Hallux Rigidus
Hallux rigidus is a condition of the big toe joint in which the joint is unable to bend freely. Due to the restricted movement, pain and stiffness result. Hallux is the medical term for the big toe, and rigidus indicates lack of movement. Hallux rigidus is a form of degenerative arthritis.
The big toe joint is involved extensively in walking, stooping down, climbing up or even standing. Therefore, the lack of movement at the joint can become debilitating. Hallux rigidus is a progressive disease and involves limited range of motion. The less severe form of hallux rigidus is hallux limitus, where there is decrease in movement at the joint.
Causes:
The main cause of this condition is faulty function (biomechanics) and abnormal foot structures. With these causes, the joint undergoes excessive wear and tear, leading to deteriorated joint function. For example, patients with flatfoot have decreased rigidity of the foot to propel off during walking. Therefore, the big toe is constantly in an overly extended position to assist with walking. This unusual motion, in the long term, causes degeneration of the big toe joint.
Overuse due to activity levels, inflammatory diseases such as rheumatoid disease, grout can also cause the joint to break down, and become rigid.
Symptoms:
Early signs of the disease include pain and stiffness in the big toe joint during walking, standing, and bending. The pain and stiffness is further aggravated by cold, or damp weather. As the disease progresses, patients might have trouble with certain activities.
As the disease worsens, the pain increases. Patients might have difficulty with wearing shoes. As the pain impacts the patient's gait pattern, pain in the hips, knees or lower back can occur. If the symptoms are severe, the patient will walk with a limp.
Diagnosis:
The earlier the diagnosis, the early the treatment can be implemented to slow the progression of the disease. Once a bone spur is present, the condition is likely more difficult to treat. A careful physical exam, with biomechanical examination, is vital. X-rays of the foot to assess the quality of the joint, and degree of deformity are recommended.
Treatments:
Conservative treatment for hallux rigidus is primarily for symptom control. Treatments can include the following.
If the symptoms worsen, or if the deformity is severe, surgery may be considered. The type of surgery will depend on the type of deformity, severity of the deformity, age, activity level, and other factors.
Hallux rigidus is a condition of the big toe joint in which the joint is unable to bend freely. Due to the restricted movement, pain and stiffness result. Hallux is the medical term for the big toe, and rigidus indicates lack of movement. Hallux rigidus is a form of degenerative arthritis.
The big toe joint is involved extensively in walking, stooping down, climbing up or even standing. Therefore, the lack of movement at the joint can become debilitating. Hallux rigidus is a progressive disease and involves limited range of motion. The less severe form of hallux rigidus is hallux limitus, where there is decrease in movement at the joint.
Causes:
The main cause of this condition is faulty function (biomechanics) and abnormal foot structures. With these causes, the joint undergoes excessive wear and tear, leading to deteriorated joint function. For example, patients with flatfoot have decreased rigidity of the foot to propel off during walking. Therefore, the big toe is constantly in an overly extended position to assist with walking. This unusual motion, in the long term, causes degeneration of the big toe joint.
Overuse due to activity levels, inflammatory diseases such as rheumatoid disease, grout can also cause the joint to break down, and become rigid.
Symptoms:
Early signs of the disease include pain and stiffness in the big toe joint during walking, standing, and bending. The pain and stiffness is further aggravated by cold, or damp weather. As the disease progresses, patients might have trouble with certain activities.
As the disease worsens, the pain increases. Patients might have difficulty with wearing shoes. As the pain impacts the patient's gait pattern, pain in the hips, knees or lower back can occur. If the symptoms are severe, the patient will walk with a limp.
Diagnosis:
The earlier the diagnosis, the early the treatment can be implemented to slow the progression of the disease. Once a bone spur is present, the condition is likely more difficult to treat. A careful physical exam, with biomechanical examination, is vital. X-rays of the foot to assess the quality of the joint, and degree of deformity are recommended.
Treatments:
Conservative treatment for hallux rigidus is primarily for symptom control. Treatments can include the following.
- Shoe modifications. Shoes with a large toe box put less pressure on your toe. Stiff or rocker-bottom soles may also be recommended.
- Orthotic devices. Custom orthotic devices may improve foot function.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Injection therapy. Injections of corticosteroids may reduce inflammation and pain.
- Physical therapy. Ultrasound therapy or other physical therapy modalities may be undertaken to provide temporary relief.
If the symptoms worsen, or if the deformity is severe, surgery may be considered. The type of surgery will depend on the type of deformity, severity of the deformity, age, activity level, and other factors.