Hallux rigidus is Latin for stiff big toe, which is the main symptom of this condition. It’s a type of degenerative arthritis that affects the joint where your big toe (hallux) attaches to your foot.
This condition happens when the cartilage covering the ends of the bones in your big toe joint is damaged or lost. This causes the joint space to narrow. It can also lead to painful bone spurs. These are small, pointed growths on a bone.
Anyone can develop hallux rigidius, but it tends to affect people between the ages of 30 and 60.
Read on to learn about what causes hallux rigidus and how it’s treated.
Symptoms often start out mild and slowly worsen over time.
Early signs and symptoms may include:
- pain and stiffness in your big toe during use
- swelling and inflammation around the joint
- pain and stiffness that worsens with cold, damp weather
As the condition progresses, you may notice:
- pain even during rest
- a hard bump that forms at the top of your foot
- inability to bend your big toe
You may also experience pain in your knee, hips, or lower back if your symptoms cause you to limp or walk differently than you usually do.
There’s no known cause of hallux rigidus, but several risk factors have been identified. Risk factors include:
- Being female. Hallux rigidus is more common in females. Of the 110 participants included in a 2009 cross-sectional study on the demographics of hallux rigidus, 66 percent were female.
- Family history. Having a family member with the condition appears to increase your risk for developing it yourself. This may come from inheriting a certain foot type or way of walking that can lead to the condition.
- Abnormal foot anatomy. Abnormalities in the structure of your foot, such as a long or elevated first metatarsal bone, may increase your risk.
- Injury. Injuries, such as stubbing your toe or spraining the joint in your big toe, can contribute to hallux rigidus.
- Overuse. Regularly stooping and squatting can cause overuse of the joint in your big toe. People in certain jobs or who participate in sports that place a lot of stress on the joint have an increased risk of developing the condition.
- Certain medical conditions. Osteoarthritis and inflammatory conditions, such as rheumatoid arthritis and gout, can cause hallux rigidus.
If you have symptoms of hallux rigidus, your doctor will start by examining your foot. They may move your big toe around a bit to rule out any other potential causes of your symptoms.
Based on what they see during the exam, your doctor might order an X-ray of your foot or toe. This will allow them to see any damage to the joint in your big toe.
There’s no way to slow down the progression of hallux rigidus on your own. But there are several things you can do to reduce pain and inflammation in your big toe.
Try the following at home:
- Apply cold and heat several times a day.
- Soak your feet, alternating between cold and warm water.
- Take nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil).
- Avoid high-impact activities, such as running.
- Wear supportive closed-toe shoes with stiff soles to prevent your big toe from bending too much.
If you find that you’re still having a lot of pain and inflammation, ask your doctor about corticosteroid injections. These can offer additional relief.
If other treatments don’t work, your doctor may recommend surgery. There are different types of surgery for hallux rigidus, depending on how severe your case is.
This type of surgery is used to treat mild to moderate damage. It involves shaving any bone spurs. A cheilectomy may also be performed in combination with another procedure called osteotomy. This cuts the bone to change the position of your big toe and relieve pressure on top of the joint.
This procedure is used to treat moderate to severe hallux rigidus. It’s a joint-sparing alternative to joint fusion or replacement. It’s also known as joint resurfacing.
The procedure consists of removing some of the damaged bone and placing a spacer between the bones to minimize contact. The spacer may be made from tissue from your foot or from donor tissue, or from synthetic cartilage.
This type of surgery is also known as joint fusion. It’s used to treat advanced hallux rigidus involving severe joint damage.
During the procedure, the damaged cartilage is removed. The two bones are fixed together with screws. Over time, the bones fuse together. This type of surgery reduces pain, but it also permanently restricts movement of your big toe.
This is joint replacement surgery. It entails replacing one or both sides of your joint with artificial joints made of plastic or metal. The goal of this surgery is to relieve your symptoms while maintaining motion of your joint.
Surgeons are often hesitant to recommend arthroplasty because it comes with some risks, including:
- implant failure
- soft tissue instability
Hallux rigidus is a progressive condition that worsens over time. You may be able to manage your symptoms using at-home treatments and avoiding certain types of shoes and activities.
Eventually, your doctor may recommend surgery if home treatments no longer provide relief.