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Stiff Big Toe (Hallux Rigidus)

Hallux limitus is a progressive arthritic condition that affects the big toe joint. It leads to reduced range of motion and function of this joint and can cause pain. Hallux rigidus is the end stage of hallux limitus, whereby there is no dorsiflexion of the toe at the metatarso-phalangeal joint. Over time there is loss of joint cartilage, joint space narrowing, bony spur formation and joint enlargement.

Hallux Rigidus Stiff Big ToeSymptoms:

  • Pain in the big toe joint especially when you push off on your toes whilst walking
  • Swelling around the joint
  • Stiffness in the joint and limited movement if you try to bend the toe up or down
  • Limping
  • Difficulty in finding appropriately fitting/ comfortable shoes due to the enlargement and swelling of the joint
  • Causes:

Hallux limitus/rigidus is often caused by unknown factors and develops in adults from ages 35-65. Some possible contributing factors include:

  • Poor mechanics of the foot/ankle/leg
  • Previous trauma/ injury to the toe that causes articular surface damage
  • Genetics
  • Gout or Inflammatory arthritis such as Rheumatoid arthritis
  • Overuse

Treatment Options


Non-Surgical Treatments

Non-surgical treatments are aimed at reducing pain and reducing further joint changes from occurring. They cant alter the joint changes that have already occurred. These treatment options include:

  • Orthotic therapy to improve foot mechanics and offload the joint
  • Shoes with a broad and deep toe box that accommodate the foot appropriately
  • Manual therapy such as dry needling, low level laser or ultrasound may relieve pain
  • Daily stretches
  • Pain killers and/or anti-inflammatories. For example, Nurofen or Panadol


Surgical Treatment

If there is significant loss of range or motion/ function, pain or non-surgical treatment fails to provide relief then surgical intervention may be the only viable option.

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