Hallux rigidus is a form of degenerative arthritis. Hallux (refers to the big toe) rigidus (refers to stiffness) usually affects adults between 30 and 60 years of age -- and often it is the result of a prior high school sports injury.
It is the joint at the base of the big toe (metatarsophalangeal joint, or MTP joint) that is affected and the condition develops gradually over time. Not all injured athletes develop hallux rigidus -- which begs the question: Why do some develop hallux rigidus but others do not?
Who Develops Hallux Rigidus?
People who participate in sports where loading, stressing, and extending movements are required of their feet become susceptible to micro-trauma and sprains in the joint at the base of the big toe. "Turf toe," the name given to these injuries, can also cause bone spurs or osteophytes to develop. Soccer and football played on artificial turf cause most toe injuries in sports. If not treated properly, turf toe can lead to hallux rigidus.
Not only athletes develop hallux rigidus though. People who have fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus. It can run in families -- foot type prone to developing hallux rigidus can be inherited. Also, it can be caused by specific inflammatory diseases, such as rheumatoid arthritis or gout.
Why Is Getting Medical Attention So Important?
The lack of proper treatment for big toe injuries can have serious consequences. Treatment is imperative so that the condition does not become debilitating. Advanced hallux rigidus can cause:
- pain, even during rest
- difficulty wearing shoes because of bone spurs
- difficulty wearing high-heeled shoes
- dull pain in the hip, knee, or lower back caused by changes in how someone walks
Nonsurgical treatment options include:
- shoe modifications (e.g., shoe pads designed to stop movement under joint of big toe)
- activity modifications (e.g., low impact exercising)
- anti-inflammatory medications or steroid injections
Surgical treatment options include:
- cheilectomy, also known as shaving the big toe joint (for patients trying to preserve the joint, mobility, but end up with less pain)
- arthrodesis, also known as joint fusion (for patients seeking lasting pain relief even though the fused joints will no longer bend)
What Should You Do if You Have Symptoms?
Early treatment and early diagnosis yield the best results for the patient with hallux rigidus. See your doctor when you first notice symptoms.
Hallux Rigidus. FootPhysicians.com. American College of Foot and Ankle Surgeons. February 1, 2004.
When Arthritis Inflames the Big Toe…Which Athletes are Vulnerable? Hospital for Special Surgery. November 21, 2007.