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The big toe joint will often appear larger or swollen and can be tender to pressure from touch or shoes. Ridges or “Lipping” may be felt on the edges of the bones as the body tries to naturally fuse the joint.<\/p>\n
Medical imaging will usually show damage and wear to the articular surface of the bones.<\/p>\n
Does this only affect older people?<\/h4>\n
No. Hallux Rigidus can also present in younger people, usually due to injury but it may even be genetic when the cause is unknown.<\/p>\n
How bad will it get?<\/h4>\n
In some people, it causes nothing more than a stiff big toe but research suggests that about 25% of people have enough pain when walking or even at rest to warrant medical intervention.<\/p>\n
Controlling weight is important as the big toe joint suffers twice your body weight when walking.<\/p>\n
Does Hallux Rigidus need surgery?<\/p>\n
Treatment options vary;<\/p>\n
Painkillers may help with occasional pain.
We often advise patients to find footwear with very rigid soles so that the big toes does not get forced upwards.
Orthotics can also be used to limit the force on the joint and rocker bars added to footwear to allow a more natural walking gait.
Patients are advised to use footwear with plenty of room in the toe box so that the joint is not coming into contact with the upper of the shoe.<\/p>\n
Injections of steroid and local anaesthetic can help reduce inflammation and patients report relief anywhere from a few days to a few months.<\/p>\n
Surgery is often used as a last resort but there are a number of surgical options available from trimming the damaged areas (cheilectomy) to fusion of the joint, where the metatarsal and tarsal bones are physically joined together.
Patients with fused big toe joints often require orthotics to offload the stress which is placed on the second and third joints which are generally not used to bearing such pressure.<\/p>\n
Replacement joints are available but this procedure is very rarely carried out in the UK.<\/p>\n