Are you experiencing pain in your big toe, particularly when you try to crouch down on the floor, go up on your toes, or when you're out running or hiking? This could be a condition called Hallux Rigidus. Hallux refers to the big toe and rigidus speaks for itself. When the joint jams in your big toe joint, you can develop Hallux rigidus. The jamming causes arthritis that affects the big toe joint also known as the first metatarsal phalangeal joint.
Symptoms of Hallux Rigidus
At first, the pain may only occur occasionally when you jam the joint too hard, but as the condition worsens and the joint becomes more rigid, the discomfort will become more constant even during normal walking. Other symptoms include:
- Climbing stairs or engaging in sports like golf, going up on your toes, or any activity that bends that great toe joint a lot may trigger or intensify the pain.
- Cold or damp weather
- Wearing shoes that are too tight or shoes that are too flexible and jam the joint too easily
- Stiffness in the joint.
- Swelling around the joint
- Reduced range of motion
- A bump similar to a bunion on the top of your big toe joint. This usually indicates a more advanced form of the condition.
What Causes Hallux Rigidus?
As mentioned earlier Hallux rigidus is caused by jamming the two bones in your great toe joint. As we age, the alignment in our feet can change causing the cartilage to wear down. This increases the likelihood of further erosion of the joint, resulting in bone on bone and the development of a rigid great toe joint and arthritic pain.
Other factors that raise the risk include:
- Faulty foot mechanics like flat feet and overpronation
- Overuse of the joint can occur from participation in sports or standing for long periods on the job.
- Previous injuries to the toe, such as stubbing or turf toe from athletic activities
- Having an extra long bone in your foot
- Health conditions like rheumatoid arthritis or gout or an autoimmune disorder
- Overweight or obesity
- People over 50 and women are more likely to develop Hallux rigidus.
Diagnosing Hallux Rigidus
To diagnose your condition and to determine how far it's progressed, I'll test your toe's range of motion, take X-rays, and watch you walk. If caught early, the condition is referred to as Hallux limitus, meaning your toe has limited motion but is not jamming all the way. Your toe has some diminished movement, but it's still relatively treatable. However, if left untreated, it may progress to the rigid stage where it could be more difficult to manage with conservative treatment.
Treatment of Hallux Rigidus
In the early stages of this condition, we'll treat it by using the following conservative measures.
- Custom Orthotics: we use orthotics to control your foot mechanics and alleviate your pain. This is especially important when the faulty alignment like flat feet is the problem, causing jamming in that joint.
- Ice Packs and Contrast Baths: I'll recommend ice packs and contrast baths for the inflammatory phase of the problem. Initially, this is done a few times a day to alleviate discomfort. Be sure not to use extreme temperatures if you use this treatment. The foot will respond better to ice than to heat when it's inflamed.
- Anti-inflammatory Medications: You can take pain relievers and anti-inflammatory medications to further reduce swelling and discomfort if your doctor approves it.
- Cortisone Injection: If the intensity increases past that, a cortisone injection into the joint can help relieve inflammation and pain if the regular pain relievers aren't that helpful.
- Shoes: Wear shoes with a wide toe box, a rocker bottom, or shoes that have more rigid soles. These types of shoes will give you more relief than shoes that flex too easily.
![Carbon Graphite Insole Hallux rigidus]()
Carbon Graphic Insoles: your shoe store or shoe repair shop may have carbon graphite insoles that stiffens the sole of the shoe and prevents the joint from jamming. You can also purchase a carbon graphite insole online.- Surgery: In more advanced cases, surgery may be necessary. The choice of procedure depends upon the severity of the condition, your age, and your activity level. Recovery time will also depend on the specific surgery recommended.
Preventing Hallux Rigidus from Progressing
While you can't stop Hallux rigidus from developing, you can slow its progression. You should intervene early.
- Avoid wearing shoes with a tight toe box, heels, and shoes that are too flexible.
- Wear your orthotics all the time if you receive them as part of your treatment plan. They will help to keep your feet in proper alignment and reduce stress on your big toe joint. Rest after physical activity and avoid playing through pain.
- Keep your toes mobile by doing foot and toe exercises.
In conclusion, while having Hallux rigidus can be a challenge, there are many treatments and modalities available to lessen the impact on your activities and keep the condition from progressing.
