Stiff Big Toe (Hallux Rigidus)

What is a Hallux Rigidus?

Hallux rigidus, also known as stiff big toe, is a form of degenerative arthritis causing pain and stiffness in the metatarsophalangeal (MTP) joint.

What are the Common Causes of Hallux Rigidus?

The 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. In the conditions of the foot such as flatfoot or excessive valgus at the ankle causes excessive force at the big toe and that leads to wear and tear in the joint. Other causes are gout, rheumatoid arthritis and other types of inflammatory arthritis.

What are the Symptoms of Hallux Rigidus?

Swelling
Pain and tenderness around the big toe
Turning of the big toe towards the adjacent toe
Change in the shape of the foot
A bony mass at the joint surface of the big toe
Pain and discomfort while walking
Restricted movements of the big toe

How is Hallux Rigidus Diagnosed?

Your orthopaedic surgeon diagnoses a Hallux Rigidus based on the following:

Medical history to rule out any diabetic conditions, hypertension, circulatory disorders
Physical examination to evaluate the nature of Hallux Vulgus
Foot or ankle X-rays to determine the bone and soft tissue damage.

What are the Conservative Treatments for Hallux Rigidus?

A Hallux Rigidus may be treated either by non-surgical or surgical methods.

The non-surgical treatment options include:

Medications to help alleviate pain and associated symptoms
Ice packs to reduce inflammation
Getting adequate rest
Wearing broad-toed shoes that fit properly to reduce the compression of the toes
Using bunion pads, cushions and splints to protect and alleviate painful foot bunions
Selecting properly fitted shoes that match the shape of your feet

What is the Surgical Treatment for Hallux Rigidus?

The surgical treatment for Hallux Rigidus varies based upon the severity of the condition. The minor problem requires debridement of the joint + cheilectomy (removal of the bony spur) and the severe problem requires fusion of the joint. The fusion surgery is very well tolerated and have excellent long-term outcomes.

Joint replacement surgery for the Hallux Rigidus is also an option but it requires very careful patient selection and adequate surgical planning.

What is the Prognosis for Hallux Rigidus?

Always try to take care of the Hallux Rigidus at the initial stage by wearing accommodative shoes. In a very few cases, post-surgical complications may interrupt the healing of the condition. If left untreated, it may cause bursitis, gait abnormalities, arthritis and other serious health problems.

How is Hallux Rigidus Prevented?

Avoid wearing poorly fitted shoes to prevent irritation and compression of the toes which may lead to the growth of a Hallux Rigidus