Are you experiencing stiffness, pain, or difficulty when moving your big toe? If so, you may be dealing with a condition called hallux rigidus, a form of degenerative arthritis that affects the joint at the base of the big toe.
This condition is considered a leading cause of foot pain and mobility issues, and can significantly impact your quality of life, making simple daily activities like walking increasingly difficult.
If a painful and stiff big toe joint restrict you from living your life to the fullest, we recommend seeking early treatment to slow down the progression of joint degeneration and prevent any further damage to your joint.
What is Hallux Rigidus?
Hallux rigidus is osteoarthritis of the big toe. This progressive arthritic condition occurs when the cartilage in the metatarsophalangeal (MTP) joint at the base of the big toe begins to wear away.
As the cartilage deteriorates, the bones in the joint start to rub against each other, causing pain, stiffness, and inflammation of the joint lining, as well as the formation of bone spurs.
Bone spurs are bony projections that develop along the edges of the joint as a result of the body's attempt to repair the damaged cartilage. These spurs can further limit the joint's range of motion and contribute to the pain and stiffness associated with hallux rigidus. In some cases, the bone spurs may be visible as a bump on the top of the foot, near the base of the big toe.
If the condition progresses significantly and is left untreated, the joint space will keep narrowing, and the bones may begin to fuse together, leading to a complete loss of motion in the MTP joint.
Causes and Risk Factors
Several factors can contribute to the development of hallux rigidus, including:
Genetics: Certain inherited foot structures, such as a long first metatarsal bone (the bone that connects the big toe to the rest of the foot), flat feet or a high arch, can increase your risk of developing hallux rigidus.
Trauma: Previous injuries to the big toe, such as stubbing or spraining, can damage the joint and lead to the development of this condition.
Overuse: Repetitive stress on the MTP joint, often seen in athletes that engage in physical activities like squatting, or individuals with physically demanding jobs, can accelerate cartilage wear and tear.
Inflammatory conditions: Systemic diseases like rheumatoid arthritis or gout can cause joint inflammation and contribute to the development of hallux rigidus.
Symptoms to Watch For
The most common symptoms associated with hallux rigidus include:
Pain and stiffness in the big toe, especially during movement
Swelling and inflammation around the MTP joint
Inability to bend your big toe
A bump or bone spur on the top of the foot, near the base of the big toe
Difficulty wearing shoes comfortably
Aching or throbbing pain in the big toe, even at rest
Limping or altered gait to avoid putting pressure on the affected toe
If you experience any of these symptoms, it's crucial to consult with your orthopedic doctor to get an accurate diagnosis and an appropriate treatment plan.
Diagnosis and Treatment Options
To diagnose hallux rigidus, your orthopedic doctor will perform a physical examination of your foot, assessing the range of motion in your big toe and checking for any visible deformities or bone spurs. Additionally, x-rays imaging tests may be taken to evaluate the extent of the joint damage, and accurately locate any formed bone spurs.
Treatment for hallux rigidus depends on the severity of the condition and may include:
Conservative measures
Wearing shoes with a stiff sole and a roomy toe box
Using orthotics or inserts to reduce pressure on the MTP joint
Applying ice to manage pain and inflammation
Taking over-the-counter pain medications
Performing toe stretches and exercises to maintain flexibility
Surgical intervention
Cheilectomy: Removing bone spurs and damaged joint surfaces
Osteotomy: Cutting and realigning the metatarsal bone to improve joint function
Arthrodesis: Fusing the MTP joint to eliminate pain and restore stability. Although you won’t be able to bend your big toe after this procedure, you can still run and walk
Arthroplasty: Replacing the damaged joint with an artificial implant, typically reserved for significantly damaged MTP joint
Preventing Hallux Rigidus Progression
While some risk factors for hallux rigidus are beyond your control, there are some tips you can use to slow down the progression of the condition:
Choose shoes with a wide, comfortable toe box and avoid high heels or narrow, pointed shoes
Maintain a healthy weight to reduce stress on your feet and joints
Perform regular foot and toe exercises to improve flexibility
Use cushioned insoles or orthotics to redistribute pressure away from the MTP joint
Address any underlying inflammatory conditions with your doctor
If you suspect you have hallux rigidus or are experiencing persistent big toe pain, don't hesitate to contact your orthopedic doctor. Dr. Errachid is committed to providing you with personalized and comprehensive care to help you manage your feet pain and get back to an active lifestyle. Schedule your appointment today.
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