When keen runner Kerry Potter got arthritis in her big toe (like Kate Winslet), she feared she’d have to hang up her trainers for good and never wear stilettos again. This is what got her back on track
The day after a friend's 40th birthday party, I didn’t just wake up with a hangover but an agonising, stabbing pain in my right foot. There was a small but deep cut on the knuckle of the big toe, although the pain felt much deeper down. I remembered taking off my heels at one point to dance – had I stepped on some broken glass, a shard of which was now lodged in my toe?
I saw various medical professionals over the coming weeks, explained my working theory, and ended up having (horrible) surgery to remove this mysterious foreign body. Except it wasn’t a foreign body at all. It was a tiny fragment of bone caused by osteoarthritis (OA), swimming around down there, intermittently knifing me.
An X-ray confirmed the diagnosis. I had big toe arthritis and it was in the left one too, albeit less advanced. Oh dear.
I now know that I am in good company at least. Kate Winslet, who is the same age as me, also suffers. At the start of an interview with Radio 4’s Woman’s Hour recently, the 47-year-old actress took her shoes off, telling the interviewer: “My feet hurt so much... I’ve got arthritis in my big toe. There are bits [of your body] that don’t do what you want them to do anymore.”
Despite the (admittedly microscopic) sprinkling of Hollywood glamour, OA is one of those slightly embarrassing, massively unsexy ailments that don’t exactly make for fun pub chat, especially if, like me, you consider yourself pretty fit. I am a keen (although snail-like) runner, having pounded the pavement three times per week for 25 odd years, with 10k races and half marathons aplenty.
“Isn’t arthritis for old people?” asked one friend. Fair enough, I thought so too until I got it. And it turns out that, like Kate and me, there are lots of midlife – and younger – people who also have it.
Does running cause arthritis?
That was my primary suspicion too. The idea of running causing OA is a common misconception though, apparently. Dr Fiona Watt, consultant rheumatologist, reader at Imperial College London and clinical spokesperson for the charity Versus Arthritis. is unequivocal: “Exercise is good for people with osteoarthritis and exercise in itself does not increase the risk of osteoarthritis and may even prevent it.”
My OA is likely caused by something less wholesome – years of careering around parties and nightclubs wearing silly shoes.
“Osteoarthritis of the first metatarsophalangeal joint, the base of the big toe, seems to be linked - at least in part - with shoe wear choices, particularly while younger,” says Dr Watt. “While some people get away with it, wearing high heels massively increases the load going through this part of the foot and this joint in particular. This almost acts like a repeated injury to the joint when we walk, increasing the risk of arthritis in this particular joint.”
What exactly is big toe arthritis?
Hallux rigidus is a type of OA that affects the big toe joint. OA happens when the cartilage, which acts as a smooth cushioning between your joints, degrades, causing inflammation and swelling. You can end up with bone rubbing on bone (as painful as it sounds) as well as those aforementioned osteophytes, which is when the affected bone has a weird growth spurt creating a little spur.
“Osteoarthritis is more common in women,” says Dr Watt. “And being post-menopause increases risks of symptomatic osteoarthritis, compared to someone who is premenopausal, although separating menopausal status from the effects of age and other life course/reproductive factors is sometimes difficult.”
OA often starts in your 40s - according to Versus Arthritis figures, 1 in 60 UK women aged 40 to 44 have an official diagnosis. In reality, it’s likely to be more. It’s more common in those with a family history of the condition (my mother and grandmother both suffered).
And elite sportspeople have a higher risk of OA, a fact “likely to be driven by the higher rate of joint injuries associated with high-level sport, compared to background population,” says Dr Watt. So, no, my friend, it’s not just for old people.
How to treat big toe arthritis
Having been referred by my GP, I saw an NHS podiatrist, who prescribed insoles to reduce the amount of stress on the big toes while walking. They made me feel a bit Forrest Gump and didn’t fit into my shoes, so I never wore them.
I then had a steroid injection in my right big toe. Cortisone can provide pain relief by reducing inflammation for up to six months. Taken aback by how painful the process was (fat needle + bony feet = aargh), I was mortified to find myself screaming the F word at the poor nurse trying to help me. Afterwards, the injection made absolutely no difference to the pain.
By this point, both big toes were exquisitely painful and swollen, and I had could barely bend either of them. I’d begun walking with a limp, could hardly run, was reluctantly regularly using Nurofen to ease the pain and had precisely two pairs of shoes I could still wear – my workout trainers and some Birkenstocks.
This was during lockdown so looking like a slob was acceptable but what would happen when I had to get back into proper shoes? Whenever I tried on even a very low-heeled pair, the pressure on my toes made me yelp. When you’re a 5’2 shorty, the prospect of never again being able to wear heels is an upsetting one.
