Hallux Rigidus

What is hallux rigidus?

Hallux rigidus is a degenerative form of arthritis that affects the big toe. It forms in the metatarsophalangeal joint, known as the MTP joint, and it is caused by a breakdown of the articular cartilage, which results in the bones of the joint rubbing together, resulting in bony growths called bone spurs. The toe stiffens, causing pain and difficulty walking.

Because of its progressive nature, hallux rigidus can be a potentially disabling condition, and will only continue to get stiffer if left untreated. Hallux rigidus is more common in active adults.

How do I know I have hallux rigidus?

If you are experiencing hallux rigidus in its early stages, you may find your toe’s range of motion is not very limited at all. At this stage, the condition is referred to as “hallux rigidus.” This being said, the condition will continue to worsen, gradually limiting the toe’s range of motion until it potentially reaches “rigidus” and becomes stiff.

Early signs and symptoms of hallux rigidus include pain and sitffness in the big toe while walking, standing, or bending, swelling and inflammation around the affected joint, and symptoms aggravated by cold, damp weather. As the arthritis progresses, you may experience more serious symptoms, such as pain regardless of whether the joint is in use or resting, the development of bone spurs, which may make it difficult to wear shoes, dull pain in the hip, knee, or lower back, often attributed to a chance in your gait (which could happen as your body’s way of minimizing the pain).

 

What causes hallux rigidus?

Hallux rigidus, along with other forms of degenerative arthritis, is caused by wear-and-tear of the joint over time. As we age, the cartilage between joints wears down, resulting in friction and inflammation. This can lead to pain and stiffness in the joint. Overuse can also contribute to the development of hallux rigidus, particularly in individuals who have jobs or participate in hobbies that increase the stress on the big toe, like those who need to squat frequently.

Hallux rigidus can also be a consequence of an injury, even one as small as a stubbed toe. Overweight individuals are more likely to develop this condition because of the increased stress on the joints.

How is hallux rigidus treated?

The first step in treating hallux rigidus is managing the condition. Treatment for mild or moderate cases may include shoe modifications or orthotic devices. Wearing shoes with a large toe box may be helpful, as this puts less pressure on the big toe. Other recommendations are to wear shoes with stiff or rocker-bottom soles and to stay away from high heels. Custom orthotic devices may be prescribed to help improve the function of the foot. Anti-inflammatory medication may be prescribed to reduce pain and inflammation. Corticosteroid injections may be administered to the affected toe in small amounts.

Physical therapy may be used to increase range of motion and strength in the big toe joint. If these conservative treatments are not successful, surgery may be recommended. Joint fusion is the most common surgical treatment for hallux rigidus, which involves fusing the bones of the big toe joint together so that it doesn’t move. This eliminates the pain associated with the joint and can improve function, but can also reduce flexibility in the toe. Arthroplasty is another surgical option, which involves replacing the worn out cartilage in the joint with a metal or plastic implant. While this can reduce pain and improve joint function, it may not be as effective in these areas as a joint fusion.

Clients reviews

Dr. Salvatore Gaudino is a miracle worker.  I had problems walking for more than five years, NOT any more.  I went to countless Specialists… One of the luckiest days of my life is when I made an appointment with him!  He is truly amazing.  The great office staff is welcoming.  What a great experience.  Thank you ALL!

Joanne K.

The staff is great, attentive and paperwork is seamlessly handled. Dr Lee is superb, friendly and goes extra steps to resolve the issue whether it’s from foot discomfort or giving insight on products. Lisa is stellar, to the point and promptly processes the  necessary paperwork.

Kenny L.

Dr. Gaudino examined my son and explained to me exactly what he needed to correct his “turned feet”, as well as showing me some exercises to relieve the tension in his feet. He was so nice and caring towards my son, and really made him feel at ease. I would definitely recommend this practice to my friends and family!

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