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Affecting the upper part of the big toe joint or in some people, the whole joint, Hallux rigidus causes joint pain. The condition can also be described as arthritis of the big toe.

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Symptoms of Hallux rigidus include: -

  • Pain in the big toe joint
  • Pain when walking or at rest
  • Pain when you turn the big toe up as far as it will go
  • Stiffness
  • Loss of the ability to turn the big toe upwards, but can be turned downwards
  • Big toe gets so stiff it points downwards and cannot be laid flat on the floor
  • A dorsal bunion or bony bump may develop on top of the joint. In some people, this is their only problem.
  • Some people tend to walk on the side of the foot that may produce pain in the ball of the foot or down its outside border.

Although the joint remains arthritic and stiff, it tends not to get much worse in the majority of people. 20-25% of people with the condition find the joint becomes progressively more stiff or painful and requires further investigation.

Your GP will examine your foot and may be able to advise you about treatments that can help.

If necessary, they may be able to refer you to a podiatrist (a specialist in foot problems) or orthopaedic surgeon to discuss possible treatments. You can also contact a podiatrist or orthopaedic surgeon directly.

Whilst we all think of arthritis as an older generation condition, Hallux rigidus has been found in teens. However, this does not mean they are any more likely to develop arthritis any earlier than anyone else.

The exact cause is currently unknown.

There are a number of treatments available including injections and manipulations, trimming arthritic bits of bone, fusing the joint and replacing the joint. your surgeon would very much evaluate your case individually and tailor the treatment to your amount of arthritis and your lifestyle.

Non-prescribed painkillers such as paracetamol can be a good starting point. If the pain continues or increases, your GP may prescribe an appropriate painkiller or anti-inflammatory medicine.

The joint is normally more painful when the big toe bends upward whilst walking. Using a shoe with a stiff sole can help prevent this. Other physical adaptations may be recommended by an orthotist (An orthotist specialises in the use of devices (orthoses) to support weakened joints, correct deformities and reduce pain and strain when the affected joints are being used in everyday life).

Steroids may be injected if the toe remains painful. This controls inflammation within the joint, but you may find the toe painful for the first couple of days. The real benefit will be experienced within about a week of the injection.

If surgery is recommended by your GP, then one of our foot and ankle consultants will discuss the options and appropriate procedure.

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