Hallux Rigidus

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Hallux Rigidus

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Hallux rigidus is more common in females and is one of the most common causes of foot pain in people over the age of 50.

Our feet are responsible for supporting our entire weight, as well as transporting us every day. Yet, they are often overlooked until they start to cause us pain. If you have started to notice pain in your big toe, especially when first standing up, it could be a condition called hallux rigidus.

What is Hallux Rigidus?

Hallux rigidus is a form of arthritis at the base of your big toe. The word hallux means toe, and the word rigidus means rigid or unmoving. So this term simply means that the movement of your toe is limited or non-existent. Your big toe is essential to your balance, so when this toe has limited movement, your entire body can be thrown off balance. You will notice the pain in your foot first, but left untreated, your knees and hips can also be affected.

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What Causes Hallux Rigidus?

Doctors suspect there is a genetic predisposition to this condition. An abnormality in the way the foot is structured or in the way it functions, such as fallen arches or excessive rolling of the ankles, can lead to hallux rigidus over time. An elevated metatarsal or injury to the big toe can also lead to this condition. Jobs that require extra stress on your big toe, such as a lot of squatting, can be a risk factor. In many cases, however, the exact cause is difficult to pinpoint.

How Do You Know if You Have Hallux Rigidus?

The early signs of hallux rigidus can be vague and you may not realize you are developing this condition. You may start to have difficulty running or squatting. You may feel pain and a certain level of stiffness when you are walking, bending over, or standing for long periods. The joint may swell and look inflamed.

As the condition progresses untreated, the symptoms will worsen. Your toe will begin to hurt even when you are not using it. Bone spurs can form over the joint, making your shoes not fit, or causing pain when your shoe rubs on them. You may start to feel pain in your knee, hip, or lower back due to the fact you are walking differently. You may not connect this pain to your foot, but remember that your feet are bearing all of your weight, and if they are not functioning correctly, your other joints will also be affected. In severe cases, the stiffness will lead to limping.

Are Imaging Tests Necessary for a Diagnosis?

Hallux rigidus can often be diagnosed solely by a physical examination. Your doctor will test the range of motion in your toe and ask questions about pain and mobility. Bone spurs are often visible, but he or she may want an x-ray to determine the extent of the damage. MRIs or CAT scans are typically not necessary.

Is There Non-Surgical Treatment Available?

If your condition is caught early, your doctor may want to hold off doing any surgical treatments. There are a few interventions you can try to reduce the pain and increase mobility. You can wear modified shoes, such as a shoe that has a larger toe box or stiff-soled shoes. There are custom orthotics that can be put in your shoe to reduce pressure to your toe and improve function. Pain relievers and anti-inflammatory medications such as ibuprofen may help reduce pain and swelling. More severe pain may be helped with injections of corticosteroids or platelet-rich plasma. Physical therapy may be prescribed as well. These treatments can relieve pain and restore function but bear in mind that they will not cure the condition.

Can Surgery Fix Hallux Rigidus?

If the condition is severe and conservative treatments are not working, your doctor might recommend surgery. There are several different types of surgery available, depending on the extent of arthritis and how deformed the toe is, as well as the formation of bone spurs. If a bone spur has formed that is impeding movement, removal of this spur may be all that is needed. For more extensive damage to the joint, the joint may need to be fused together. This solves the problem but does limit mobility to some degree. Other options include resurfacing of the joint and total replacement of the joint.

If you think you suffer from hallux rigidus, talk to your doctor. Early treatment is best to prevent the condition from progressing.