Big Toe Arthritis - Hallux Rigidus (Stiff Big Toes)

Hallux Rigidus Overview

Hallux Rigidus is a form of arthritis that affects the joint at the base of the big toe, which leads to pain and stiffness of the joint.

Hallux Rigidus Causes

Hallux Rigidus can occur after:

  • An injury, where you may develop Osteonecrosis, which can damage the blood flow to a portion of bone and cartilage.
  • Rheumatoid disease, which causes joint inflammation and damage to cartilage
  • Deterioration of cartilage due to age
  • Genetics

Hallux Rigidus Symptoms and Diagnosis

Hallux Rigidus is characterised by achiness, pain and stiffness.

Hallux Rigidus Treatment and Prevention

Resting, Icing, Compressing and Elevating (RICE) can assist with a flare up. If symptoms persist then you should arrange an appointment with a specialist who may refer for an X-ray to assess the issue.

How do you Fix Hallux Rigidus Without Surgery?

Surgery is normally only recommended after other treatments have failed to alleviate symptoms. Your specialist will recommend non-surgical treatments particular to your case, and may include:

Treatments may include:

Physiotherapy and Strengthening

Your specialist may provide you with physiotherapy exercises to assist with joint movement, alongside deep tissue massage. These can help delay joint deterioration, reduce symptoms and improve strength and range of motion.


 Following a gait analysis, custom orthotics may be suggested to help support the area around your big toe, this can reduce the strain, and therefore pain, that can occur in the joint.

Steroid Injections

 If pain persists in your ankle then your specialist may advise on a steroid injection.

Typically the choice of substance for a steroid injection will be Cortisone, the steroid can decrease inflammation as it acts like a hormone that stops inflammation. Usually a lower dose of steroid is administered to provide relief from pain and stiffness, but a higher dose can be administered if you have a severe flare up of arthritis.

We may also choose to inject Hyaluronic Acid or Platelet Rich Plasma to help healing.

Manipulation of the Joint under Anaesthesia (MUA)

 Manipulation of the joint is typically an outpatient procedure which can be performed under local anaesthesia. There are however some cases where your specialist may instead suggest arranging under IV sedation or general anesthesia in a hospital setting.

MUA may be suggested if you have had a previous injury, this will help realign the joint and improve motion.

Surgical Management

However, if conservative measures fail to resolve your complaint, surgery may be recommended.


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