Hallux Rigidus

The technical name for the big toe joint is the ‘hallux’ joint and the ‘rigidus’ obviously refers to something rigid, so ‘hallux rigidus’ is a stiffer big toe joint. It is also usually painful. Typically the joint is not rigid, but its range of motion is much less than what is needed for normal function, so some prefer to call it ‘hallux limitus’. The most common reason for a hallux rigidus is osteoarthritis.

The reason for the osteoarthritis is either a ‘wear and tear’ issue from years of biomechanical issues like a flat foot or wearing bad shoes or the osteoarthritis could have been triggered by trauma to the joint. Typically the symptoms start off very slowly and get progressively worse over time. The pain is in and around the joint. The slow onset of pain also means that the symptoms are not gout (which is acutely painful with a rapid onset). There are fairly typical changes that can be seen on an x-ray.

What can be done for hallux rigidus?

Short term pain relief can be with medicines for the pain and the use of ice, but this is not a good option for the longer term. As the joint hurts to move, it makes sense to restrict its movement to help the pain. There are many ways to do this. Podiatrists often use felt padding on the foot under the joint to restrict motion. Being stuck on the foot means that its not a good option long term, but does give an indication if this sort of padding could be incorporated into a foot orthotic or on an insole in the shoe. Strapping the joint can also be used to help in the very short term if it is painful. Exercises and mobilizations are also good to try and restore some motion and keep the joint a bit more healthier.

Using shoes that are stiffer or more rigid in the sole can also be of some help as you bend the big toe joint less when walking in these shoes. Some shoes have a rocker action built into them (eg the Hoka running shoes) and this can also help you walk (or run) without using the joint so much. Another way is to use the carbon fibre plate insoles that are very thin (<1.5mm) and very rigid and fits in the shoe to restrict movement across the forefoot.

The final option is surgery. There are several alternatives here depending on the exact nature of your hallux rigidus. Some may just need a bit of bone removed (cheilectomy) that allows for more motion at the joint; some may benefit from a replacement of the joint surfaces with an artificial joint; and others may have to have the joint fused so it does not move. Which one suits you will depend on the nature of the problem and what the surgeon thinks is the better option.

FootStore.au Products for Cracked Heels

Our most popular product for hallux rigidus is the carbon plate insole to make the shoe stiffer.

See also:

For more on hallux rigidus you could ask a question in the Foot Health Forum on hallux rigidus or browse the hallux rigidus threads on Podiatry Arena or see this from PodiaPaedia.