The Saint Alphonsus Coughlin Clinic

Patient Education: Hallux Rigidus

Watch a video about Hallux Rigidus

The term hallux rigidus refers to a painful condition of the big toe characterized by stiffness and bone spur formation about the MTP (knuckle) joint.

Other than bunions hallux rigidus is the most common condition to affect the great toe. This condition may severely impair a person’s ability to walk or run.

The cause is not truly known but it may be associated with prior injury, heredity, abnormal posture of the foot and abnormalities of bone and muscle structure.

X-rays

• X-rays show bone spurs and sometimes a decrease in the cartilage space or joint.
• X-rays also help your doctor appreciate what might be the cause of your condition.
• These x-rays demonstrate bone spur formation especially on the lateral view.
• This person’s MTP joint is well preserved.
• Despite this the toe is stiff and painful.

Treatment

• Conservative treatment involves shoe-wear modification, specially made shoe inserts and sometimes taping or padding of the toe.
• Medications are sometimes helpful to decrease swelling and improve comfort.
• Operative treatment is considered when conservative measures fail and entails different procedures depending on the activities of the patient, the severity of joint involvement and the cause of the hallux rigidus.
• Procedures vary from cleaning out the joint and bone spurs at one end of the spectrum to fusing the joint using plates and screws at the other end.
• Recovery from surgery averages 2-3 months with motion exercises and progressive weight bearing in a bunion shoe. Time off from work depends on the activity level and type of job.

References
Roger A. Mann MD, Michael J. Coughlin MD, Henri L. Duvries MD. Hallux Rigidus: A Review of the Literature and a Method of Treatment. CORR 142:57-63, 1979.

Coughlin and Mann. Surgery of the Foot and Ankle. Chapter 13: Arthritides. 7th edition, Mosby 1999.