Hallux rigidus

Hallux rigidus is a progressive arthritis that leads to stiffness and swelling in the big toe joints.   This condition can develop over the course of many years and become very painful. The bump is actually your body’s attempt to increase the area of joint surface in response to increase pressure in the joint as the toe bends upward.  Unfortunately, the effort is futile and worsens the problem.

Symptoms:
Symptoms of hallux rigidus will most commonly be pain, stiffness and swelling in the big toe joint.  This pain may be aggravated by any activity where the big toe endures repetitive upward movement.  Patients may also notice a bump or ridge on the top of the joint.  The area may be quite tender to touch.  One may also appreciate numbness to part of the toe.  Another important issue regarding this problem is the tendency to begin to bear weight on the outside of the foot creating even more problems.

Diagnosis:
This condition is diagnosed through physical examination and weight bearing x-rays.  This condition may be present in both feet although only one foot may be symptomatic. 

Treatment:
Hallux rigidus can be treated conservatively  or may require surgery.  In the case of non-operative treatment, patients are encouraged to wear well-fitting shoes with a stiff sole.  This minimizes motion at the joint.  Orthotics may help limit the great toes motion and balance the forces of weight bearing on the foot.  Often anti-inflammatory medication will also help to improve symptoms.  In the cases not improved by conservative means operative treatment may be indicated. Your orthopaedic surgeon can determine the best course of action based upon your case.   Commonly, the surgery is quite simple and consists of smoothing of the bump and the upper portion of the joint where the pressure became abnormal.  The result is increased upward motion and pain reduction.

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