Hallux Rigidus
Hallux Rigidus is a type of arthritis that efeects the base of the big toe.
Symptoms of Hallux Rigidus
The big toe joint where it joins the foot can become arthritic and result in bunions or
also a condition called Hallux Rigidus, where the big toe is stiff and it is
painful to bend the toe back, as occurs in walking. The toe joint may look swollen and
there may be bony lumps that you can feel around the top of the joint.
- Pain in the joint when you are active, especially as you push-off on the toes when you
walk
- Swelling around the joint
- A bump, like a bunion or callus, that develops on the top of the foot
- Stiffness in the great toe and an inability to bend it up or down
Treatment of Hallux Rigidus
Pain relievers and anti-inflammatory medications such as ibuprofen may help reduce the
swelling and ease the pain. Applying ice packs or taking contrast baths (described below)
may also help reduce inflammation and control symptoms for a short period of time. But
they aren’t enough to stop the condition from progressing. Wearing a shoe with a
large toe box will reduce the pressure on the toe, and you will probably have to give up
wearing high heels. Your doctor may recommend that you get a stiff-soled shoe with a
rocker or roller bottom design and possibly even a steel shank or metal brace in the sole.
This type of shoe supports the foot when you walk and reduces the amount of bend in the
big toe.
A contrast bath uses alternating cold and hot water to reduce inflammation. You’ll
need two buckets, one with water as cold as you can tolerate and the other with water as
warm as you can tolerate. Immerse your foot in the cold water for 30 seconds, then
immediately place it in the hot water for 30 seconds. Continue to alternate between cold
and hot for five minutes, ending in the cold water. You can do contrast baths up to three
times a day. However, be careful to avoid extreme temperatures in the water, especially if
your feet aren’t very sensitive to heat or cold.
Surgery for Hallux Rigidus
- Cheilectomy (kI-lek’-toe-me)
This surgery is usually recommended when
damage is mild or moderate. It involves removing the bone spurs as well as a portion of
the foot bone, so the toe has more room to bend. The incision is made on the top of the
foot. The toe and the operative site may remain swollen for several months after the
operation, and you will have to wear a wooden-soled sandal for at least two weeks after
the surgery. But most patients do experience long-term relief.
- Arthrodesis (are-throw-dee’-sis)
Fusing the bones together (arthrodesis)
is often recommended when the damage to the cartilage is severe. The damaged cartilage is
removed and pins, screws, or a plate are used to fix the joint in a permanent position.
Gradually, the bones grow together. This type of surgery means that you will not be able
to bend the toe at all. However, it is the most reliable way to reduce pain in these
severe cases.
For the first six weeks after surgery, you will have to wear a cast and then use
crutches for about another six weeks. You won’t be able to wear high heels, and you
may need to wear a shoe with a rocker-type sole.
- Arthroplasty (are-throw-plas’-tee)
Older patients who place few
functional demands on the feet may be candidates for joint replacement surgery. The joint
surfaces are removed and an artificial joint is implanted. This procedure may relieve pain
and preserve joint motion.
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