Hallux Rigidus

Hallux rigidus is a term used to describe decreased motion in the big toe joint. Another term used is hallux limitus. Hallux rigidus refers to the more severe end stage deformity. This problem is often accompanied by pain in the joint as well as calluses and difficulties walking.

There are many different causes of hallux rigidus. Many of the causes are genetic. In some cases people are predisposed to the problem due to a long or short metatarsal bone. The abnormal metatarsal bone leads to abnormal motion of the joint. This abnormal motion leads to break down of the joint.

A second cause of hallux rigidus is bunion deformities. The bunion deformity causes the big toe joint to be deviated and not move in the correct alignment. This abnormality in the alignment causes wearing down of the cartilage. This wearing down of the cartilage causes the motion to decrease in the joint.

A third cause is repeated trauma to the joint. Many people have heard of the term turf toe, which is repeated dislocation of the big toe joint. This often happens in athletes who have to plant their foot and change directions quickly. The repeated dislocations of the joint cause scar tissue to form around the joint. This scar tissue causes the motion in the joint to be restricted.

Another cause of hallux rigidus is arthritis. There are many different forms of arthritis as discussed in other sections. Arthritis is the wearing down of joint cartilage. When the joint cartilage wears down, and bone is rubbing on bone, the motion is much less smooth. This also causes significant pain.

Hallux rigidus can have a significant effect on a person’s quality of life due to the location of the deformity. With every step we take the big toe joint is required to dorsiflex or bend upwards approximately 60 to 75°. When the motion this joint is decreased normal walking is severely hindered.

Hallux rigidus is often accompanied by a callus underneath the big toe. This is due to the increased pressure with every step a person takes. The calluses themselves can become painful and may need to be reduced on a regular basis.

Conservative treatments for hallux rigidus consist of bracing and accommodating the shoe gear to decrease the amount of motion needed for normal walking. In some cases a stiff brace is put underneath the toe joint. This keeps the shoe from bending at the toe joint and requiring the toe to bend.

There are several different surgical procedures to treat hallux rigidus. In less severe cases procedures can be performed to increase the motion in the joint. These procedures involve removing bone spurs around the joint and repairing cartilage. In more severe cases the joint has to be replaced with an implant or fused in a position that allows for pain-free walking.

If you are starting to develop pain in the big toe joint it would be advisable to be evaluated. If there are problems that are going to lead to hallux rigidus often times they can be resolved before extensive surgery is needed.