Hallux rigidus is the medical name for a common problem of the big toe: arthritis. The joint at the base of the big toe is called the metatarophalangeal joint, or MTP joint. This is the junction of the long bone of the forefoot, and the small bone of the big toe. Because of the mechanics of our feet, this joint is especially prone to developing arthritis. In fact, hallux rigidus, or big toe arthritis, is the most common site of arthritis in the foot.
What are the symptoms of hallux rigidus?
The most common symptom, and the most common reason to seek medical attention for this problem, is pain around the base of the big toe. This pain is accentuated with activity, especially running or jumping. Often wearing firm soled shoes that prevent motion at the base of the big toe will help relieve symptoms. Other common symptoms include swelling at the base of the big toe, a lump next to this joint due to bone spur formation, and calluses from the abnormal shape of the toe.
Your doctor will test the mobility of the joint, usually comparing it to the opposite foot to see how much motion is lost at the joint. X-Rays are done to determine if the joint cartilage is worn away, and to see if bone spurs have formed in this area. Determining the extent of the arthritis will help guide treatments.
What treatment is available for hallux rigidus?
The most common treatments include:
- Wearing Stiff-soled Shoes
As described before, these limit motion at the base of the big toe. Inserts can be made for shoes that can help your existing footwear. Other shoe-wear modifications include shoes with a wider toe box, or rocker-bottom heels that allow foot motion without as much bending. - Anti-Inflammatory Medications
These medications will help to decrease pain and swelling at areas of inflammation. If the oral medications are not sufficient, and injection of cortisone may also be considered.
Is surgery necessary for hallux rigidus treatment?
Surgery is sometimes the best treatment for hallux rigidus, especially if the more conservative measures are not working for you. The two most common surgical procedures are called a chilectomy (pronounced "K-eye-leck-toe-me") or an arthrodesis (fusion). The chilectomy is a procedure done to remove the bone spurs. This often helps if the spurs are causing a block to the joint motion. However, if the joint cartilage is all worn off, a chilectomy may not help the pain. The arthrodesis, or fusion, is an excellent procedure at eliminating much of the pain, but it will cause the toe to be still at its base.
