Hallux Rigidus

What is it?

Literally stiff (rigidus) toe (hallux).  Pain in the big toe can arise for a number of reasons but commonly it is caused by arthritis.  This wear and tear can cause stiffness and pain in the big toe joint. Often a bony lump grows on the top of the joint and this may be uncomfortable if it rubs on shoes.

What causes it?

Sometimes there is a preceding injury where the cartilage of the joint may have been damaged. More often, there is no obvious cause and it is suspected that the shape of your foot and the bones that predispose you to this condition, something that may be passed down in your genes. This has not been proven.

How is it diagnosed?

Examination may reveal a tender bony lump, swelling around the joint and reduced range of movement.  X-rays are taken which may reveal loss of joint space and osteophytes (bony lumps).

What are the treatment options?

If the joint is reasonably well preserved and the main problem is the bony lump then padding over the lump and sensible shoes may be all that is required.  If this fails then the lump might need to be removed (cheilectomy).

If there has been significant loss of the cartilage in the joint then there are two options.  These joints hurt because the rough joint surfaces are painful when they move against each other. The solution is to reduce the movement.  The first option is to modifying your activities and use a stiffened insert in your shoe to help reduce the amount of movement through the joint.  The second option is to fuse the joint which is a permanent solution.  This entails an operation where the joint surfaces are carefully prepared and the held together with a small plate and screws.