hallux rigidis

Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, and with time, it gets increasingly harder to bend the toe. Hallux refers to the big toe, while rigidus indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis.

This disorder can be very disabling since we use the big toe whenever we walk, stoop down, climb up or even stand. Many patients confuse hallux rigidus with a bunion, which affects the same joint, but they are very different conditions requiring different treatment.

Because hallux rigidus is a progressive condition, the toe’s motion decreases as time goes on. In its earlier stage, when motion of the big toe is only somewhat limited, the condition is called hallux limitus. But as the problem advances, the toe’s range of motion gradually decreases until it potentially reaches the end stage of rigidus, in which the big toe becomes stiff or what is sometimes called a frozen joint.

Causes

Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis—the kind that results from wear and tear—often develops in people who have defects that change the way their foot and big toe functions.

Symptoms

Early signs and symptoms include:

  • Pain and stiffness in the big toe during use (walking, standing, bending, etc.)

  • Pain and stiffness aggravated by cold, damp weather

  • Difficulty with certain activities (running, squatting)

  • Swelling and inflammation around the joint

     

As the disorder gets more serious, additional symptoms may develop, including:

  • Pain, even during rest

  • Difficulty wearing shoes because bone spurs (overgrowths) develop

  • Dull pain in the hip, knee or lower back due to changes in the way you walk

  • Limping (in severe cases)
     

Conservative measures

In many cases, early treatment may prevent or postpone the need for surgery in the future. Treatment for mild or moderate cases of hallux rigidus may include:

  • Shoe modifications.  Orthotic devices. Custom orthotic devices may improve foot function.

  • Medications. 

  • Injection therapy. 

  • Physical therapy. 
     

Surgery:

In some cases, surgery is the only way to eliminate or reduce pain. Several types of surgery are available for treatment of hallux rigidus. A comprehensive surgical plan would be made based on clinical exam, xrays, bone quality, lifestyle, and age. Feel free to discuss options with your doctor!

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