What is hallux rigidus?

Hallux rigidus is arthritis at the base of the big toe, in a joint called the metatarsophalangeal joint (MTPJ). Like most joints, the ends of the bones are covered by smooth cartilage called articular cartilage. If this wears away, it can cause arthritis of the joint. A bone spur called an osteophyte can form, leading to decreased movement of the big toe. If all the cartilage wears way, it leads to the bone rubbing against the bone which can cause pain and stiffness.

Causes of hallux rigidus?

Hallux rigidus is most often caused by wear and tear over time, like most joint arthritis. There can be a genetic predisposition or an incidence of a previous injury, which can also contribute or accelerate the wear and tear.

Risk factors for hallux rigidus?

  • Poor foot alignment such as hallux valgus or flat foot
  • Traumatic injury to the big toe such as turf toe
  • Inflammatory conditions such as gout and rheumatoid arthritis

Symptoms of hallux rigidus?

  • Pain in the big toe joint (just at the base of the big toe), often during or after walking and activity
  • Stiffness of the big toe (harder to move it up and down)
  • Swelling around the big toe joint
  • A bump or deformity just at the base of the big toe

Diagnosis of hallux rigidus

Hallux rigidus can usually be seen on x-rays. In mild or early cases, an MRI may be required to help diagnose it.

Management and treatment of hallux rigidus

The aim of treatment is to relieve pain in the big toe. This can include:

  • Shoes: Shoes that have a wider toe box relieves pressure over the painful area. Shoes with stiff soles also help by limiting movement of the painful area during walking. Avoiding high heels will also help relieve pain.
  • Orthotics: A rigid big toe extension in the shoe or supporting padding may be available through the chemist or the podiatrist
  • Medications: Paracetamol and or ibuprofen (anti-inflammatory medications) can help with the pain during acute periods of pain
  • Injections: Steroid injections can provide relief from pain but does not change the underlying problem
  • Surgery: If the measures above are not helping with pain, surgery can be performed to help.

If you would like an opinion on this condition, please book an appointment with Dr Christy Graff.

Pre and post operative x-ray imaging of a patient who underwent surgery for treatment of hallux rigidus by Dr Christy Graff

Pre and post operative x-ray imaging of a patient who underwent surgery for treatment of hallux rigidus by Dr Christy Graff

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Foot Health Facts