Big Toe Arthritis (Hallux Rigidus)
Hallux rigidus is arthritis of the joint at the base of the big toe. It is the most common arthritic condition of the foot, affecting 1 in 40 people over the age of 50. Most patients complain of pain in the big toe joint while active, especially when pushing off to walk. There can also be swelling around the big toe joint or difficulty moving and bending the toe. A bump, like a bunion, can develop on top of the big toe joint and be aggravated by rubbing against the inside of a shoe.
The cause of hallux rigidus is not known but there are several risks factors, including a long or elevated first foot bone (metatarsal) or other differences in foot anatomy, injury to the big toe, and family history. These can lead to excessive wear of the joint, which in turn leads to arthritis.
Non-surgical management includes pain relievers and anti-inflammatory medicines, ice or heat packs to reduce pain, and changes in footwear. Avoid thin-soled shoes or high-heeled shoes and look for shoes with a stiff sole or curved sole (rocker bottom). Shoe inserts (orthotics) can also help.
Although these treatments may help decrease the symptoms, they do not stop the condition from progressing and if pain persist, surgical treatment is recommended. Techniques include removing some bone on the top of the metatarsal (Cheilectomy), joint fusion (Arthrodesis) or joint resurfacing (Interpositional Arthroplasty).