Hallux Rigidus (Stiff big toe)
Introduction to Hallux Rigidus (Stiff Big Toe)
Hallux rigidus can be characterized as arthritis of the main joint of the big toe. It is a wearing out of the joint surfaces. It is called “hallux rigidus” because its main feature is stiffness (“rigidus”) of the big toe (“hallux”).
Symptoms of Hallux Rigidius
- Early signs and symptoms include:
- Pain and stiffness in the big toe during use (walking, standing, bending, etc.)
- Pain and stiffness aggravated by cold, damp weather
- Difficulty with certain activities (running, squatting)
- Swelling and inflammation around the joint
- As the disorder gets more serious, additional symptoms may develop, including:
- Pain, even during rest
- Difficulty wearing shoes because bone spurs (overgrowths) develop. Wearing high-heeled shoes can be particularly difficult.
- Dull pain in the hip, knee, or lower back due to changes in the way you walk
- Limping, in severe cases
Cause of Hallux Rigidus
- In the majority of cases the cause is unknown, the reason for this may be due to wear and tear of the joint which is particularly subject to pressure out due to tremendous stress placed on it during walking. With each step, a force equal to twice your body weight passes through this very small joint.
Contributing conditions such as gout or infection of the toe can lead to this condition.
An underlying biomechanical condition can also cause this condition. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus.
In detail, excessive pronation may destabilize the great toe joint. If the foot pronates (or flattens) excessively, there is an increase in pressure under the first metatarsal as the foot rolls in. This force may be considered as an upward pressure from the floor on the inside of the weight-bearing portion of the foot. This pressure beneath the first metatarsal can cause it to elevate, resulting in hypermobility, hallux limitus or hallux rigidus. Simple orthotics such as the Dr Foot Work Insoles can often provide relief.
Long Term Prognosis
Research shows that although the joint remains arthritic and stiff, it tends not to get much worse in the majority of people. Even after 20 years the joint was much the same as it had been when the people who were studied first went to the doctor.
However, in about 20-25% the joint becomes progressively more stiff or painful and treatment may be required.