Hallux rigidus means stiff great toe, a problem that develops when arthritis settles into the joint at the base of your big toe. Beyond stiffness, you’ll also deal with pain that’s often so severe it’s hard to stand or walk — forget about participating in athletic activities.
If a stiff, painful big toe affects your daily life, our podiatry specialists at Cascade Orthopedics & Sports Medicine can help. Early treatment can slow down progressive joint degeneration and support your active lifestyle.
About hallux rigidus
Hallux rigidus affects the metatarsophalangeal (MTP) joint located at the base of your big toe. Bunions also develop in the MTP joint, but these two conditions aren’t related. They have different causes and treatments.
Your big toe has an essential role in propelling you forward and balancing your body weight. Every time you take a step, whether walking, running, or jumping, you bend the toe and put a lot of stress on the MTP joint. This stress leads to degenerative arthritis (osteoarthritis).
Risk factors for hallux rigidus
Over years of MTP joint movement, the cartilage covering the bones gradually breaks down. As the cartilage wears away, bone rubs against bone, causing pain, stiffness, and bone damage. At the same time, the tissues lining the joint become inflamed, and bone spurs develop. All these changes contribute to progressive osteoarthritis.
Though anyone can develop hallux rigidus from normal wear and tear, you’re more likely to face this condition if you:
- Engage in activities that bend the toe (stooping, squatting, athletics)
- Have structural abnormalities in your foot (flat feet)
- Had an earlier injury in the joint (stubbed the toe or sprained the joint)
- Have inflammatory diseases (like gout or rheumatoid arthritis)
A family history of osteoarthritis also raises your risk for hallux rigidus.
Symptoms of hallux rigidus
Stiffness, pain, and difficulty bending your big toe are the primary symptoms. You may also experience:
- Joint swelling and inflammation
- Bump on top of the joint
- Redness around the bump
- Frozen toe (unable to bend it)
- Pain that’s worse after exercise or in cold weather
- Pain when resting (as arthritis progresses)
- Difficulty wearing shoes
Increasing pain and stiffness in the MTP joint changes how you walk, placing more stress on your knees, hips, and lower back. As a result, you may also end up with pain in those joints.
Diagnosing hallux rigidus
We can usually identify hallux rigidus with a physical exam. After evaluating the joint for pain and range of motion and checking for bone spurs, we may take X-rays. X-rays reveal the amount of joint degeneration and the precise location of bone spurs.
Treating hallux rigidus
Hallus rigidus treatment initially starts with nonsurgical therapies, such as:
- Over-the-counter pain relievers
- Anti-inflammatory medications
- Joint injections
- Customized orthotics
- Physical therapy
You may not think of physical therapy as an option for a toe joint, but structured exercises can reduce your pain, improve the toe’s movement and strength, and help you regain normal walking mechanics.
We can’t predict the rate at which your big toe arthritis will progress. But we do know surgery is the only option for relieving pain and improving movement when advanced osteoarthritis causes severe joint damage.
Surgery for hallux rigidus
Several types of surgery can improve hallux rigidus, including:
Bone spur removal
Removing excess bone can significantly reduce your pain and improve mobility.
Fusing the bones dramatically improves your pain by preventing movement in the joint. Despite fusing the joint, you can still walk and run.
During joint resurfacing, we remove the damaged bone and place a spacer between the bones to prevent them from rubbing together.
Some people may be good candidates for an MTP joint replacement. This option eases your pain while also preserving toe movement.
Don’t wait to seek treatment for a stiff, painful big toe. Call or book an appointment online today with Cascade Orthopedics & Sports Medicine Center, P.C. at our office in Hood River or The Dalles, Oregon.