Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, 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 of the great-toe MTP joint. The symptoms result from cartilage wear, altered joint mechanics, and osteophyte formation, particularly on the dorsal aspect of the first MT head. Hallux rigidus usually causes pain from impingement of dorsal osteophytes, from inflammation, and from shoe-related pressure on prominent osteophytes.
This disorder can be very troubling and even disabling, since we use the big toe whenever we walk, stoop down, climb up, or even stand. Many patients confuse hallux rigidus with a bunion, which affects the same joint, but they are very different conditions requiring different treatment.
Because hallux rigidus is a progressive condition, the toe’s motion decreases as time goes on. In its earlier stage, when motion of the big toe is only somewhat limited, the condition is called “hallux limitus.” But as the problem advances, 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”.
Causes
- Faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint are common causes of hallux rigidus. This type of arthritis – the kind that results from “wear and tear” – often develops in people who have defects that change the way their foot and big toe functions. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus.
- Inflammatory diseases: It may be caused by inflammatory diseases such as rheumatoid arthritis or gout.
- Family History: In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition.
- Overuse: Hallus rigidus is also 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.
- Injury: Hallux rigidus can also result from an injury, such as stubbing your toe.
Treatments We provide
- Shoe modifications. Shoes with a large toe box put less pressure on the toe. Stiff or rocker-bottom soles is another modification.
- Orthotic devices. Custom orthotic devices may improve foot function.
- Physical therapy. Ultrasound therapy and other physical therapy modalities are undertaken to provide temporary relief.