Stiff big toe (Hallux limitus)
Hallux is the medical term for the big toe, and stiffness of the big toe joint is termed hallux limitus, because the movement of the toe is limited. When the big toe cannot move at all, it is called Hallux Rigidus.
The most common cause of hallux limitus is an abnormal alignment of the long bone behind the big toe joint called the first metatarsal bone. In this condition, the first metatarsal bone is elevated relative to the other metatarsal bones that lie behind the other toes. When this is the case, the big toe joint cannot move smoothly and jamming occurs at the joint. A variety of symptoms can begin to occur. One common problem that occurs is pain in the bottom of the big toe where a central callous can develop. The pain and callous develop because the big toe does not bend upward enough as the bottom of the toe is jammed into the ground. People who have diabetes must watch this area carefully because the pressure can cause the development of an ulceration that can become infected.
Another consequence of a stiff big toe joint is the development of bone spurs on the top of the joint. This bump on the top of the big toe joint can become painful as a result of shoe pressure. As the joint continues to degenerate more bone spurring occurs, and if the condition is left untreated complete destruction of the joint can occur.
Although oral medications and cortisone injections can be useful in treating the pain associated with the condition, they do not halt the process because they do not address the underlying cause of the condition. Functional orthotics, however, are designed to treat the cause of the condition. These devices will generally fit into normal shoes and correct the underlying functional problem with the joint. Orthotics will not reverse whatever damage may have already occurred, but can slow or halt the on-going damage to the joint.
If the condition progresses to the point of spurring around the joint, surgery may be indicated.