Hallux (Great Toe) Rigidus
Your big toe (hallux) contains two bones (phalanges). The ends of the bones meet to form two joints, one at its base, and one in the middle of the toe. The joint at the base of the toe where hallux rigidus occurs is called the metatarsophalagneal (MTP) joint.
The exact cause of hallux rigidus is unknown. The bone ends in the MTP joint are covered with protective cartilage. The cartilage allows the bones to glide smoothly during motion.
Degenerative arthritis causes the protective cartilage to wear away, causing bone on bone rubbing and stiffness. Abnormal bone growths (bone spurs) can grow on the bone and restrict motion as well.
Hallux rigidus most frequently occurs in people between the ages of 30 and 60. It appears to develop after injury, or significant stress. Researchers do not know why some people develop hallux rigidus and others do not.
Hallux rigidus is a condition that gets worse over time. Eventually, it may be very difficult to move your big toe. It can affect your ability to walk, stand, and participate in your regular activities. Your toe may feel painful even when you are resting.
Treating hallux rigidus in the early stages can help prevent surgery in the future. There are a variety of non-surgical treatments for hallux rigidus. It can help to stop wearing high-heeled shoes and wear stiff soled shoes with a large toe box. Custom orthotics can help relieve pressure and improve foot function. Over-the-counter anti-inflammatory medications, such as ibuprofen, can help reduce pain and swelling. For more severe symptoms, your podiatrist may inject the toe joint with steroid medication.
Cheilectomy is a surgical procedure used to remove excess bone and bone spurs, to allow the toe to bend. Cheilectomy is most appropriate for mild to moderate cases of hallux rigidus. The surgery is performed through an incision on the top of the foot. You will need to wear a rigid sole shoe for a few weeks following surgery. The procedure is quite successful for most people.
Arthrodesis (fusion) is another type of surgical procedure that is used to secure the toe joint in a permanent fixed position. Arthrodesis is reserved for severe cases of hallux rigidus. The procedure involves removing the damaged cartilage, aligning the bones, and securing them with surgical hardware. Your foot will be placed in a cast for about six weeks, and you will need to walk with crutches during this period. Over time, the bones grow together (fuse) and pain is relieved.
The toe joint may be removed and replaced with artificial implants, in a procedure called arthroplasty. Arthroplasty is used to restore motion and relieve pain. It can be a good option for older adults.
Recovery from hallux rigidus depends on the severity of your condition and the treatment that you receive. Recovery is individualized, and your podiatrist will let you know what to expect.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.