Hallux Rigidus

What is Hallux Rigidus

Hallux rigidus is a type of joint pain or joint disease (arthritis) that affects your big toe (hallux). This condition involves the joint that connects the base of your big toe to the main part of your foot (metatarsophalangeal joint).

This condition can cause your big toe to become stiff, painful, and difficult to move. Symptoms may get worse with movement or in cold or damp weather. The condition also gets worse over time.

What are the causes?

This condition may be caused by having a foot that does not function the way that it should or has an abnormal shape (structural deformity). These foot problems can run in families (be hereditary). This condition can also be caused by:

  • Injury.
  • Overuse.
  • Certain inflammatory diseases, including gout and rheumatoid arthritis.

What increases the risk?

This condition is more likely to develop in people who:

  • Have a foot bone (metatarsal) that is longer or higher than normal.
  • Have a family history of hallux rigidus.
  • Have previously injured their big toe.
  • Have feet that do not have a curve (arch) on the inner side of the foot. This may be called flat feet or fallen arches.
  • Turn their ankles in when they walk (pronation).
  • Have rheumatoid arthritis or gout.
  • Have to stoop down often at work.

What are the signs or symptoms?

Symptoms of this condition include:

  • Big toe pain.
  • Stiffness and difficulty moving the big toe.
  • Swelling of the toe and surrounding area.
  • Bone spurs. These are bony growths that can form on the joint of the big toe.
  • A limp.

How is this diagnosed?

This condition is diagnosed based on a medical history and physical exam. This may include X-rays.

How is this treated?

Treatment for this condition includes:

  • Wearing roomy, comfortable shoes that have a large toe box.
  • Putting orthotic devices in your shoes.
  • Pain medicines.
  • Physical therapy.
  • Icing the injured area.
  • Alternate between putting your foot in cold water then warm water.

If your condition is severe, treatment may include:

  • Corticosteroid injections to relieve pain.
  • Surgery to remove bone spurs, fuse damaged bones together, or replace the entire joint.

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not wear high heels or other restrictive footwear. Wear comfortable, supportive shoes that have a large toe box.
  • Wear orthotics as told by your health care provider, if this applies.
  • Put your feet in cold water for 30 seconds, then in warm water for 30 seconds. Alternate between the cold and warm water for 5 minutes. Do this several times a day or as told by your health care provider.
  • If directed, apply ice to the injured area.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times per day.
  • Do foot exercises as instructed by your health care provider or a physical therapist.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You notice bone spurs or growths on or around your big toe.
  • Your pain does not get better or it gets worse.
  • You have pain while resting.
  • You have pain in other parts of your body, such as your back, hip, or knee.
  • You start to limp.
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