What is Hallux Rigidus?
Hallux rigidus is a degenerative arthritis of the big toe’s metatarsophalangeal (MTP) joint, leading to stiffness, pain, and limited motion—especially when lifting the toe (dorsiflexion). Over time, bone spurs (osteophytes) develop around the joint, worsening discomfort.
Causes & Risk Factors
- Trauma or repetitive stress (e.g., sports, running)
- Family history (genetic predisposition)
- Gout or inflammatory arthritis (e.g., rheumatoid arthritis)
- Age-related wear and tear
Symptoms
- Pain & stiffness when walking or standing
- Swelling & inflammation around the big toe joint
- Difficulty wearing shoes due to bone spurs
- Reduced upward motion of the toe
Non-Surgical Treatments
- Stiff-soled or rocker-bottom shoes – Reduce joint movement and pain.
- Orthotics & insoles – Support the foot and redistribute pressure.
- Anti-inflammatory medications – Help manage pain and swelling.
- Corticosteroid injections – Temporarily relieve inflammation.
Surgical Treatment Options
If conservative methods fail, surgery may be recommended:
1. Cheilectomy
- Removes bone spurs and damaged cartilage.
- Preserves joint motion.
- Best for mild to moderate cases.
2. Joint Fusion (Arthrodesis)
- Permanently stiffens the joint to eliminate pain.
- Ideal for severe arthritis.
- May alter walking mechanics but allows return to sports.
3. Interposition Arthroplasty (Keller’s Procedure)
- Removes part of the joint bone and inserts soft tissue.
- Used for low-demand patients or when fusion isn’t suitable.
4. Joint Replacement (Prosthetic Arthroplasty)
- Hemi or total toe implants (less common due to high failure rates).
- Some newer spacers show promise but lack long-term data.
Recovery & Potential Complications
- Fusion recovery: 6–12 weeks in a walking boot.
- Cheilectomy recovery: Faster return to activity (4–6 weeks).
- Possible risks: Infection, nerve damage, or persistent pain under the sesamoids.
Conclusion
Hallux rigidus can significantly impact mobility, but early treatment helps slow progression. While shoe modifications and injections provide relief, surgery may be needed for advanced cases. A foot specialist can guide the best approach based on severity and lifestyle.