Next stop, an orthopaedic surgeon. I had two options – fusion surgery (the remaining cartilage is removed and a plate inserted to stiffen the joint and thus reduce pain) or arthroplasty, which is joint replacement surgery. Fusion surgery felt like admitting defeat and the thought of never being able to bend my big toes again freaked me out. Joint replacements, the surgeon told me, have a ten per cent failure rate, last between five and 20 years (I’d assumed they’d be permanent) and each foot would need to be operated on separately. So, I was looking at, in total, a three-month period during which I wouldn’t be able to walk. I have two children and work full-time – how would that work? And the sour cherry on the cake – I may never be able to run again. Yikes. Back to the drawing board then…
All of the above, clearly, weren’t for me. But they may be for you. First stop is to get a GP referral.
What has helped me manage my OA
Having exhausted all the medical options, I needed to learn to manage it. It’s in my knees now too and I have a suspicion my hands might be next. The following things have worked for me over the last couple of years, but I emphasize again that these are obviously personal choices rather than professional advice.
By this point, both big toes were exquisitely painful and swollen, and I had could barely bend either of them. I’d begun walking with a limp, could hardl run, was reluctantly regularly using Nurofen to ease the pain and had precisely two pairs of shoes I could still wear – my workout trainers and some Birkenstocks.
Turmeric shots: The Turmeric Co’s Raw Turmeric & Ginger £31.50 for a 14-day supply
A daily shot of this has been a total game-changer. Within two months, the swelling had reduced so much that I could comfortably wear, all of my (flat and low-heeled) shoes again. I could also run up to 12km at a time without issue, which is plenty far enough for me. Brucey bonus: this golden potion also nixes my period pains and hangover headaches.
Each shot has 35g of raw turmeric, which contains curcumin, a polyphenol believed to help reduce pain and inflammation. It’s been used for thousands of years in Ayurvedic medicine. It’s blended with black pepper and flax oil, both of which help aid absorption. Do read the small print if you try turmeric shots – many on the market are mainly apple or orange juice, only containing a tiny amount of the good stuff. But here you get a bumper dose, for which I believe it’s worth forking out.
The Turmeric Co was founded by professional footballer Thomas Robson Kanu, former Premier League player and Wales international. When he was staring down the barrel of a career-ending knee injury at the age of just 15, his Nigerian father (whose own father was a naturopath who’d heal his fellow villagers) concocted a turmeric blend that had astonishing effects on his son’s condition. “It changed my life, it saved my career and it allowed me to play pain-free in over 400 games at the highest level in my sport,” says Robson Kanu. The company now partners with 50 different sports teams and bodies, including British Gymnastics and the English Institute of Sport.
Want to do your own research? Michael Mosley’s Just One Thing podcast recently looked at the potential benefits of adding curcumin to your diet, with Mosley interviewing a doctor currently running trials. Plus this study, published in the journal Clinical Interventions In Ageing, favourably compared curcumin with anti-inflammatory painkillers for reducing pain in knee arthritis sufferers.
Collagen supplements: Kollo £29.87 for a 14-day supply
This collagen supplement, which contains 10g of liquid marine collagen, has been a more recent discovery. Like many women, I initially took collagen for its visual benefits – thicker hair, plumper skin, stronger nails. But I’ve also noticed an improvement in my joint pain, especially in my knees. Again, read the small print on your supplement as many contain less than 10g but this is the amount normally recommended for joint pain, guidance that was informed by this study of 147 amateur athletes.
TV and radio presenter Jenni Falconer, a keen marathon runner, founded Kollo three years ago, having taken other collagen supplements for years and noticing the positive impact on her joints, despite the huge amount of miles she was clocking up. “We have a lot of customers with OA, who say Kollo has helped alleviate pain, including my mum,” she says. Falconer suffered a nasty running injury, gluteal tendinopathy, last year. “When I went for an MRI scan, despite my huge swollen backside, I was so happy to hear the doctor say, ‘How interesting - your joints are in great shape.’ I thought, ‘Hallelujah, that’s the collagen!’” Two months in, I’m similarly evangelical.
I know I can’t run on consecutive days anymore without pain, so I mix it up with weight-lifting classes and cardio boot camps. I’ve always done a lot of yoga and have learned to modify the poses that put too much pressure on my joints. If an upward-facing dog is too painful for my toes, for example, I just do a cobra instead.
CBD muscle balm: Holland & Barrett’s CBD Muscle Balm Extra £19.99 and finally being sensible about shoes
I’ve accepted that I’m unlikely to ever wear my spindly-heeled silver wedding day Louboutins again. I splurge on Nike Air Max 90s these days rather than ridiculous stilettos. On the odd night out when I want to wear heels, I rub Holland & Barrett’s CBD Muscle Balm Extra (£19.99) onto my big-toe joints, which takes the edge off the pain, and then rely on a couple of glasses of champagne to take my mind off things. I didn’t bother asking Dr Watt for her professional opinion on that one, funnily enough.
For more information on arthritis, see versusarthritis.org