One of the most common pathologies in consultation in addition to hallux valgus or bunion is the so-called hallux rigidus. What differentiates this pathology is stiffness of the joint of the first toe; there is no medial deviation of the big toe, but a bony protrusion at the dorsal level of the head of the first metatarsal.
What makes hallux rigidus hurt?
The joint that allows the big toe to move degrades, leading to early osteoarthritis, which results in progressive loss of mobility and therefore functional limitation. In addition to the pain caused by osteoarthritis, over time, this osteoarthritis makes the joint more bulky and creates additional pain when wearing constrictive shoes.
How is it treated?
Hallux rigidus itself cannot be cured, as there is no method to reverse early osteoarthritis and therefore the affected joint cannot be restored to its original mobility. But it is possible to treat the pain that occurs when walking.
This residual mobility is the cause of the discomfort, so the treatments performed will be aimed at splinting the joint.
As conservative treatments, there are custom-made plantar supports, a rigid element with an extension to the ball of the big toe that splints that area. What is the advantage? That traditional footwear can be used. What is the disadvantage? Wearing an insole also means that there is less space in the shoe and it puts more pressure on the bony protrusion at the dorsal level of the big toe joint.
The alternative is to try an MBT type rocker shoe, as the stiff and curved sole allows the joint not to have to act while walking. However, there are people who find this type of footwear unstable or who are not convinced by its aesthetics.
Occasionally, the judicious use of intra-articular infiltrations may provide temporary pain relief. However, it is not recommended to repeat this treatment continuously as it may accelerate the degenerative process of the joint.
The second option is surgery if the hallux rigidus is at an advanced stage, the joint is fixed with osteosynthesis material.
Do you feel discomfort in your big toe? Contact Clínica San Román, we will help you identify the problem and offer the best treatment.
Article prepared by Clínica San Román
Date of publication: 24-07-2018
Date of revision: 8-02-2020
