Hallux Rigidus

Similar to a bunion, Hallux rigidus is a disorder of the big toe joint. It causes pain and stiffness in the joint, and with time, it gets increasingly harder to bend the toe. Hallux rigidus is actually a form of degenerative arthritis.

This disorder can be very troubling and even disabling since we use the big toe whenever we walk, stoop down, climb up or even stand. Many patients confuse hallux rigidus with a bunion, which affects the same joint, but they are very different conditions requiring different treatment.

What is Hallux Rigidus?

Hallux rigidus is a progressive condition, the toe’s motion decreases as time goes on. In its earlier stage, when motion of the big toe is only somewhat limited, the condition is called hallux limitus. As the problem advances, the toe’s range of motion gradually decreases until it can no longer move at all.

What causes Hallux Rigidus?

Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can leads to arthritis in the big toe joint. In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse, especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases, such as rheumatoid arthritis or gout.

Symptoms of Hallux Rigidus

Early signs and symptoms include:

• Bone spurs/ Bump on top of the big toe joint
• Pain and stiffness in the big toe when bringing the toe upward towards the nose
• Pain and stiffness aggravated by cold, damp weather
• Difficulty with shoes and certain activities (lunges, squatting, yoga poses)

What is the treatment for Hallux Rigidus?

Conservative treatments aim to prevent the progression of the deformity.  Early treatment may prevent or postpone the need for surgery in the future. Treatment for mild or moderate cases of hallux rigidus may include:

• Shoe modifications: Stiff or rocker-bottom soles may also be recommended.
• Orthotics: Custom orthotic devices may improve foot function.
• Medications: Oral anti-inflammatory drugs such may be recommended to reduce pain and inflammation.
• Injections: Steroid injections can reduce severe inflammation and pain almost immediately.

Do I need Surgery?

In most cases, surgery is the best way to eliminate or reduce pain. Several types of surgery are available for treatment of hallux rigidus. In selecting the procedure or combination of procedures for your particular case, Dr. Williams will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level and other factors. The length of the recovery period will vary depending on the procedure(s) performed.