Stiff Big Toe – Hallux Rigidus

Hallux rigidus or stiff big toe is the arthritis of the metatarsophalangeal joint of the big toe. It is usually associated with some case of trauma history in the patient however sometimes there is no such history of mechanical injury. It more commonly affects females especially between 30 and 60 years of age. The underlying reason is the wearing off of the cartilage present at the metatarsophalangeal joint of the big toe which maybe age related or trauma related however factors such as foot structure also contribute majorly.

Symptoms of Stiff Big Toe / Hallux Rigidus:

  • Pain is the foremost symptom and is strongly indicative of the wear and tear of the cartilage which in case of the big toe is almost invariably suggestive of hallux rigidus.
  • Inflammation at the site of the disease is evident on inspection and further explained by the tenderness experienced at this site and not being able to shift weight on the corresponding foot.
  • Difficulties in physical performances even those of daily routine.

Treatment options for a stiff big toe :

Non surgical approach is opted in mild cases or in the presence of factors contraindicated for surgery such as poor circulation to the affected site.

Non surgical approaches include:

  • Shoe adjustments
  • Anti inflammatory drugs which may be non steroidal or steroidal in nature.
  • Physiotherapy

Surgical approach is opted when all available non surgical options have been ruled out. These include:

  • Dorsal cheilectomy to remove the excessive bony part if present.
  • Keller procedure where the joint’s articular surface is renewed.
  • Arthrodesis which is the induction of joint ossification.
  • Arhtroplasty with silicone implant.

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