Hallux Rigidus

Hallux Rigidus

Hallux Rigidus is just a big stiff toe that can’t bend as you try and push off. This leads to severe jamming and pain at the base of your big toe joint! Learn how to treat it here.

Hallux Rigidus
Big toe is beginning to lose or has lost motion.

What are the Symptoms of Hallux Rigidus?

  • Pain at the base of the big toe during walking.
  • A giant callus develops on the inside of the big toe joint.
  • Stiffness in the MTP joint.
  • Swelling and inflammation may be present.
  • As the condition progresses the patient may experience:
  • A considerable loss of motion in the MTP joint.
  • Pain even when resting.
  • Pain on touching the top of the joint.
  • Additional growths of bone may be felt here.
  • A limp.
  • Pains in the lower back, hips, or knees due to changes to walking patterns.

 

What is Hallux Rigidus?
The Hallux is the Latin word for the big toe and rigidus literally means rigid or stiff. The big toe is important in walking and running as it dorsiflexes (bends back) during the push-off phase of the gait cycle.

In Hallux Rigidus, the movement in the joint at the base of the big toe (the metatarso-phalangeal or MTP joint) gradually decreases. Initially the term Hallux Limitus is often used and the term rigidus is used in the later stages as movement becomes considerably reduced. It is a form of degenerative arthritis although is often initially confused with a bunion.

The condition can cause lots of further problems, especially with walking, as we require at least 60 degrees of dorsiflexion at the MTP joint for a ‘normal’ walking pattern. If this is not available, compensations are made elsewhere, for example the ankle, knee and pelvis.

 

What Causes Hallux Rigidus?

  • Hallux rigidus can be caused by either a truamatic injury, or through overuse.
  • Overpronation – increases the stress on the joint.
  • ¬†Repetitive weight bearing in a dorsiflexed position.
  • Traumatic injury such as stubbing the big toe which can cause chondral (cartilage) damage.
  • Hypermobile 1st metatarsal.
  • Rheumatoid arthritis.
  • Gout.

 

Treatment

  • X-rays may display degeneration and excess bone growth at the MTP joint.
  • Treatment is usually conservative, starting with a period of relative rest.
  • Anti-inflammatory medications may be prescibed, or a Corticosteroid injection may be administered.
  • Any contributing biomechanical factors such as overpronation should be corrected.
  • Physical therapy may be employed to try to increase the range of motion at the joint using mobilisations.
  • In extreme cases surgery may be required to remove the bony growth on top of the joint, or even a total arthroplasty (joint replacement) may be used.

 

Big Toe Joint Fusion

-This is the recommended surgery to permanently take care of your big toe joint pain.