A stiff big toe seems like a minor ailment and is something you may be tempted to ignore. It’s easy to assume the issue will soon get better on its own.
However, some people find that this foot problem doesn’t go away. The stiffness persists and gets progressively worse. If you’re really struggling to move your big toe and it’s painful as well as stiff, you may be suffering from hallux rigidus, a condition that won’t improve without expert help.
Osteoarthritis Affecting the MTP Joint
What is hallux rigidus exactly? It’s a form of osteoarthritis affecting the joint at the base of the big toe. That joint, known as the metatarsophalangeal or MTP, connects the first bone of the big toe to the first bone of the forefoot and is vital to movement. It bends when you take a step, helping your foot push off from the ground.
Where the bones meet, they’re covered in cartilage tissue, which cushions them, absorbs shock and lets the joint move smoothly. Hallux rigidus occurs when the cartilage has largely worn away or been badly damaged. The ends of the bones rub against each other, unprotected, and the joint can’t function properly anymore.
Hallux rigidus is particularly unpleasant at this time of year, as people often find their joint pain is aggravated by cold, damp weather.
Symptoms of Hallux Rigidus
Pain, stiffness and aching in the big toe, especially when being active
Swelling, redness and tenderness
Cracking noise when bending the toe
Loss of flexibility and movement
Weakness and instability
Bony lumps – these are bone spurs, created by your body in an effort to compensate for the loss of cartilage (which is hard to repair)
Gait changes – you may develop a limp
Pain further up the kinetic chain (in the knee, for example)
What Increases Your Risk?
Anything that puts the big toe’s MTP joint under strain or leads to it being overused increases your risk of developing hallux rigidus. People who squat or kneel at work (carpet fitters or bricklayers, for example) are more likely to damage their cartilage. High-impact sports and dance can contribute to stiff, painful big toes. (In ballet, the demi-pointe position creates a 90° angle between the toes and the rest of the foot, really testing the joints.) In addition, hallux rigidus is one of the foot problems associated with obesity.
People with diabetes are at greater risk of hallux rigidus, as high blood sugar levels are detrimental to cartilage. That’s one reason our regular diabetic foot assessments are crucial. Gout, which affects the big toe joints in particular, is another risk factor.
As joints suffer from wear and tear, the aging process can lead to stiff, painful big toes. OrthoInfo, an orthopaedic surgery resource, states that hallux rigidus sufferers are typically aged 30-60. Big toe injuries make the problem more likely.
Some people suffer from hallux rigidus because they have poor foot function. For instance, overpronation (i.e. your feet roll too far inwards when walking) puts your big toes under stress. Another relevant biomechanical issue is poor alignment of the bones in the joints.
Hallux rigidus can be hereditary, so do ask your relatives if they have the condition.
Hallux Rigidus Diagnosis and Treatment
‘This disorder can be very troubling and even disabling since we use the big toe whenever we walk, stoop down, climb up or even stand,’ emphasises Foot Health Facts. The huge impact hallux rigidus has on mobility makes seeking professional assistance crucial.
Our podiatry services include prescribing bespoke orthotics to improve foot function, correct abnormalities and take the pressure off your sore joint. We can suggest foot exercises designed to make the toe stronger and suppler. Plus we can advise whether pain-relieving injection therapy or rocker-bottom shoes that reduce the need for the toe to bend would benefit you.
In severe cases, hallux rigidus surgery may be needed. Cheilectomy is a common procedure in which excess bone is removed from the MTP joint to restore movement. As well as discussing surgery with you, our podiatrists can support you during the recovery period.