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Hallux Rigidus

What is it?

Hallux rigidus literally means “stiff big toe”. This condition is a type of degenerative arthritis in which the joint surfaces at one of the joints in your big toe begin to both wear away and develop extra, joint-limiting bone along the margins, called osteophytes or ‘spurs’. This joint is important because it has to bend significantly every time you take a step.

Hallux rigidus most commonly develops in adults aged 30 to 60, although it can develop at almost any age. Symptoms of this condition include pain in the toe when you are active (especially as you push off with your toe), swelling, a loss of joint mobility and bone spurs on the top of the joint.

Walking may become difficult and painful. As you change your gait or walking style because of pain, other common problems can occur in your knees, hips and low back.

Diagnosis of this condition is of-ten done by physical examination and x-ray. X-rays will show the location and size of any bone spurs that have formed, as well as the degree of degeneration in the joint space.

How did I get it?

Your big toe undergoes tremendous stress when you are walking. Forces that equal twice your body weight (more when running) pass through your foot on every step. Your big toe, along with the ‘ball’ of your foot, was designed to bear much of that force. When the arch of your foot collapses excessively, as in the case of flat feet or over-pronation, your big toe becomes locked-out of normal bending. This causes the joint of your big toe to jam along the top of the joint and even partially dislocate with every step. Over time, arthritic changes lead to cartilage degeneration and spur formation.

Other contributing factors may include: previous trauma or injury to the toe, repetitive stress, and anatomical deformities of the foot.

spur formation on top of the joint

How is it treated?

Anti-Inflammatory Agents: These may include ice and oral anti-inflammatory medications. These may provide some temporary relief and ease the pain of inflammation, but are not helpful in addressing the underlying cause of your condition.

Footwear: Advice that focuses on taking the pressure off the big toe should be followed. A stiff-soled shoe with a rocker or roller bottom may be recommended to help you walk and lessen the bend in the big toe. A shoe with a wide toe box may also help relieve pain. Avoiding high heels and weight loss are other important considerations.

Surgery: In cases that do not respond to conservative measures, your doctor may recommend surgery. There are a few common surgeries that are performed depending on the degree of arthritic changes. Removal of the bone spurs, joint fusion, and complete joint replacement can be performed. These procedures are not without risks and often the disease continues to progress after a temporary period of pain relief. Also, operative measures performed on one foot may have negative effects on the other foot due to the excessive load.

Foot Orthotics:

The right custom made orthotics will address your pain by restoring correct arch height and function, effectively releasing the big toe, allowing it to unlock and function properly. When this is done, the cause of your pain is being addressed rather than just the symptoms.

Sole Supports orthotic, unlike typical custom orthotics, is designed to completely support the corrected arch of your foot, determined by a unique way of capturing your optimal foot position.

Abnormal joint stresses can be reversed, allowing affected tissues to heal and normal joint function to be restored. In this way, the orthotic provides both primary treatment and preventative care by restoring normal weight bearing function and range of motion to your big toe. Joint healing times will vary depending on condition severity, nutrition, overall health and faithful use of the orthotics.

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