When Is Surgery Needed for Trigger Toe?

In some instances, trigger toe requires surgical release if conservative treatments fail to provide lasting relief after several months. Surgery typically involves:

• Local anesthetic
• Incision to access the inflamed tendon/tendon sheath
• Removal of any nodules
• Release of constricting tendon pulleys
• Irrigation to reduce swelling and scar tissue

Recovery takes approximately 4-6 weeks with weightbearing restrictions. Physical therapy then helps regain flexibility and strength. Prompt surgery when conservative treatment fails prevents worsening damage.

Preventing Trigger Toe Through RA Disease Control

The key to avoiding trigger toe lies in keeping rheumatoid arthritis inflammation at bay before it can affect the intricate joints of the feet.

DMARDs and biologics work systemically to control immune overactivity. But local therapies directly targeting foot pain also help. Custom orthotics, shoe inserts, toe spacers, and kinesiology tape protect vulnerable pressure points.

Along with medication adherence, losing weight, regular exercise, and supportive footwear minimize friction and force on the toes. Staying vigilant through rheumatology check-ups ensures any flares get addressed before triggering sets in.

While trigger toe can feel like just another RA complication, it signals disease progression requiring action. Prompt treatment provides the best chance of resolution and lasting mobility.

Don't Ignore Triggering as "Just Part of RA"

For those living with rheumatoid arthritis, it's easy to dismiss minor swelling or pain as normal effects of the condition. But seemingly small symptoms like trigger toe can have an outsized impact on quality of life.

Triggering and stuck toes make walking difficult and painful. And without treatment, the situation tends to get worse over time as RA gnaws away at the joints.

Being proactive with prompt care maximizes the chances of overcoming trigger toe before permanent joint changes develop. Staying on top of RA management protects mobility and keeps activity possible even with the disease.

While trigger toe may fly under the radar, recognizing it early and taking action provides one more way to defy rheumatoid arthritis from further restricting daily life.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.