What is the best treatment for hallux rigidus?
Which treatment you’ll need depends on the severity of your symptoms and what caused hallux rigidus. Your provider might suggest:
- Footwear changes: Wearing shoes that have plenty of room for your toes can relieve pressure on your MTP joint. Shoes with stiff soles relieve pain. Avoid wearing high heels or shoes that squeeze your toes (have a small toe box).
- Limiting your toe movement: Your provider may recommend over-the-counter (OTC) pads that you can put in your shoe to support your big toe and limit its movement. You might need to avoid activities that stress your toe joint, like running or playing sports.
- Pain relievers: Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) can relieve pain and reduce swelling. Don’t take NSAIDs for more than 10 days in a row without talking to your provider.
- Icing: Applying ice or cold packs to your affected toe can relieve your symptoms. Wrap a cold pack in a thin towel to avoid putting it directly onto your skin. Ask your provider how often (and for how long) you should ice your toe.
- Corticosteroids: Corticosteroids are prescription medications that reduce inflammation. You may need cortisone shots injected directly into your big toe joint.
- Foot soaks: Your provider might suggest soaking your feet in a contrast bath, switching between hot and cold water to relieve inflammation. Place your foot in hot water for 30 seconds, then right away in cold water for 30 seconds.
Will I need surgery for hallux rigidus?
Most people don’t need surgery to treat hallux rigidus. Your provider might suggest surgery if other treatments don’t relieve your symptoms, or if the hallux rigidus makes it hard (or impossible) to participate in your daily routine.
Surgical procedures for hallux rigidus include:
- Cheilectomy (kie-LEK-toe-me): A cheilectomy gives your toe more room to bend. Your surgeon will shave down any bone spurs or growths on your MTP joint to relieve pain and help your joint move better.
- Osteotomy: Your surgeon will cut your toe bones to realign or shorten your affected big toe.
- Arthroplasty: An arthroplasty is a joint replacement. Your surgeon will remove the damaged bone in your MTP joint and replace it with a “spacer” of donor tissue between the joint ends.
- Arthrodesis: An arthrodesis is a joint fusion. Your surgeon will remove damaged cartilage and join the bones in your joint together. This surgery offers a permanent solution but may restrict how much you can move your big toe.
Hallux rigidus surgery complications
Complications from hallux rigidus surgery are rare, but they can happen. The most common complications include:
- Infection.
- Joint stiffness.
- Arthritis progression (getting worse).
- Misshapen toe recurring (coming back).
- Long-term swelling.
How long does it take to recover from hallux rigidus?
How long it takes to recover depends on which treatments you need and how severe the hallux rigidus is. Treatments like switching shoes and wearing toe pads might be all you need to relieve your symptoms. If that’s the case, you should be able to return to your usual routine as soon as your provider says it’s safe.
If you need hallux rigidus surgery, your recovery time will depend on which procedure your surgeon performed:
- Cheilectomy and arthroplasty: You’ll wear a special shoe for about two weeks before returning to regular footwear. Swelling may last for a few months.
- Osteotomy: Swelling should go down in six to eight weeks. Complete healing can take up to three months.
- Joint fusion: You’ll wear a cast or boot for three to six weeks. Then you’ll need crutches for a few weeks. You may have some swelling and stiffness for a few months after the procedure.
FAQs
Hallux rigidus (stiff big toe) occurs when the joint at the base of the big toe stiffens. It is the most common arthritic condition in the foot and can make walking painful and difficult. Hallux rigidus usually develops in adults between the ages of 30 and 60.
How do I get rid of hallux rigidus? ›
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.
How do I know if I have hallux rigidus? ›
Early signs of hallux rigidus include pain and stiffness in the big toe joint during use, such as walking or exercising, especially as the foot rolls forward to push off.
What happens if hallux rigidus is left untreated? ›
Hallux rigidus is a progressive disease, so it gets worse without treatment. That means not only causing ongoing foot problems — eventually, you're unable to wear shoes, stand, or walk — but also affecting other parts of your body.
What is the most common procedure to treat hallux rigidus? ›
Arthrodesis. Fusing the bones together (arthrodesis) is often recommended when the damage to the big toe's cartilage is severe. During arthrodesis, your doctor will remove the damaged cartilage and use pins, screws, or a plate to fix the joint in a permanent position.
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 do you fix hallux rigidus at home? ›
Can I treat hallux rigidus at home?
- Apply cold and heat several times a day.
- Soak your feet, alternating between cold and warm water.
- Take nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil).
- Avoid high-impact activities, such as running.
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 kind of shoes are good for hallux rigidus? ›
Shoes with a rocker sole (ie Hoka and Nike Zoom Fly) are better for forefoot problems, especially big toe arthritis (Hallux Rigidus), neuromas and midfoot arthritis.
Does stretching help hallux rigidus? ›
Exercises can help with arthritis in the big toe because they increase range of motion and strength. Stretching and strengthening exercises can also help your toes become more flexible and relaxed, effectively reducing stiffness and risk of injury and improving joint function.
After surgery, you will likely experience some throbbing pain, although this can be managed by either prescribed or over the counter painkillers. You will experience some swelling, but elevating the foot whenever possible in the first week following surgery will help alleviate this.
Are compression socks good for hallux rigidus? ›
This provides additional cushioning for the foot and supports it with every step. For people who have hallux complaints and wear medical compression stockings, there are special versions, such as those with a hallux relief zone.
Can a podiatrist treat hallux rigidus? ›
If a diagnosis of hallux rigidus is made your podiatrist will then discuss treatment options with you. The aim of treatment for hallux rigidus is to reduce pain, as well as to improve the function of the big toe joint so that everyday activities such as walking become easier.
What is the new treatment for hallux rigidus? ›
Synthetic cartilage implant surgery is an excellent option for the patient with great toe arthritis and good alignment of the toe who wishes to retain first metatarsophalangeal motion and obtain 90% improved pain relief and function.
Are you put to sleep for hallux rigidus surgery? ›
You may be put to sleep with anesthesia, or may be given only a localized injection to numb your foot for surgery. Then your surgeon will make a tiny incision over the top of your big toe. This incision will allow your surgeon to remove the excess bone that is causing you pain and that has blocked your joint.
What type of doctor treats hallux rigidus? ›
The board certified and fellowship-trained doctors at Orthopedic Specialists will carefully evaluate your toe. X-rays can help identify arthritic changes within the joint to confirm the diagnosis.
Can big toe arthritis be reversed? ›
Big toe joint arthritis is a progressive condition that gets worse over time and treatment outcomes are significantly improved if medical evaluation is sought when symptoms first start. In many cases, symptoms of big toe joint arthritis can be successfully treated or managed long-term with nonsurgical methods.
Is surgery necessary for hallux rigidus? ›
There are both surgical and nonsurgical treatment options available for Hallux Rigidus, but non-surgical treatments are recommended first. Surgical treatments are only recommended if non-surgical treatments are unsuccessful or if the Hallux Rigidus severe.
