What is Hallux Rigidus?

Hallux rigidus—also known as its primary symptom,“stiff big toe”—causes a tear or stretching in the soft tissue of the big toe joint, and worn out cartilage. This progressive condition most commonly occurs in people between the ages of 30-60. In athletes, it is referred to as “turf toe.”

What Causes Hallux Rigidus?

This condition is technically a form of degenerative arthritis. It can be caused by a number of factors:

• Sports injuries. In some athletes, Hallux rigidus can be caused by repeatedly jamming or pushing off forcefully from the big toe (as in sprinting or jumping), by making sudden movements while running, or by forcefully stubbing the toe.
• Wear and tear. The articular cartilage in the big toe joint can get damaged over time through normal use, or by stooping or squatting excessively while working.
• Improper foot alignment. Genetic abnormalities in the structure of the foot, or conditions that cause poor alignment (i.e., bunions, flat feet) can put undue stress on the big toe joint, causing it to stiffen and become painful.
• Arthritis. Hallux rigidus may be caused by inflammation in the big toe joint due to gout, osteoarthritis or rheumatoid arthritis.

Symptoms of Hallux Rigidus

Along with the big toe being stiff and painful while walking, running or jumping, other symptoms may include:

• Decreased motion over time
• Discomfort while wearing shoes
• A progressive worsening of symptoms which may even make standing painful.
• Cold, damp weather making stiffness & pain worse
• Swollen and painful toe joint
• Bumps, bunions or calluses forming on the top of the foot

Diagnosing and Treating Hallux Rigidus

Your podiatrist may diagnose your condition after a physical examination, a review of your medical history, testing to see how flexible your toe is, and an X-ray to check for bone spurs.

There are a variety of ways your podiatrist may try to treat hallux rigidus including urging you to refrain from activities that stress the toe joint, prescribing custom orthotics, making changes or modifications to footwear, physical therapy, nonsteroidal anti-inflammatory medications, and corticosteroid injections.

If more conservative approaches do not adequately improve symptoms and mobility, your podiatrist may suggest one of the following surgical procedures:

• Cutting the bone to realign or shorten the big toe (osteotomy).
• If a bone spur is present, shaving it can help improve joint motion, relieve pain, make room, and help the toe bend better (cheilectomy).
• Certain patients may be good candidates for a procedure that relieves pain by resurfacing the big toe joint to remove damaged bone and insert donor tissue between joint ends (interpositional arthroplasty).
• Removing damaged cartilage and fusing the joint may provide long-lasting pain relief in severe cases of hallux rigidus, however it may restrict movement in the big toe (arthrodesis).

With proper treatment, pain and inflammation can be reduced. It is important to discuss your condition and have it assessed by your podiatrist as soon as possible to discuss treatments and any potential risks.