HALLUX RIGIDUS

TYPES

There are two main types of hallux rigidus:

• Primary Hallux Rigidus: This type is usually caused by structural abnormalities in the foot, such as genetic predisposition, abnormal foot mechanics, or an excessively long first metatarsal bone.
• Secondary Hallux Rigidus: This type is often the result of trauma or injury to the big toe joint, such as a fracture, dislocation, or repetitive stress from activities like running or dancing.

SYMPTOMS

Symptoms of Hallux rigidus include:

• Pain and stiffness in the big toe joint, particularly during movement or when bearing weight.
• Swelling and inflammation around the affected joint.
• Difficulty bending the big toe upwards or downwards.
• Formation of bone spurs (osteophytes) around the joint, leading to further restriction of movement.
• Difficulty wearing shoes, particularly those with narrow toe boxes.

DIAGNOSIS

Diagnosing hallux rigidus typically involves a comprehensive medical history review, physical examination, and imaging studies. During the physical examination, the healthcare provider may assess the range of motion in the big toe joint and look for signs of inflammation and deformity. Imaging studies such as X-rays may be ordered to visualize the extent of joint damage, presence of bone spurs, and any underlying structural abnormalities.

TREATMENT

Treatment for hallux rigidus aims to alleviate pain, improve joint function, and prevent further deterioration of the joint. Depending on the severity of the condition, treatment options may include:

a. Conservative Measures:

• Rest and activity modification to reduce stress on the affected joint.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate pain and inflammation.
• Shoe modifications, such as wearing shoes with a wide toe box or stiff sole to reduce pressure on the joint.
• Orthotic devices, such as shoe inserts or custom-made orthotics, to improve foot mechanics and reduce stress on the big toe joint.

b. Physical Therapy: Specific exercises and stretching techniques may help improve joint flexibility and strengthen the surrounding muscles, reducing pain and improving function.

c. Injection Therapy: Corticosteroid injections may be administered directly into the affected joint to provide temporary pain relief and reduce inflammation.

d. Surgery: In cases where conservative treatments fail to provide adequate relief, surgical intervention may be considered. Surgical options may include:

• Cheilectomy: Removal of bone spurs and damaged tissue to improve joint movement.
• Arthrodesis (fusion): Fusing the bones of the big toe joint together to eliminate painful motion and provide stability.
• Joint replacement: Removing the damaged joint surfaces and replacing them with artificial implants to restore function and reduce pain.

It’s important for individuals with hallux rigidus to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to their specific needs and lifestyle. Early intervention and proper management can help alleviate symptoms and improve overall foot function, enabling individuals to maintain an active and healthy lifestyle.