What Is Hallux Rigidus?
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 troubling and even 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. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus. In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse, especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often must stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases, such as rheumatoid arthritis or gout. Your foot and ankle surgeon can determine the cause of your hallux rigidus and recommend the best treatment.
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)
Diagnosis
The sooner this condition is diagnosed, the easier it is to treat. Therefore, the best time to see a foot and ankle surgeon is when you first notice symptoms. If you wait until bone spurs develop, your condition is likely to be more difficult to manage.
In diagnosing hallux rigidus, the surgeon will examine your feet and move the toe to determine its range of motion. X-rays help determine how much arthritis is present as well as to evaluate any bone spurs or other abnormalities that may have formed.
Nonsurgical Treatment
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. Shoes with a large toe box put less pressure on your toe. Stiff or rocker-bottom soles may also be recommended.
- Orthotic devices. Custom orthotic devices may improve foot function.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Injection therapy. Injections of corticosteroids may reduce inflammation and pain.
- Physical therapy. Ultrasound therapy or other physical therapy modalities may be undertaken to provide temporary relief.
When Is Surgery Needed?
In some cases, surgery is the only way to eliminate or reduce pain. Several types of surgery are available for treatment of hallux rigidus. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level and other factors. The length of the recovery period will vary depending on the procedure or procedures performed.
FAQs
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 troubling and even disabling since we use the big toe whenever we walk, stoop down, climb up or even stand.
What is hallux rigidus foot health facts? ›
Hallux rigidus can be hereditary, but often it is caused by repetitive stress from the workplace or some sports. Workers who are required to stoop a lot, golf and tennis players are more prone to developing hallux rigidus. It can also stem from an injury like a severe stubbed toe.
What is the best treatment for hallux rigidus? ›
Arthrodesis (fusion)
In this procedure, the damaged cartilage is removed, and the two bones of the joint are fixed together with plates and screws to allow them to heal together. This procedure removes all remaining motion from the big toe joint. Fusion is very reliable at eliminating pain permanently from the joint.
What is the new treatment for hallux rigidus? ›
New Technology in the Treatment of Hallux Rigidus with a Synthetic Cartilage Implant Hemiarthroplasty.
Does hallux rigidus ever go away? ›
Surgery is usually the only way to permanently get rid of hallux rigidus. But most people with hallux rigidus are able to find a combination of nonsurgical treatments that manage their symptoms.
What aggravates hallux rigidus? ›
In other cases, it is associated with overuse, especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often must stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe.
Is walking bad for hallux rigidus? ›
Walking, provided it is not too painful to do and can be done with proper alignment, also assists with improving the toe range of motion. Walking uphill is particularly helpful for the big toe joint range of motion but for many patients this is too painful and cannot be done for a while until the joint pain settles.
How to reverse hallux rigidus? ›
Cheilectomy is the treatment of choice for early stages of hallux rigidus. It is a relatively simple procedure that preserves 1st MTP joint motion, allowing for faster return to daily activities.
What is the best exercise for hallux rigidus? ›
Hallux Rigidus Treatment Exercises
- Toe Pulls. These will help stretch your big toe and increase your mobility so you can hold a typical walking pattern. ...
- Extension Stretches. This will help in cases of stiffness in the big toe. ...
- Towel Curl. ...
- Toe Press, Point, and Curl. ...
- Toe Salutes.
Wearing a shoe with a large toe box will reduce the pressure on the top of the toe. High heels are not recommended. Your doctor may suggest that you get a stiff-soled shoe with a rocker or roller bottom design.
Supplements such as glucosamine-chondroitin sulfate and some vitamins and minerals may also be helpful. Injection therapy. Injections of corticosteroids in small amounts are sometimes given in the affected toe to help reduce the inflammation and pain.
Is hallux rigidus surgery worth it? ›
This condition worsens over time, resulting in increased pain and stiffness until treated. Many cases of Hallux Rigidus can be treated non-surgically, but surgery is usually recommended if the non-surgical treatments are unsuccessful or if the Hallux Rigidus is severe.
What can be mistaken for hallux rigidus? ›
The pain and deformity of hallux rigidus can clinically mimic hallux valgus, and the deformity of hallux valgus can result in arthrosis, similar to hallux rigidus.
What is end stage arthritis in the big toe? ›
End-stage arthritis of the first metatarsophalangeal joint (MTPJ) typically results in anexophytic process with marked limitation of motion. Pain may occur from the degenerative process itself and/or the bone spur formation that may become directly inflamed from shoe gear.
Does weight loss help hallux rigidus? ›
If you are overweight, then losing weight can help. This will reduce the stresses going through the foot. There are some excellent resources for losing weight here and advice on the best diet for those with arthritis.
Can you live with hallux rigidus? ›
Occasionally the condition begins in early life, even in the teens. The reason for this is unknown but it does not always get progressively worse. Many people can live comfortably with Hallux Rigidus for life. You do not need surgery if your foot is not painful.
What are the risk factors for hallux rigidus? ›
People in certain jobs or who participate in sports that place a lot of stress on the joint have an increased risk of developing the condition. Certain medical conditions. Osteoarthritis and inflammatory conditions, such as rheumatoid arthritis and gout, can cause hallux rigidus.
What is hallux rigidus patient info? ›
Hallux rigidus is the most common degenerative disorder of the foot and it is one of the most common causes of forefoot pain. Most cases are bilateral and many have a family history. Women are affected more often than men. It most commonly presents after the age of 40 years, although it can occur at young age.
How do you treat hallux rigidus naturally? ›
Hallux Rigidus Treatment Exercises
- Toe Pulls. These will help stretch your big toe and increase your mobility so you can hold a typical walking pattern. ...
- Extension Stretches. This will help in cases of stiffness in the big toe. ...
- Towel Curl. ...
- Toe Press, Point, and Curl. ...
- Toe Salutes.
The main advantage of this procedure is that it is a permanent correction with elimination of the arthritis and pain. The major disadvantage is the restriction of movement of the big toe.
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.
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. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus. In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse, especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often must stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases, such as rheumatoid arthritis or gout. Your foot and ankle surgeon can determine the cause of your hallux rigidus and recommend the best treatment.
