Each day, people spend much of their time traveling from place to place on foot. Thus, it can be especially concerning when one develops pain in their foot while walking. This can become a more prevalent concern in older adults, with aches and pains from conditions like arthritis becoming much more common.
What is Hallux Rigidus?
Hallux rigidus is one of the most common types of foot arthritis, especially in adults over the age of 50. It affects the joint that connects the big toe to the foot—known as the first metatarsophalangeal (MTP) joint—causing pain and stiffness in the joint.
Symptoms
The most common symptoms include pain in the big toe or the surrounding area, stiffness or swelling of the big toe, and the presence of a bump that appears to be a bunion or callus. These symptoms may be worsened by factors such as standing or moving, cold weather, and ill-fitting shoes.
Causes and Risk Factors
Hallux rigidus develops naturally with age as the cartilage in the joint experiences wear and tear, with the first MTP joint experiencing a significant amount of stress when walking. However, things like toe sprains, stubbing the big toe, and overuse of the MTP joint can increase risk of hallux rigidus.
Additionally, hallux rigidus is more common in those over the age of 50, women, athletes, and those who are constantly on their feet all day. The presence of other health conditions—such as rheumatoid arthritis, gout, autoimmune disorders, and osteochondritis dissecans—can also increase the risk of developing hallux rigidus.
Diagnosis and Treatment
Oftentimes, a healthcare provider—usually a podiatrist—can diagnose hallux rigidus by performing a physical exam where they move the toe up and down to assess for range of motion in the first MTP joint. They may also obtain a foot X-ray to further assess the foot.
In many cases, surgical intervention is not required to treat hallux rigidus. Some noninvasive methods of treatment include changes in footwear, orthotics, icing, over-the-counter pain medications, and corticosteroids. However, with severe cases of hallux rigidus, surgical interventions may be required.
Surgical options for treatment
During a cheilectomy, the surgeon will go in and shave down any bone spurs to create more space for the toe to bend. The recovery period is typically around 2 weeks, with swelling potentially persisting for several months.
During an arthrodesis, any damaged cartilage in the joint will be removed and the bones in the joint are fused together. This results in limited range of motion in the big toe. The full recovery period is several months.
During an arthroplasty, damaged cartilage is removed and replaced with a prosthetic implant. Similar to a cheilectomy, the recovery period is typically around 2 weeks, with swelling potentially persisting for several months.
Outlook
While surgical options are the only way to permanently resolve pain or stiffness from hallux rigidus, many patients are able to manage the symptoms through nonsurgical methods. With treatment, patients are often able to resume usual physical activities.
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