Great Big Toe Joint Disorder (Hallux Rigidus)

Hallux rigidus is a disorder of the joint located at the base of the great big toe. It causes pain and stiffness in the joint. With time, it gets increasingly harder to bend the toe. Hallux refers to the big toe, while rigidus indicates that the toe is rigid and cannot move. This condition is a form of degenerative arthritis.

This disorder can be very troubling and even disabling since we use our big toe whenever we walk, stoop down, climb up or even stand. You may confuse hallux rigidus with a bunion, which affects the same joint, but they are very different conditions requiring different treatments.

Hallux rigidus is a progressive condition. In its earlier stage, when motion of your big toe is only somewhat limited, the condition is called hallux limitus. But as the problem advances, the toe’s range of motion gradually decreases until it potentially reaches the end stage of rigidus, in which your big toe becomes stiff.

Causes

Common causes of hallux rigidus are a faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis often develops in people who have defects that change the way their foot and big toe functions. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus. In some cases, hallux rigidus is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse, especially among people engaged in activities or jobs that increase the stress on the big toe. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases, such as rheumatoid arthritis or gout.

Symptoms

Early signs and symptoms include:

• Pain and stiffness in the big toe during use (walking, standing, bending, etc.)
• Pain and stiffness aggravated by cold, damp weather
• Difficulty with certain activities (running, squatting)
• Swelling and inflammation around the joint

As the disorder gets more serious, additional symptoms may develop, including:

• Pain, even during rest
• Difficulty wearing shoes because bone spurs (overgrowths) develop
• Dull pain in the hip, knee or lower back due to changes in the way you walk
• Limping (in severe cases)

Potential Treatments

The sooner this condition is diagnosed, the easier it is to treat. Therefore, contact a doctor immediately when symptoms are first noticed. If you wait until bone spurs develop, your condition will likely be more difficult to manage.

In diagnosing hallux rigidus, your doctor will examine your feet and move the toe to determine its range of motion. X-rays help determine if arthritis is present and to evaluate any bone spurs or other abnormalities that may have formed.