Hallux Rigidus (Stiff Big Toe)

Hallux rigidus, or stiff big toe, is a form of arthritis that causes pain and rigidity in the large toe. Doctors refer to your big toe as the hallux metatarsophalangeal (MTP) joint, and arthritis most commonly occurs in the MTP joint. When the MTP joint is affected by hallux rigidus, then walking, bending your toes, and doing other normal, everyday movements becomes painful and restrictive.

What You Need To Know About Hallux Rigidus

What Is Hallux Rigidus?

Hallux rigidus literally means "stiff great toe"; however, limited mobility in the big toe is only one symptom of hallux rigidus. Hallux rigidus encompasses mild to severe degenerative arthritis of the first MTP joint of the foot, which leads to pain and difficulty while walking.

Hallux Rigidus causes the cartilage around the MTP joint to deteriorate. Without protective cartilage, the bones in the foot begin rubbing together and sometimes create bone spurs.

Most commonly, 30-60 year old adults contract "stiff great toe." Though we know very little of why this affliction develops in 1 out of every 40 adults, physicians believe foot anatomy and other injuries increase the odds of developing hallux rigidus.

Finding hallux rigidus treatment starts with a visit to Resurgens Foot & Ankle Center. Schedule an appointment with one of our Metro Atlanta experts now!

What Causes Hallux Rigidus?

While physicians have not drawn specific conclusions on what causes this arthritis, most doctors believe the following factors affect the cartilage deterioration that leads to a stiff big toe:

  • Overuse: Our bodies put an excessive amount of weight and pressure on the big toe, causing it to weaken and sometimes disintegrate over time.

  • Foot injury: Stubbed toes or other joint injuries may lead to Hallux Rigidus.

  • Foot anatomy and heredity: Structural issues in the foot, either inherited or established with wear and tear, may place added stress on the MTP joint and damage the cartilage.

  • Excessive stooping and squatting: Motions or stances that overstretch or place too much pressure on the big toe may cause a breakdown in the soft tissues and protective cartilage safeguarding the foot joints.

Hallux Rigidus Symptoms

Symptoms of Hallux Rigidus range from mild to disabling. While most common in adults ages 30-60, adolescents with a history of previous foot trauma may also contract this condition. Schedule an appointment with a foot expert at Resurgens Orthopaedics if you experience any of the following symptoms:

  • Pain in the joint when you are active, especially as you push-off on the toes when you walk

  • Swelling around the joint

  • A bump, like a bunion or callus, that develops on the top of the foot

  • Stiffness in the great toe and an inability to bend it up or down

How is Hallux Rigidus Diagnosed?

An early diagnosis of hallux rigidus will improve your chances of restored mobility. To get started, a Resurgens Orthopaedics physician will ask about your medical history. Any previous foot injuries or structural issues in the foot should be shared with your physician.

After hearing about the occurrence of your injury and assessing the severity of your pain, your physician may test your range of motion by having you bend your toes up and down. They will observe your foot for any noticeable bone spurs or calluses caused by hallux rigidus treatment and they may require imaging tests, such as X-rays or MRIs, to detect the level of bone and tissue deterioration. These processes will ensure a proper diagnosis and provide insight into the best way to treat your stiff and aching toe.

Hallux Rigidus Treatment

Because stiff big toes can vary in severity, the level of treatment each patient needs also varies. Cases of hallux rigidus that were caught early might only require rest and stress relief for your feet, while most severe cases require surgery. At Resurgens Orthopaedics, we address each foot individually and create a customized plan to return motion and comfort to your foot.

Non-Surgical Treatment

When Hallux Rigidus is diagnosed early, patients may be able to avoid surgery. Some non-surgical treatments used to address early stages of Hallux Rigidus include:

  • Pain relievers and anti-inflammatory medications such as ibuprofen, which may help reduce the swelling and ease the pain.

  • Applying ice packs or taking contrast baths, which can moderate inflammation and other symptoms. This process involves bathing your feet for 30 seconds in ice water, then 30 seconds in hot water. Go back and forth for 5 minutes, ending with cold water.

  • Wearing a shoe with a large toe box reduces the pressure placed on the toe.

  • Your doctor may recommend that you wear a stiff-soled shoe with a rocker or roller bottom design and possibly even a steel shank or metal brace in the sole. This type of shoe supports the foot when you walk and reduces the amount of bend in the big toe.

  • Limiting physical activities, especially those that require up and down movement of the toes, will be a crucial method in your healing process.

  • Physical therapy relieves the stress in the other joints around the big toe, helping to reduce pain.

  • In severe cases, cortisone injections may help relieve swelling and intense pain caused by hallux rigidus.

Surgical Treatment

While non-surgical treatment relieves symptoms, some cases of Hallux Rigidus require surgery, and the most severe cases often require multiple surgeries.

For patients who require surgery, one of the following may be prescribed to repair your foot structure.

  • Cheilectomy: This procedure involves removing the bone spurs as well as a portion of the foot bone so the toe has more room to bend.

  • Arthrodesis - Fusing the bones together (arthrodesis) is often recommended when cartilage damage is severe. The damaged cartilage is removed and pins, screws, or a plate are used to fix the joint in a permanent position.

  • Arthroplasty - In select patients, the joint surfaces are removed and an artificial joint is implanted. This procedure may relieve pain and preserve joint motion.

The expert physicians and staff at Resurgens Orthopaedics provide a comfortable and welcoming environment for patients experiencing all types of orthopaedic conditions. We want to help you find stability and comfort in your everyday movements. Schedule an appointment today to learn more about hallux rigidus and to let us help you reach for more

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