Hallux rigidus

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Hallux rigidus
Synonyms	Stiff big toe
Pronounce	N/A
Specialty	N/A
Symptoms	Pain and stiffness in the big toe, difficulty walking
Complications	Osteoarthritis
Onset	Usually after age 30
Duration	Long-term
Types	N/A
Causes	Degenerative joint disease, trauma
Risks	Family history, foot anatomy, gout
Diagnosis	Physical examination, X-ray
Differential diagnosis	Gout, bunion, sesamoiditis
Prevention	Proper footwear, avoiding foot injuries
Treatment	NSAIDs, physical therapy, surgery
Medication	NSAIDs
Prognosis	Variable, can lead to arthritis
Frequency	Common
Deaths	N/A

Hallux rigidus is a medical condition characterized by stiffness and pain in the metatarsophalangeal joint (MTP) of the big toe. It is a form of degenerative arthritis and can significantly impact a person's ability to walk and engage in physical activities.

Signs and Symptoms

The primary symptoms of hallux rigidus include:

• Pain and stiffness in the big toe, especially during walking or standing.
• Swelling and inflammation around the MTP joint.
• Difficulty in bending the big toe.
• Development of bone spurs on the top of the MTP joint, which can lead to a bump that is painful and limits shoe wear.

Causes

Hallux rigidus is often caused by wear and tear of the joint over time. Factors that may contribute to the development of this condition include:

• Osteoarthritis.
• Previous injury to the big toe.
• Abnormal foot anatomy or biomechanics.
• Genetic predisposition.

Diagnosis

Diagnosis of hallux rigidus typically involves:

• A physical examination of the foot.
• X-ray imaging to assess the extent of joint degeneration and the presence of bone spurs.
• Magnetic resonance imaging (MRI) or computed tomography (CT) scans in more complex cases.

Treatment

Treatment options for hallux rigidus vary depending on the severity of the condition and may include:

• Non-surgical treatments:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
  • Physical therapy to improve joint mobility.
  • Custom orthotic devices to support the foot and reduce stress on the MTP joint.
  • Shoe modifications, such as stiff-soled shoes or shoes with a large toe box.
• Surgical treatments:
  • Cheilectomy: Removal of bone spurs and part of the foot bone to improve joint movement.
  • Arthrodesis: Fusion of the MTP joint to eliminate pain by preventing joint movement.
  • Arthroplasty: Joint replacement surgery to restore function and relieve pain.

Prognosis

The prognosis for individuals with hallux rigidus varies. Non-surgical treatments can often manage symptoms effectively, but in severe cases, surgery may be necessary to restore function and alleviate pain. Early diagnosis and treatment are crucial to prevent the progression of the condition.

Prevention

Preventive measures for hallux rigidus include:

• Wearing appropriate footwear that provides adequate support and room for the toes.
• Avoiding activities that place excessive stress on the big toe.
• Maintaining a healthy weight to reduce pressure on the feet.
• Performing regular foot exercises to maintain joint flexibility and strength.

See Also

• Arthritis
• Foot and ankle surgery
• Orthopedic surgery

External Links

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