Has the joint at the base of your big toe caused you pain and stiffness? Has it progressively gotten worse that you now have lost all motion in the toe and it’s rigid? You likely have hallux rigidus.
A form of degenerative arthritis, hallux rigidus causes pain and stiffness in the metatarsophalangeal or MTP joint at the base of the big toe that connects your toe to your foot. Since hallux rigidus gets worse over time, the motion in your toe decreases progressively until walking, stooping, climbing stairs and even standing becomes painful. This condition can make it difficult to wear shoes due to bone spurs. And since you’ll likely change your gait to compensate for your painful toe, this can lead to pain in your ankle, knee, hip or lower back.
Hallux rigidus can occur in adolescents and adults. However, it usually develops in adults between the ages of 30 and 60 years. Some possible causes of hallux rigidus include:
- Overuse of the big toe from bending or kneeling due to your occupation or excessive stress due to sports, like football or gymnastics, or from ballet dancing
- Injury to the toe from stubbing it badly
- Family heredity of a foot type or way of walking that leads to the condition
- Osteoarthritis or rheumatoid arthritis
- Pain in the joint as you push off with the toe when you walk.
- Swelling and inflammation around the joint.
- Stiffness in the big toe with an inability to bend it up or down.
- Pain and stiffness especially in cold, damp weather.
- A bone spur, which is a bump like a bunion, can develop on top of the foot.
- Numbness along the inside edge of the big toe due to pressure on the nerves from a bone spur.
- Increased pain when wearing shoes that have elevated heels.
It’s important not to ignore this condition when pain and stiffness first starts. See your doctor when you first notice symptoms. Your doctor will examine your foot and perform diagnostic imaging procedures to evaluate your joint damage and rule out other conditions.
Early diagnosis and treatment can help alleviate the symptoms. If you wait too long, it becomes more difficult to treat the condition conservatively.
Early treatment of hallux rigidus can provide tremendous pain relief. Treatment may include:
- Taking non-steroidal anti-inflammatory medications, like ibuprofen, and/or receiving cortisone injections to relieve pain and reduce swelling.
- Avoiding high-impact activities, like jogging.
- Performing physical therapy to improve big toe extension and movement.
- Placing pads in your shoe to limit the movement of your big toe.
- Wearing properly fitted shoes that provide plenty of room for your toes. Refer to our Shoe Fitting Guide for more information on how to correctly fit your shoes.
- Not wearing high heels to reduce stress on your big toe.
- Wearing custom orthotics, like ezWalker® Performance Custom Orthotics, to correct structural foot abnormalities that could be causing the problem. These custom orthotics support the your arches and your 1st metatarsal, the bone connected to your big toe, to encourage normal function of the big toe joint. They also decrease stress and trauma on the joint to slow down or eliminate the arthritic process while reducing pain.
If your pain and stiffness continues after conservative treatment, you may require surgery. However, with proper treatment, you can reduce the pain and discomfort of hallux rigidus.
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Note: If you follow these guidelines and your pain persists, you should see a physician for proper diagnosis and treatment.
Photo credit: The American College of Foot and Ankle Surgeons