Hallux rigidus is the most common arthritic condition of the foot and second only to hallux valgus (bunions) as a condition associated with the big toe. ‘Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move.
This condition occurs at the base of the big toe in an area known as the metatarsophalangeal (MTP) joint. Because of the mechanics of our feet, this joint is especially prone to developing arthritis.
Hallux rigidus typically develops in adults between the ages of 30 and 60 years and is far more common among females than males. This disorder can be very difficult to live with as the big toe is used whenever we walk, stoop down, climb up, or even stand.
In its earlier stages, when motion of the big toe is only somewhat limited, the condition is called “hallux limitus.” As the condition progresses, however, the toe’s range of motion gradually decreases until it potentially reaches the end stage of “rigidus,” in which the big toe becomes stiff, or what is sometimes called a “frozen joint.”
Symptoms
– Pain in the big toe joint while active, especially when pushing off to walk.
– Inability to bend the toe up or down.
– Swelling and inflammation around the MTP joint.
– The development of spurs or bunions.
– Calluses from the abnormal shape of the toe.
Diagnosis
The sooner this condition is diagnosed, the easier it is to treat. In most cases, the diagnosis of hallux rigidus can be made by a physician on physical examination alone. The MTP joint will be examined by moving it up and down to see how much motion is available without pain. In order to fully understand the extent of the joint damage, an X-ray may also be performed.
The best time to see a foot and ankle surgeon is when you first notice symptoms. If you wait until bone spurs develop, your condition is likely to be more difficult to manage.
Non-Surgical Treatment
Non-surgical treatments can help decrease the symptoms of hallux rigidus, but do not stop the condition from progressing.
These treatments include:
– Wearing shoes with a large toe box in order to put less pressure on your toe.
– In order to get the best fit possible, a podiatrist may recommend a custom-made orthoic device. Orthopedic devices are made of lightweight materials that range in complexity from simple shoe inserts bought over-the-counter to custom-made devices that require impressions, casting, and computer technology to create.
– Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
– Injections of corticosteroids may reduce inflammation and pain.
– Ultrasound therapy or other physical therapy modalities may provide temporary relief.
When is surgery needed?
Surgical treatments for hallux rigidus are determined by the failure of non-surgical treatment and the extent of arthritis and deformity of the toe.
Surgery is sometimes the best treatment for hallux rigidus, especially if the more conservative measures are not working for you. The two most common surgical procedures are a cheilectomy or an arthrodesis.
A cheilectomy involves shaving the bone spur on top of the metatarsal, allowing for more room for the toe to bend and alleviating the pain caused when pushing off the toe. The advantages of this procedure are that it is joint sparing, preserves joint motion and maintains joint stability.
With an arthrodesis, the damaged cartilage is removed and the two bones are fixed together with screws and/or plates to allow for them to grow together. The main advantage of this procedure is that it is a permanent correction with elimination of the arthritis and pain.
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The content on this website is for informational purposes only. Do not rely or act upon information from www.DelrayBeachPodiatry.com without seeking professional medical advice. If you live in South Florida and would like a consultation with Dr. Ian Goldbaum, a podiatric physician and surgeon with over 30 years of experience, please see our contact information below:
BOCA/DELRAY
16244 S. Military Trail #290, Delray Beach, FL 33445
561-499-0033
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