Hallux Rigidus

Hallux rigidus is a condition where the great toe becomes stiff. "Hallux" refers to the great toe, and "rigidus" indicates that it is becoming stiff. Stiffness of the great toe may be due to arthritis at the base of the great toe at the first MTP joint. Sometimes the joint will stiffen without evidence of arthritis. Then it is probably caused by contracture in the soft-tissue, the ligaments that support the joint.

In normal walking, your body’s weight rolls onto the ball of the foot at the end of each step. The great toe joint must flex upward during that for a normal walking gait to occur. If that joint begins to stiffen, it can make walking difficult and painful. As the condition progresses, bone spurs may form about the top of the joint. If those become very large they may also make fitting shoes uncomfortable.

Treatment
General treatment recommendations include avoiding painful activities and taking oral anti-inflammatory medications for pain relief. Wearing a shoe with a stiff sole can limit the motion at the first MTP joint, and minimize the discomfort. Some shoes can be modified to stiffen the sole if it is not possible to find one off the shelf. Cortisone Injections into the joint with may relieve pain for an extended time.

When symptoms persist there are surgical treatments that can be performed. Those include Cheilectomy to remove the spurs about the joint, or Fusion of the joint.

The Cheilectomy is the smaller of the two procedures. In that procedure these spurs are removed from both sides of the joint, which generally improves the motion at the joint and hopefully eliminates pain. Nothing is done to the joint surfaces themselves. The Fusion operation is done if there is significant arthritis at the joint, or if you have had a cheilectomy and persist with pain.

For a further discussion of Hallux Rigidus please see the AAOS website.