When you visited your doctor with pain in your big toe, it was diagnosed as hallux rigidus. Hallux rigidus is a form of degenerative arthritis (also called osteoarthritis) specific to the first metatarsophalangeal joint—the joint at the base of the big toe.


Similar to osteoarthritis, the root cause of the pain is a degeneration of the cartilage that cushions the bone ends within the joint. Additionally, bone spurs—unnecessary outgrowths of bone—can form in the joint, adding to stiffness and discomfort. The cause of hallux rigidus is not always known for certain, but a previous injury may lead to a predisposition to the condition.


Hallux rigidus can be particularly challenging and painful because so much weight is placed on the big-toe joint in every normal step we take. A natural reaction to alleviate such pain is to avoid putting undue pressure on the joint by modifying your gait. Such compensatory actions throw off your body mechanics, and you can develop other problems, such as low back pain. Thus, treating hallux rigidus quickly and effectively is quite important to your overall well-being. Strategies we might employ include


  • ultrasound


  • gait training


  • ice and/or heat therapy


  • mobilization to regain motion


It is also very important to modify your footwear. This may include wearing shoes with large toe boxes and stiff soles, adding orthotics and avoiding high heels. Nonsteroidal anti-inflammatory medications (if approved by your physician) and occasional corticosteroid injections may also help ease pain and swelling.


If these measures are not enough, surgery may be necessary to physically remove bone spurs and/or fuse or replace the joint. We can design a postsurgical rehabilitation plan to keep swelling to a minimum, help you learn to use crutches temporarily and, after fusion surgery, help you learn to walk without the benefit of a flexible big-toe joint.


Although hallux rigidus is not a household phrase, the condition is relatively common. Through exercises, we can make you feel more comfortable, help you to avoid other problems and walk more smoothly and without pain.