Your big toe has been a bit creaky and sore for a while, but lately it has become just plain stiff and you want to figure out what's going on. If this sounds familiar, it's time to make an appointment with a medical professional. You might have hallux rigidus or “Stiff Big Toe,” a form of degenerative arthritis.
Typically, hallux rigidus is caused by irregular biomechanics or structural problems with the foot. Over time, the big toe metatarsophalangeal, or MTP joint, may become arthritic. This can occur through repeated pressure due to other foot abnormalities, like fallen arches, which put additional weight on the joint.
Hallux rigidus may also have a genetic component. So, if it runs in your family, that may be part of the cause. Other potential causes include excessive squatting or other activities that place continual pressure on the big toe joint, contributing to the disintegration of the surrounding cartilage.
Medical conditions like gout or rheumatoid arthritis can also contribute to the development of Stiff Big Toe, which is most common in people between the ages of 30 and 60 years of age.
If you've experienced discomfort, rigidity, or swelling in your big toe while walking, squatting, bending, climbing stairs, or during other activities, these could be early symptoms of hallux rigidus.
The symptoms may be exacerbated during damp or cold weather. Eventually, as the condition progresses, you may experience pain even when you’re off your feet.
You may begin to limp while walking or feel hip, knee, or lower back pain. These symptoms are signs that your body is attempting to compensate for the loss of flexibility and balance.
You could even develop unsightly and painful bone spurs, caused by the friction of your bones rubbing together when the surrounding cartilage wears away.
Diagnosing hallux rigidus involves a visit to a podiatrist or foot surgeon—preferably before the condition has progressed to full rigidity or before a bone spur has developed. Your practitioner will examine the flexibility of your big toe by moving it in different directions.
If arthritis or a bone spur is suspected, the doctor may order a series of X-rays to examine the extent of damage to the area before deciding on the best course of treatment.
The following are some surgical treatments that may be required to help correct more serious cases of Stiff Big Toe:
If your hallux rigidus is moderate-to-severe, your doctor may recommend removal of any spurs and/or a portion of the bone. This will help the joint to move more freely. A cheilectomy for hallux rigidus involves creating an incision along the top of the foot to provide access to the bone, which is then surgically cut.
Post-surgery, your big toe will require months of healing time, and you'll need to wear a special sandal with a wooden sole for at least two weeks after your procedure. Patient outcomes following cheilectomy are generally positive and effective for the long-term.
For extreme cases of hallux rigidus, your foot surgeon may need to do a bone fusion. This is accomplished through a surgical incision and removal of the damaged cartilage, followed by the insertion of pins, a plate, and screws to affix the toe joint into the proper position.
Although you will be permanently unable to move the toe joint after your surgery, the pain, bone spurs, and swelling associated with the condition will eventually subside.
You will be in a cast for at least six-weeks post-surgery, and you’ll need crutches for another six weeks after that, so you’ll need to plan for a lengthy recovery. Because your toe will be unable to bend after the fusion, you will have to wear flat heels and may require a rocker sole on your footwear.
Joint replacement surgery may be an option to restore flexibility to the toe and reduce chronic pain and swelling. Usually, this procedure is only recommended for elderly patients whose mobility needs are less demanding than younger patients.
Stiff Big Toe is often a result of pressure placed on the joint due to biomechanical issues with your feet. Insoles for hallux rigidus are designed to correct such issues can be helpful.
When you're looking for insoles to relieve arthritis pain in your big toe, you'll want to make sure you find ones that have firm, medical grade support. Soft, foam insoles won't give your feet the support they need to align your ankles, knees, and hips. Aligning your body properly takes pressure of your big toe joints.
Check these boxes when you're shopping for hallux rigidus orthotics:
Like most progressive conditions, the best time to seek treatment for hallux rigidus is early on. Speak to your doctor if you notice pain, swelling, or stiffness in your big toe or if activities that require toe flexibility become difficult.
With a proactive approach to foot wellness, you may be able to avoid foot surgery and a lengthy recovery. With proper shoes and the use of supportive hallux rigidus orthotics, you can remediate the discomfort and reduce the cartilage and joint damage of this condition.
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