Hallux Rigidus

Hallux Rigidus Overview

Hallux rigidus is a progressively painful condition of the big toe that is generally a “wear and tear” phenomenon.  Hallux is Latin for big toe while rigidus means “stiff”.  It is sometimes referred to as hallux limitus. This condition primarily occurs from chronic overuse and in some cases can be related to a specific injury. Genetics can also play a role.

Hallux Rigidus Symptoms

Symptoms of hallux rigidus include a dull, aching pain, and decreased movement of the big toe.  This can lead to difficulty with shoe wear, walking or standing for periods of time.  Over time limping can create pain in other areas of the foot, or even other joints, as they see more stress.

Diagnostic Testing for Hallux Rigidus

Our physicians will perform an extensive evaluation including x-rays of the foot.  X-rays will generally show decrease space within the big toe joint (MTP) as well as bone spurs around the joint. Usually, this is enough to properly guide treatment, but some cases require advanced imaging such as MRI or CT.

Treatment for Hallux Rigidus

Non-Surgical of Hallux Rigidus

Patients who have mild cases of hallux rigidus can be treated conservatively.  Conservative treatment includes activity modification, shoe modifications, insoles or orthotic devices, anti-inflammatory medications or steroid injections.  

Surgical Treatment for Hallux Rigidus

In severe cases of hallux rigidus where persistent pain and loss of function persists, surgery may be the best option. Our orthopaedic surgeons offer several surgical approaches that can improve this condition. For some patients, an arthroscopic debridement of the joint can alleviate pain.  With a small incision, a cheilectomy is another procedure that is used to remove bone spurs around the big toe joint. This helps preserve the joint and often decreases pain and improves mobility.  In patients who have significantly reduced joint space, a synthetic cartilage implant may be an option.  This is an FDA approved implant known as Cartiva. For patients who have severe motion limitation and degenerative changes in the joint, a fusion of the joint may be needed.

Post-Operative Care for Hallux Rigidus

Post-operative recovery following surgery for hallux rigidus will depend on the surgery that was performed.  Instructions on how to begin mobility of the joint will occur soon after surgery. Some patients are allowed to weight bear immediately in a hard sole (postoperative) shoe. It is essential that patients follow the post-operative protocol for recovery as set forth by our surgeons since this is a crucial part of the healing process.

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