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Hallux Rigidus

What is Hallux Rigidus?

Hallux rigidus is stiffness of the big toe. This occurs as a result of osteoarthritis affecting the metatarsophalangeal (MTP) joint, which connects the metatarsal bone in the forefoot to the phalanx bone in the big toe. The MTP joint plays a major role in the foot—when walking, approximately 50% of your body's weight is supported by the MTP joint.

Injury to the joint due to osteoarthritis results in a stiff big toe that affects movement. Patients with hallux rigidus have trouble while walking, exercising, and in severe cases, daily activity and quality of life can be severely impeded and impossible.

What Are the Causes of Hallux Rigidus?

Hallux rigidus can be caused by acute injury. However, for most patients, it occurs as a result of degenerative arthritis, which causes wear and tear to the joint. Ultimately, patients are unable to bend their big toe and experience stiffness and rigidity.

Hallux rigidus can also occur due to:

  • playing sports on artificial surfaces, leading to "turf toe"
  • gout
  • congenital disabilities of the foot
  • stubbing or breaking of the toe
  • ballet — repetitive use of positions that cause the MTP joint to flex at a 90-degree angle

What Are the Symptoms of Hallux Rigidus?

(3) Symptoms of hallux rigidus include:

  • pain, especially while wearing high heels
  • inability to bear weight
  • stiffness and inability to bend toe
  • reduced range of movement
  • swelling
  • inflammation
  • redness

What to Expect During Treatment for Hallux Rigidus at the Podiatrist

Diagnosis of hallux rigidus at the podiatrist begins with a thorough foot exam, medical history, and evaluation of your current lifestyle. MRIs and X-rays may also be required to check for the presence of cartilage degeneration of the MTP joint.

Treatment is individualized and differs from one patient to the next, mainly depending on the severity of symptoms of hallux rigidus experienced. It can include:

  • practice of RICE (rest, icing, compress, and elevation) protocol
  • cortisone injections to reduce inflammation
  • custom-fitted orthotics and shoes with a wide toe box
  • avoid high heels
  • ultrasound therapy and physical therapy for pain relief and reduction of stiffness
  • reduce high impact sports
  • surgery—only if other forms of treatment have not worked. The two most common procedures are:
    • cheilectomy—removal of bone spurs in MTP joint
    • arthrodesis—joint fusion

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