The 26 Review
- What is Hallux Rigidus Arthritis of the big toe joint including bone spur formation and limited range of motion.
- Causes hereditary genes, trauma, poor shoe gear
- Symptoms pain, stiffness, redness and swelling, visible bump, limited range of motion in big toe
- Diagnosis physical examination and X-Ray imaging
- Treatment oral and topical anti-inflammatory medications, steroid injection, shoe modifications, orthotics surgery
Let’s take a closer look…
Hallux rigidus, also known as a stiff big toe or arthritic big toe, is a common condition that causes severe pain and discomfort to the joint at the base of your big toe. Hallux rigidus is characterized by pain, stiffness, swelling, and tenderness to touch of the big toe joint. This condition can prevent you from fully bending your big toe upward, which can make it difficult to get shoes on and off easily. It may also be difficult to walk normally because of the limited movement in your big toe joint.
This condition involves inflammation and extra bone growth of one or more joints in your big toe, which can be caused by either osteoarthritis or rheumatoid arthritis. Osteoarthritis develops gradually over time as a result of wear and tear on your joints sometimes as a result of trauma or based on the structure of your foot (genetics); rheumatoid arthritis occurs when your immune system attacks healthy tissue and joints. Both are treatable through a combination of lifestyle changes and medication prescribed by a doctor; however, if left untreated it can lead to permanent loss of flexibility in your joint.
There are many potential symptoms of hallux rigidus, including pain on or around your big toe joint, pain or stiffness when walking, soreness at night while lying down and decreased range of motion in your big toe. There is swelling in and around the big toe joint (with or without redness) and this is most noticed after extended time on your feet and at the end of the day. Additionally, bone spurs develop on the top and side of the joint, causing the joint to enlarge over time.
Most notable symptoms include:
- Pain in the big toe during use or activity
- Aggravation by cold, damp weather
- Decrease or lack of range of motion in the toe joint
- Swelling and inflammation
Physician clinical experience and x-ray are the primary ways this condition is diagnosed. X-rays will typically demonstrate enlarged bone formation and spurring on the top and side of the metatarsal associated with the great toe joint. In some cases, loose bone chips and fragments of bone may be seen floating within the joint. Additionally, there may also be wear patterns in your shoes and shoe inserts demonstrating breakdown of the shoe gear under the big toe.
Treatment For Hallux Rigidus
The treatment of hallux rigidus depends on its severity. In mild cases, oral and topical anti-inflammatory pain relievers and shoes with a wide toe box are sufficient to relieve pain. Properly placed cortisone injections by a foot specialist also work well in reducing chronic pain in the joint. Orthotics are highly recommended to stabilize the foot and reduce excess motion at the big toe joint. This aids in pain relief by reducing the amount of abnormal contact within the joint. In some cases, a medical grade over-the-counter orthotics can suffice, however, buyer beware as there are many useless shoe inserts readily available in the local store. We recommend this medical grade over-the-counter orthotic as a great start if you are suffering from pain in your great toe joint. In more severe cases of arthritis and joint breakdown, a prescription for a custom orthotic may be necessary. The custom orthotic is more specific to your arch structure and can have specific modifications included to further stabilize your big toe joint. Conservative treatment options such as these can work to help prevent Hallux Rigidus surgery such as Big Toe Joint: Joint Fusion and Big Toe Joint: Joint Replacement surgeries.
The sooner this condition is diagnosed, the easier it is to treat. If you experience any of the symptoms above, make an appointment at one of our locations. Our foot specialist will examine your feet and can discuss both conservative and surgical options. X-rays may be taken to help determine the severity of the joint disease as well as to rule out other abnormalities.