Hallux rigidus is often defined as osteoarthritis of the big toe. A joint in the big toe becomes deformed and stiffened due to deterioration of the cartilage. Several treatments can be considered.

Definition of hallux rigidus

In anatomy, the hallux corresponds to the big toe. This can experience various disorders including hallux rigidus characterized by deformation and stiffness of the metatarsophalangeal joint of the big toe. This joint connects the phalanges to the metatarsus (bone structure located in the center of the foot).

Before a hallux rigidus, there is often a hallux liminus characterized by reduced mobility of the metatarsophalangeal joint of the big toe.

Cause of hallux rigidus

We often tend to define hallux rigidus as osteoarthritis of the big toe because it is caused by deterioration of the articular cartilage. The wear and tear of the cartilage causes friction between the bones and the formation of bone growths called osteophytes or “parrot beaks”. These growths will deform the joint and cause discomfort and pain.

Diagnostic de l’rigid tow

Hallux rigidus, or arthritis of the big toe, is suspected by clinical examination. The doctor notes the deformation, stiffness and reduced mobility of the metatarsophalangeal joint of the big toe. To confirm the diagnosis, the doctor may order medical imaging tests such as an x-ray, MRI (magnetic resonance imaging), CT scan, or scintigraphy.

Risk factors for hallux rigidus

Like other forms of osteoarthritis, that of the big toe can be favored by many factors. For example, several mechanical factors have been identified that can lead to the development of hallux rigidus:

• micro-traumas which can in particular be caused by the practice of certain sports such as football or dance;
• the pressure caused by a long big toe, as is the case with the Egyptian foot;
• wearing narrow shoes or high heels.

Joint deformity

Hallux rigidus results in a deformation of the metatarsophalangeal joint of the big toe caused by the formation of bone growths. There is the appearance of a lump on the big toe, at the level of the metatarsophalangeal joint.

Joint stiffness

Joint deformity is accompanied by stiffening of the joint. The stiffness tends to increase over time with a significant or even total loss of mobility of the joint. 

Big toe pain

The deformation of the joint also causes the appearance of pain in the big toe. These can become more and more intense and cause significant discomfort.

In the event of hallux rigidus, analgesics or anti-inflammatory drugs may be prescribed. Intra-articular injections can also be used.

It may also be advisable in the event of hallux rigidus to adapt your footwear and limit certain activities that may accentuate the deformation of the joint (eg football, dance, etc.).

Surgical treatments

If previous treatments are not effective, surgery may be offered. Several techniques can be considered:

• metatarsophalangeal arthrodesis which involves blocking the joint;
• the placement of a metatarsophalangeal prosthesis;
• osteotomy or arthrolysis, operations consisting in repairing bone and joint deformities.

The prevention of hallux rigidus consists in limiting as much as possible the pressure and the micro-traumas in the big toe. For this, it is particularly recommended to have adequate footwear and to adapt it to your activity.