From the Guidelines
Hallux Rigidus Definition
Hallux rigidus is a degenerative joint disorder that affects the big toe, causing stiffness, pain, and limited mobility. It is characterized by the formation of bone spurs and cartilage degeneration in the metatarsophalangeal joint, leading to a reduction in the range of motion and flexibility of the toe 1.
Key Characteristics
- Pain and stiffness in the big toe, especially during activities such as walking or running
- Difficulty wearing certain types of shoes due to limited mobility and discomfort
- Reduced range of motion and flexibility of the toe
Treatment Options
Treatment options may include:
- Orthotics to support the foot and reduce pressure on the affected joint
- Physical therapy to improve mobility and strength
- Anti-inflammatory medications such as ibuprofen 200-400mg every 4-6 hours as needed, with a maximum daily dose of 1200mg
- Surgery to remove bone spurs, repair or replace the joint, or fuse the joint to alleviate pain and improve mobility in severe cases
Importance of Professional Diagnosis
It is essential to consult a healthcare professional for proper diagnosis and treatment of hallux rigidus, as the condition can be debilitating if left untreated or improperly managed 2.
From the Research
Definition and Characteristics of Hallux Rigidus
- Hallux rigidus (HR) is a degenerative disease of the first metatarsophalangeal (MTP1) joint, affecting about 2.5% of people older than 50 years 3, 4.
- It is characterized by stiffness and limited mobility of the first MTP joint, leading to debilitating pain and limited range of motion 4, 5.
- The condition is often associated with dorsal osteophytes and narrowed joint space, and can be caused by various factors, including trauma, hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions 4, 6.
Clinical Symptoms and Assessment
- Clinical symptoms, physical exam, and radiographic evidence are important in assessing and grading the disease 3, 4, 7.
- The condition can be graded based on the severity of symptoms and radiographic findings, which helps guide therapeutic choices 7.
Treatment Options
- Non-operative management, including nonsteroidal anti-inflammatory drugs, intra-articular injections, shoe modification, activity modification, and physical therapy, should always be attempted for all hallux rigidus patients 4.
- Surgical options, including joint-sparing and joint-sacrificing procedures, can be considered for patients with more severe disease or refractory to conservative management 4, 5, 7.
- Joint-sparing techniques, such as cheilectomy and Moberg osteotomy, can be effective in early stages of hallux rigidus, while joint-sacrificing procedures, such as arthrodesis, may be necessary for advanced cases 4, 5.