Hallux Rigidus

What is Hallux Rigidus?

Arthritis in the ball of the foot of the main big toe joint is known as hallux rigidus. It occurs when the joints surface wears away. The name hallux rigidus means stiffness of the big toe. The entire joint or the upper part of it can be affected.

What causes Hallux Rigidus?

Hallux rigidus is a condition that just develops; there is no exact cause for it. It can affect anyone at any age. There are underlying biomechanical causes that could make a individual more susceptible to damage of this joint. The joint may be stiff and arthritic but generally it will not worsen over the years. It more or less stays the same. There are a small percentage of people who will notice it getting more painful and treatment will be needed.

The big toe joint wearing away from the pressure of walking is most probably the main reason for developing this condition. This small joint has to take a force twice your body weight with every step it takes. An infection, gout or an injury can be some other causes.

What are the symptoms of Hallux Rigidus?

The most common symptom is pain in the big toe joint. Some people suffer from pain all the time with this condition, whether it is when resting or walking. Others will only experience pain when moving the big toe.

Another common symptom is stiffness in the big toe. When there is stiffness, the toe can be moved to face downwards but sometimes it may be really still that once it’s downwards it will not straighten. Generally moving the big toe upwards isn’t an option where there is stiffness.
There may be a bony bump on top of the toe joint. This is the body’s way of protecting the worn out joint. This bony bump may rub against shoes when walking.

Some people experience pain in the ball of the foot or on the outside of the foot. This is from walking on the sides of your feet. People tend to do this when the big toe is in pain.

How is Hallux Rigidus treated?

Wearing shoes that are comfortable and fit your feet correctly and maintaining a healthy weight by keeping fit will help ease symptoms. Taking over the counter painkillers like paracetamol help manage the pain. If these do not work for you then your doctor will be able to prescribe you some stronger painkillers. Anti-inflammatory tablets can also be prescribed if they are suitable for you.

If you have persistent pain that does not ease with painkillers then you may need a steroid injection with a local anaesthetic into the toe joint. This injection will help to ease the inflammation inside the joint. You can visit our podiatrists for this injection or a doctor can refer you to the out patients clinic. You may experience pain over the next couple of days after the injection which should subside fairly quickly and you should notice a difference within a week. Sometimes the results from an injection are permanent but generally they last several months.