Hallux Rigidus

Stiff Big Toe

What could be my problem?

Most common site of arthritis in the foot is at the base of the big toe, the metatarsophalangeal or MTP joint.  If the joint starts to stiffen, walking can become painful and difficult, and this is known at Hallux Rigidus.

What causes Hallux Rigidus?

  • Wear and tear or injury damage the articular cartilage and the raw bone ends of the MTP joint rub together
  • A bone spur or overgrowth develops on the top of the bone. This overgrowth can prevent the big toe from bending as much as it needs to when you walk.
  • Injury to the toe that damages the articular cartilage differences in foot anatomy that increase stress on the joint

When to see a foot pain doctor about Hallux Rigidus:

  • Pain in the joint when you are active, especially as you push off the toes when you walk
  • Swelling around the joint
  • A bump, like a bunion or a callus, that develops on the top of the foot
  • Stiffness in the great toe and an inability to bend it up or down

If I have Hallux Rigidus, what are my toe pain treatment options?

Non-Surgical:

  •   Over the counter pain relievers and anti-inflammatory medications
  •   Cold therapy
  •   Contrast baths

Surgical:

  • Cheilectomy:  when damage is mild or moderate.  An incision is made on the top of the foot. The bone spurs, as well as a portion of the foot bone, are removed so the toe has more room to bend.
  • Arthodesis: when damage to the cartilage is severe fusing the bones together is often recommended.  The damaged cartilage is removed and pins, screws or a plate are used to fix the joint in a permanent position.  Gradually the bones grow together.  This type of surgery means you will not be able to bend the toe at all, however, it is the most reliable way to reduce pain in these severe cases.
  • Arthoplasty:  older patients who place few functional demands on the feet may be candidates for joint replacement surgery.  The joint surfaces are removed and an artificial joint is implanted. This procedure may relieve pain and preserve joint motion.