Hallux Rigidus

What is Hallux Rigidus?

Hallux Rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the big toe, and with time it gets increasingly harder to bend the toe. “Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move. Hallux Rigidus is actually a form of degenerative arthritis (a wearing out of the cartilage within the joint that occurs in the foot and other parts of the body).

Because Hallux Rigidus is a progressive condition, the toe’s motion decreases as time goes on. In its earlier stage, motion of the big toe is only somewhat limited—at that point, the condition is called Hallux Limitus. As the problem advances, the toe’s range of motion gradually decreases until it reaches the end stage of rigidus—the big toe becomes stiff, or what is sometimes called a frozen joint. Other problems are also likely to occur as the disorder progresses.

Symptoms of Hallux Rigidus

Common causes of Hallux Rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis—resulting from “wear and tear”—often develops in people who have defects that change the way their foot and big toe functions. For example, people with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing Hallux Rigidus.

For some, Hallux Rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse—especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux Rigidus can also result from an injury—even from stubbing your toe. Or it may be caused by certain inflammatory diseases, such as rheumatoid arthritis or gout. Your foot and ankle surgeon can determine the cause of your hallux rigidus and recommend the best treatment.

Treatment

The sooner this condition is diagnosed the easier it is to treat. The best time to see a foot and ankle surgeon is when you first notice that your big toe feels stiff or hurts when you walk, stand, bend over, or squat. If you wait until bone spurs develop, your condition is likely to be more difficult to manage.

An examine your feet and toe is conducted to determine its range of motion; X-rays are usually required to determine how much arthritis is present; as well as an evaluation to determine the presence of any bone spurs or other abnormalities that may have formed.

If your condition is caught early enough, it is more likely to respond to less aggressive treatment. In many cases early treatment may prevent or postpone the need for surgery in the future.

 

When is Surgery Necessary

There are several types of surgery to treat allux rigidus, and in some cases surgery is the only way to eliminate or reduce pain. These surgical procedures fall into two categories: reconstruct and “clean up” the joint. This requires the removal of the arthritic damage from the joint and any accompanying bone spurs, and altering the position of one or more bones in the big toe. These procedures are designed to preserve and restore normal alignment and function of the joint as well as reduce or eliminate pain.

More aggressive procedures are used when the joint cannot be preserved. These may involve fusing the joint, or removing part or all of the joint, or in some cases, replacing it with an implant, such as is done for the hip or knee. These procedures eliminate painful motion in the joint and provide a stable foot.

If surgery is performed, the length of the recovery period will vary, depending upon the procedure or procedures performed.