Diagnosis and Treatment of Hallux Rigidus in Wake County

What is Hallux Rigidus?

The most common site of arthritis in the foot is at the base of the big toe. This joint is known as the metatarsophalangeal (MTP) joint, which is covered by articular cartilage. If wear and tear or injury damages the articular cartilage, the raw ends of the bone can rub together. A bone spur, or overgrowth, may develop on the top of the bone. This overgrowth can prevent the toe from bending as much as it needs to during movement. The result is a stiff big toe, or hallux rigidus, which can make walking painful and difficult.

What Causes Hallux Rigidus?

Hallux rigidus usually develops in adults between the ages of 30 and 60 years old. It may result from an injury to the toe that damages the articular cartilage or from differences in foot anatomy that increase stress on the MTP joint. It can also be caused by wear and tear accumulated over time. The wear and tear that comes with aging can damage the cartilage, leading to arthritis of the joint.

Symptoms of Hallux Rigidus

Being aware of the symptoms of hallux rigidus is crucial to maintaining proper foot health and getting the help you need when you need it. If you experience any of the following symptoms, we encourage you to schedule an appointment with a foot and ankle specialist at Raleigh Orthopaedic. The members of our team will work with you to determine the cause of your pain and get you on the path to relief.

  • Joint pain while walking or during activity, especially if pushing off on the toes when walking
  • Swelling
  • Stiffness in the big toe and difficulty bending it up and down
  • Pain with walking and bearing weight
  • A bump that has formed on top of the big toe, which indicates a bone spur

How is Hallux Rigidus Diagnosed?

A physical examination is required for your healthcare provider to diagnose hallux rigidus. They will check the range of motion in your toes by bending them up and down. In some cases, your primary doctor may recommend seeing a podiatrist, who specializes in the health of your ankles, feet, and toes. An X-ray of the foot may also be necessary for diagnosing hallux rigidus because it can capture bone spurs in the foot.

Treatment Options for Hallux Rigidus at Raleigh Orthopaedic

Nonsurgical Treatment

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There are nonsurgical methods to manage the symptoms of hallux rigidus. However, these techniques are not enough to stop the condition from advancing and typically do not reverse the damage.

  • Anti-inflammatory pain relievers: Pain relievers like ibuprofen can be used to ease symptoms like inflammation, swelling, and pain.
  • Ice packs and contrast baths: Applying ice packs or taking contrast baths may help reduce inflammation and control symptoms for a short period of time. A contrast bath uses alternating cold and hot water to reduce inflammation. Alternate feet between cold water for 30 seconds, then hot water for 30 seconds immediately after. Continue to alternate between cold and hot for five minutes, ending in the cold water. Contrast baths can be done up to three times a day to reduce inflammation.
  • Proper footwear: Wearing a shoe with a large toe box will reduce the pressure on the toe. For women, giving up high heels may be recommended.
  • Injections: Occasional steroid injections into the big toe joint can be used to temporarily reduce symptoms but do not change the ultimate course of treatment.

Surgical Treatment Options

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There are three primary surgical procedures for a stiff big toe.

  • Cheilectomy: This surgery is for more mild degenerative changes and bone spurs. The spurs are removed surgically to allow the toe to bend again. The joint is cleaned out and loose flaps of cartilage are removed as well. Sometimes, part of the bone is removed to allow for improved motion. The foot is usually swollen for several months, but this procedure typically results in relief in the long run.
  • Arthroplasty: This joint replacement surgery is considered for older patients who place few functional demands on the feet. The joint surfaces are removed and an artificial joint is implanted. This procedure may relieve pain and preserve joint motion.
  • Arthrodesis: This procedure is only for severe cases of hallux rigidus. After surgery, the toe will no longer bend, as the bones of the big toe joint are fused together. Damaged cartilage is removed, and the joint is put into a set position to allow the bones to grow together. Surgery is followed by boot immobilization and protected weight bearing for several weeks. The end result is still a stiff toe, but now without any pain.

Recovery Time After Hallux Rigidus Surgery

Recovery from hallux rigidus surgery depends on which type of surgery your condition requires. A cheilectomy and arthroplasty will require you to wear a boot for two weeks. Swelling can last for about two months after surgery. Before your procedure, your doctor will explain the recovery process and the steps you need to take for a successful recovery. They will ensure that all of your questions are answered and that you have the tools you need to recover at home.

Prevention of Hallux Rigidus

It may not be possible to prevent hallux rigidus from developing. However, there are a few steps you can take to slow its progression and keep your feet and toes as healthy as possible. Keeping the big toe joint mobile through exercise, along with resting the joint after physical activity, can be beneficial in slowing the progression of hallux rigidus. Wearing comfortable shoes that offer support can also slow the progression of this condition and combat stiffness of the toe.

Learn More About Foot and Ankle Treatment at Raleigh Orthopaedic

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Your well-being is important to us. Raleigh Orthopaedic is Wake County’s oldest and most experienced orthopedic practice, serving the Triangle and surrounding regions of central North Carolina since 1919. When you visit one of our clinic locations in Wake County, a member of our team will work with you to understand your symptoms and help you find relief. To get started with Raleigh Orthopaedic, give us a call today or book an appointment online!