Rigid big toe (Hallux Rigidus)
Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe. “Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis
Common causes of hallux rigidus are faulty biomechanics and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis – the kind that results from “wear and tear” – often develops in people who have defects that change the way their foot and big toe functions. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus. In some people, hallux rigidus runs in the family, while in other cases, it is associated with overuse – especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases such as rheumatoid arthritis or gout.
In many cases, early treatment may prevent or postpone the need for surgery in the future. Treatment for mild or moderate cases of hallux rigidus may include:
- Shoe modifications. Shoes with a lot of toe room put less pressure on your toe. Stiff or rocker-bottom soles may also be recommended.
- Orthotic devices. Custom orthotic devices may help.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may reduce pain and inflammation.
- Injection therapy. Injections of corticosteroids may help to reduce inflammation and pain.
- Physical therapy. Ultrasound therapy or other physical therapy treatment may provide temporary relief.
In some cases, surgery is the only way to eliminate or reduce pain, and the type of surgery required will be determined by a foot specialist.