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What is hallux rigidus?

A wear-and-tear type of arthritis known as hallux rigidus affects the joint of the big toe. It makes walking and carrying out daily tasks challenging by causing discomfort and stiffness in the toe, which can get worse with time.

What can cause hallux rigidus?

Hallux rigidus can be caused by a variety of factors.

  • Structural abnormalities:Some people are born with foot anatomy predisposing them to hallux rigidus. For example, if the metatarsal bone in your foot is longer or shorter than normal, it can increase the stress on the joint and lead to this condition.
  • Overuse:Repetitive stress or injuries, especially in people who engage in activities that increase the pressure on the big toe, such as ballet dancing or certain sports, can lead to hallux rigidus.
  • Previous injury: If you’ve had an injury to your toe that didn’t heal correctly, such as a severe sprain, fracture, or even a small repetitive injury, it could eventually lead to hallux rigidus.
  • Inflammatory diseases:Certain inflammatory diseases, like rheumatoid arthritis or gout, can contribute to the development of hallux rigidus.
  • Age:Although hallux rigidus can develop at any age, it most commonly affects adults aged 30–60.

What are the symptoms of hallux rigidus, and how is it diagnosed?

Symptoms of hallux rigidus typically develop gradually, starting with stiffness in the toe joint that may get worse over time. Here are some common signs.

  • Pain and stiffness:These are usually felt in the big toe during use, particularly when pushing off to walk or stand. It might be more pronounced during cold, damp weather and involve a dull ache or sharp pain.
  • Swelling and inflammation:The area around the joint may become swollen or inflamed.
  • Difficulty walking:As the condition worsens, it might become hard to walk, especially on uneven surfaces, uphill, or when running.
  • Bone growth: In severe cases, a bump, like a bunion or callus, may develop on the top of the foot.

As for diagnosis, doctors usually start with a physical examination of the foot, checking for areas of pain, range of motion, and evidence of bone growth. Imaging tests can confirm the diagnosis by showing changes in the joint, such as bone spurs, narrowing of the joint space, or changes in the shape of the bones.

What are the treatment and aftercare options for hallux rigidus?

Pain can be managed through icing, ibuprofen, and cortisone injections. To alleviate pressure on the toe, which is the major cause of pain, conservative treatments involve wearing stiffer shoes or implementing a full-length graphite plate or Morton’s extension.

If these measures don’t work, surgery becomes an option. Two reliable surgical methods are cheilectomy, a “clean-out” procedure ideal for patients with some joint mobility and less severe symptoms, and arthrodesis, the “gold standard” that involves fusing the joint. While fusion guarantees no more pain, it eliminates joint motion and requires a longer recovery period of about four months. Older patients who don’t perform as demanding actions on their feet may be candidates for joint replacement surgery.

One step at a time

At Texas Orthopaedic Associates, we’re passionate about getting you back on your feet. We understand how debilitating hallux rigidus can be and are dedicated to finding the right treatment plan for you. Contact us today to schedule your consultation and take the first step toward a pain-free future.