Hallux rigidus, meaning "stiff big toe," is a type of degenerative arthritis affecting the joint located at the bottom of the big toe (the metatarsophalangeal joint). This condition causes the joint to stiffen and become painful, eventually making it difficult to walk, stand up, bend, squat or run. Hallux rigidus may occur as a result of structural abnormalities, heredity, traumatic injury, or underlying disease conditions, such as rheumatoid arthritis or gout.
As in other forms of arthritis, the affected joint becomes inflamed and may be more painful in cold, damp weather. Hallux rigidus is often accompanied by a bunion on the top of the foot, making shoes uncomfortable to wear. As the condition worsens, patients may experience aching or pain in the knee, hip of lower back. Hallux rigidus is diagnosed through the taking of a medical history, physical examination and X-rays.
Nonsurgical Treatment for Hallux Rigidus
There are several treatment options for hallux rigidus, depending on the severity of the condition and the patient's mobility issues. Nonsurgical treatments include:
- Avoiding activities that cause pain, such as running
- Wearing roomier or customized shoes
- Wearing shoe pads to limit the motion of the big toe
- Wearing orthotics
- Taking over-the-counter anti-inflammatory medications
- Engaging in physical therapy
- Receiving corticosteroid injections
When these conservative methods are insufficient to provide relief, surgical intervention may become necessary.
Surgical Treatment for Hallux Rigidus
In situations where refraining from designated activities is impossible long term, as in the case of professional athletes, and in cases where conservative methods are not sufficient to reduce pain and inflammation, surgery will be necessary. There are a few surgical procedures that may be performed to relieve hallux rigidus, depending on individual circumstances. These include:
- Cheilectomy, shaving the bone spur
- Osteotomy, cutting bone to realign the big toe
- Arthroplasty, resection of joint with or without implant (joint replacement)
- Arthrodesis, joint fusion
One or another of these surgeries may be more appropriate for particular patients because of the severity of their condition or because of their need to regain full mobility of the affected joint as well as to relieve pain.