Hallux Rigidus

What is hallux rigidus (arthritis of the big toe)?

Hallux rigidus is the medical term for arthritis in the joint at the base of the big toe. The joint can become stiff and painful, with a bony lump often developing over the big toe. This can cause a lot of discomfort when walking, exercising or playing sports.

What causes hallux rigidus?

Hallux rigidus often occurs as a result of repetitive ‘wear and tear’ so often affects people who are very active or do a lot of sports. Other joint diseases like gout or rheumatoid arthritis can also contribute to the development of hallux rigidus.

How is hallux rigidus diagnosed?

An initial diagnosis can be made by clinical examination of the joint. Further imaging like an x-ray can be used to further investigate the joint and check how severe the arthritis is; this can help decide the most appropriate treatment.

Treatment and recovery

Our foot and ankle specialists are highly experienced in treating hallux rigidus. In the initial stages, hallux rigidus can be managed effectively by modified footwear, using specially designed insoles and painkilling injections. Biological joint injections may also be considered for treatment.

However, with time, many people go on to require surgery. There are several different surgical procedures, dependent on the joint itself and various other factors:

• Cheilectomy – this procedure removes the extra bony growths that can develop in arthritis. It can be done as a day case and recovery takes around 6 weeks with physiotherapy.
• Fusion – joint fusion (known as ‘arthrodesis’) can be useful in very arthritic joints with little or no movement. Small plates and screws can be used to completely immobilise the joint. The aim of this process is to relieve pain, whilst retaining the ability to run and play sports. Recovery can involve up to 12 weeks of physiotherapy
• Joint replacement – a full joint replacement can be used when it is necessary to retain a full range of movement within the joint. The joint itself is removed and replaced with a prosthetic joint. Recovery usually requires 6-12 weeks of physiotherapy.