The big toe plays a major role when walking. If the toe is no longer able to ensure a proper rolling movement and also causes pain, you may have hallux rigidus. Here you will find further information as well as selected hallux rigidus specialists and centers.
Hallux rigidus is a wear and tear disease(osteoarthritis) of the metatarsophalangeal joint of the big toe. It is also known colloquially as a stiff toe.
It affects the area between the first bone of the metatarsus and the metatarsophalangeal joint of the big toe. As it develops, hallux rigidus causes pain on the one hand. On the other hand, it also leads to a restriction of movement that makes it difficult or impossible to roll the big toe.
The reason for this is the continuous loss of cartilage mass in this joint, which is typical of osteoarthritis. At a late stage, the bone surfaces rub against each other as the joint cartilage is severely damaged or completely missing.
In many cases, the development of hallux rigidus is not entirely clear. However, there are factors that can promote this condition. For example, overloading or incorrect loading can play a role, as can the wrong footwear. Competitive athletes are at greater risk here, as their joints are generally exposed to higher loads.
Factors such as minor, possibly unrecognized injuries can also result in hallux rigidus. Hereditary factors must also be included in the list of possible causes.
Misalignments of the foot can contribute to the development of hallux rigidus due to incorrect loading of the metatarsophalangeal joint. Anyone who bends their ankle joint inwards when walking, for example, puts incorrect strain on the knee, foot and big toe. This misalignment in the ankle joint is called overpronation.
A metabolic disorder such as gout is also a possible cause. They often trigger secondary arthrosis, which can also affect the big toe joint.
Another cause is excessive compression pressure on the round joint of the big toe.
Hallux rigidus leads to pain in the big toe joint © © staras | AdobeStock
There are several symptoms that indicate hallux rigidus. Typical symptoms are severe pain in the toe joint combined with an increasing restriction of movement. The stiffness of the joint means that the toe can no longer be rolled as normal.
Inflammatory reactions can also occur. These are manifested by
In addition, over time
may occur.
In most cases, a clinical examination by the attending physician, usually an orthopaedic surgeon, can provide clarity. A lack of mobility and so-called bone noses (exostoses) are signs of hallux rigidus.
The following symptoms in the area of the metatarsophalangeal joint of the big toe indicate hallux rigidus:
When treating this condition, a basic distinction must be made between conservative and surgical therapy. The type of treatment depends on
In the early stages, special hallux rigidus insoles or hallux rigidus shoes can provide relief. The insoles are usually made with a rigid sole. This transfers the rolling movement from the big toe to the sole. The result: less movement in the toe joint and therefore less pain.
With a bunion roll, the mobility in the toe joint is also restricted, thus relieving pain. Athletes who suffer from hallux rigidus can benefit from a different technique: The sole area under the toe is reamed out and lined with a soft material. This also prevents the toe from being pushed too far towards the back of the foot when rolling on or off, which would lead to severe pain.
Other conservative treatment methods include the administration of anti-inflammatory medication or cartilage regeneration preparations.
Orthopaedic insoles can already help with hallux rigidus © glashaut | AdobeStock
An operation as part of foot surgery is an option if
Various surgical techniques are available for this.
In standard surgical treatment, the metatarsophalangeal joint is completely stiffened (arthrodesis). The damaged cartilage is removed during this hallux rigidus operation and the two joint surfaces are firmly screwed together.
Despite patients' initial reluctance to undergo arthrodesis, most patients are very satisfied after arthrodesis. Not only does the pain largely disappear, but sporting activity can also be restored. The rolling movement of the toe is mainly ensured by the end joint of the toe.
Cartilage reconstruction is another procedure. Damaged cartilage is restored by transplanting it from other parts of the body. Alternatively, a membrane can be used to stimulate cartilage growth. As with the knee joint, these methods have not yet been conclusively researched scientifically and success is not guaranteed.
Another hallux rigidus operation is a joint replacement. However, this method should only be used if all other methods of joint preservation no longer work.
One disadvantage of joint-preserving therapies is that they do not eliminate the cause of hallux rigidus. The disease can therefore continue to progress. A shortening of the metatarsal bone, which widens and decompresses the joint space, is also offered by some specialists.
After hallux rigidus surgery, the first priority is to reduce pain. Professional lymphatic drainage helps to reduce swelling.
Unless the joint has been stiffened, mobilization should begin as soon as possible. Depending on the degree of discomfort, therapy can extend over a period of several weeks to several months. After a fusion, the foot is immobilized for 6-12 weeks, depending on the postoperative healing process.
It is not always possible to prevent this condition, as there are many different causes.
If misalignments are present, they should be treated with insoles or special footwear. Misalignments may not only lead to hallux rigidus, but also to problems in other joints such as the ankle or knee joints.
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