What is Hallux Rigidus?
Hallux Rigidus is a condition characterized by stiffness at the base of the big toe joint. The most common arthritic condition in the foot, Hallux Rigidus can make even the easiest of activities – like walking – painful and hard to do.
Causes and Symptoms of Hallux Rigidus:
Hallux Rigidus is most observed among adults ranging from 30 to 60 years old. This condition can be the result of a past injury that’s damaged the cartilage around the big toe joint or can be as simple as a result of wear and tear from aging and, in some cases, genetics. It’s important to know that bunions and flatfoot can create additional stress on the big toe joint and lead to a Hallux Rigidus diagnosis.
Symptoms of Hallux Rigidus include:
- Pain in the big toe joint, specifically when walking or participating in activities that require movement, that originates at the top of the joint, but can also be felt deeper inside the joint
- Swelling around the affected big toe and joint area, and may cause you to modify your footwear to allow room for the swelling
- A bunion or callus-like bump that appears on the top of the foot, potentially with accompanying redness
- A feeling of stiffness or rigidness when bending the big toe and limited mobility
Diagnosis of Hallux Rigidus:
To best diagnose hallux rigidus, a healthcare provider will do a physical examination, testing the range of motion and functionality in the affected toe. You may be referred to a podiatrics, foot and ankle specialist or orthopaedic physician to see someone that specializes in feet. A foot x-ray may also be ordered to get a better look at the bones and check for bone spurs.
From there, if signs point toward a hallux rigidus diagnosis, your doctor will assess your condition and what “grade” it is ranging from 0 to 4. Read on for a breakdown of each stage:
- Grade 0: The affected toe can move, but 10-20% less than the other big toe
- Grade 1: Movement in the affected toe is 20-50% less
- Grade 2: Your affected toe has 50-75% less movement
- Grade 3: 75-100% less movement
- Grade 4: 75-100% less movement along with severe pain while moving the affected big toe
Treatment for Hallux Rigidus:
Your doctor will examine your feet to check for Hallux Rigidus and potential evidence of bone spurs. It’s common that if they suspect Hallux Rigidus, they may test your big toe’s range of motion to better determine where the pain and stiffness is stemming from. Imaging, such as x-rays, may also be involved. From there, a treatment plan will be recommended.
Non-surgical options for treatment include:
- Over-the-counter medication
- Ice
- Contrast baths
- Footwear
- Injections
What is the difference between Hallux Limitus and Hallux Rigidus?
The main characteristic identified in Hallux Limitus is the decrease in range of motion in the joint of the big toe, whereas Hallux Rigidus is complete stiffness of the whole joint.
Surgical Treatment for Hallux Rigidus or Hallux Limitus:
Surgery for Hallux Limitus and Hallux Rigidus is often recommended to patients if less invasive treatment options aren’t cutting it. Your doctor may first recommend more conservative options like orthotics, physical therapy and medication before resorting to surgery. There are a few different surgical procedures for a healthcare provider to pick from when considering a surgery to repair Hallux Limitus and Hallux Rigidus depending on the severity of the condition. Commonly used procedures include:
- Cheilectomy (removal of bone spurs, if present)
- Osteotomy (reshaping the bone)
- Arthrodesis (fusing the joint)
- Joint replacement
Always consult with your foot and ankle specialist to determine the best plan of action for your Hallux Limitus or Hallux Rigidus.
Most patients that undergo a surgical procedure can expect to be off their feet for weeks to a few months. It’s important to always consult with a trust healthcare provider regarding treatment and recovery for optimal quality of life.