A Brief Look at Hallux Rigidus

Hallux Rigidus can be defined as arthritis of the big toe joint. By far it is one of the most common types of arthritic foot condition and along with Hallux Valgus (bunion), it is one of the most frequently occurring conditions to affect the big toe. Women are typically more affected than men in almost all age groups. The condition commonly develops in adults between thirty and sixty years of age and in most cases, patients complain of pain in the big toe joint while doing some work or being active, particularly when walking. At other times, there can be stiffness or swelling around big toe joint. The patient can find it difficult to bend the affected toe up or down. Sometimes a bump, such as a bone spur or a bunion can develop around the top of the affected big toe joint, which can be further aggravated by rubbing against the insides of a shoe.

Causes of Hallux Rigidus:

The actual causes of Hallux Rigidus have not been identified. Nevertheless, numerous risk factors have been acknowledged, including an elevated or very long first foot bone (i.e. metatarsal), prior traumatic injuries to the big toe, anatomical differences in the foot and family history. These risk factors mainly cause serious damage to the bone surfaces, which in turn can cause wearing and tearing of the joint. Such wearing and tearing can eventually lead to arthritis.

Treating Hallux Rigidus:

Non-surgical treatment of Hallux Rigidus will always be attempted in the first instance:

Non-Surgical Treatment:

In trying to treat Hallux Rigidus non-surgically, a physician may recommend a number of anti-inflammatory medicines and pain relievers. Additional methods, such as ice packs or heat packs and injections into the joint can also help in reducing pain and stiffness. A change in footwear may also be recommended, particularly the avoidance of high heels or thin-soled shoes, with wider shoes that have curved soles being advisable. Adding shoe inserts that restrict motion around the MTP joint may also be recommended. It should be noted that although these treatments can help to reduce the symptoms and manage pain, they do not actually stop the progression of Hallux Rigidus.

Surgical Treatment:

If the non-surgical treatments fail to produce desired results, then surgical treatments may be applied to correct the deformity of the affected toe.

For minor cases of Hallux Rigidus that are characterized by mild to moderate damage, a Cheilectomy procedure may be attempted. This involves bone spur from the top of metatarsal being shaved, which creates more room for the toe to bend easily. This alleviates the pain caused by pushing the toe, helps to preserve joint motion and maintain joint stability. For more critical cases, surgeries like Arthrodesis and Interpositional Arthroplasty can be carried out.