Hallux Rigidus – Stiff Big Toes
Hallux Rigidus is a form of arthritis that affects the big toe joint. It is one of the most frequently occuring arthritic foot conditions, which most commonly develops in adults between the ages of 30 and 60. Hallux Rigidus can cause pain, swelling and stiffness around the big toe joint during activity and in some cases can lead to the development of a bony bump, causing additional difficulty in footwear.
Causes of Hallux Rigidus:
There are many causes of this Hallux Rigidus. Patients generally report an injury, stubbing or an old fracture that occurred often decades ago to the big toe and which gradually resulted in stiffness and pain. Enlargement of the joint results in difficulty with getting into comfortable shoes and especially high heels.
Other causes of hallux rigidus can be genetic or biomechanical, as a result of poor foot posture and mechanical dysfunction. Systemic diseases such as gout and rheumatoid diseases can also damage the joint and result in the problem.
Hallux Rigidus Diagnosis:
Our specialists would start with an examination of your feet and lower limb. They will make note of the movement available in big toe joints and any change in shape. The quality of big toe joint movement will also be assessed.
X-rays will allow examination of the joint, in particular the available joint space, giving an indication of cartilage present and osteophytes/bone spur formation.
For subtle cases, an MRI may be requested to look at soft tissue inflammation and lesions on cartilage that may not be visible on bone.
Non-Surgical Hallux Rigidus Treatment
Whenever possible, our foot specialists will recommend non-surgical treatment, which may include:
- Orthotics and Specialist Footwear
- Joint Lubricant and Steroid Injection
- Manipulation Under Anaesthesia
- Splinting and Activity Modification
Hallux Rigidus Surgery
When Surgery is the most appropriate treatment, then the choice depends upon the degree of joint damage, the patients job, footwear choice and anticipated activities.
Surgical options include:
- Cheilectomy: this involves shaving off the extra bone spurs that are blocking and restricting joint movement.
- Osteotomy: this involves re-aligning the joint to improve function.
- Joint Implant: This involves implantation of an artificial joint with similar properties to normal joint. This is not suitable for all cases.
- Joint Fusion: This involves fusion of the joint to eradicate all movement and pain in joint.