Hallux Rigidus / Hallux Limitus

• Hallux Limitus: Refers to limited range of motion in the big toe joint. Pain and stiffness are more pronounced during activities requiring mobility.
• Hallux Rigidus: Is a more advanced form of Hallux Limitus, characterized by almost complete joint stiffness of the big toe. This severely limits toe flexion ability and can cause significant pain.

The causes of both conditions may include:

• Arthritis: Degenerative arthritis, such as osteoarthritis, is one of the main causes, resulting in toe joint cartilage wear and loss of mobility.
• Trauma: Injuries or repetitive trauma to the toe joint, such as fractures or sprains, can lead to these conditions' development.
• Structural Deformities: Anatomical changes in the foot, such as Hallux Valgus (bunion) or other arch deformities, can contribute to Hallux Rigidus and Limitus development.
• Overuse: Activities requiring repetitive big toe flexion, such as running or jumping, can overload the joint and result in wear and stiffness.

Symptoms vary depending on condition severity and may include:

• Big Toe Pain: Localized joint pain, which can worsen with activities involving downward toe flexion.
• Stiffness: Restricted joint range of motion, making it difficult to completely bend or straighten the toe.
• Swelling and Inflammation: The affected joint may be swollen and inflamed, especially after physical activities.
• Pain When Walking: Discomfort or pain when walking or wearing footwear, particularly those that press on the big toe joint.
• Bone Spur Formation: In advanced cases, bone spurs (osteophytes) may form around the joint, which can aggravate pain and stiffness.

To diagnose these conditions, doctors use:

• Physical Examination: Assessment of pain, stiffness, and range of motion in the big toe joint. The doctor may perform specific tests to check mobility and identify presence of bone spurs.
• Imaging Tests: Weight-bearing foot X-rays are used to visualize joint changes, such as cartilage wear, bone spurs, and associated bone changes. In some cases, computed tomography (CT) or magnetic resonance imaging (MRI) may be necessary for a more detailed assessment.

Treatment aims to relieve pain, improve mobility, and prevent condition progression. Options include:

• Conservative Treatment: Includes use of wide-toed shoes with rigid soles, orthopedic insoles for additional support, and support devices to reduce pressure on the big toe joint.
• Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) can be used to control pain and inflammation associated with the condition.
• Physical Therapy: Specific exercises to improve mobility and strengthen muscles around the joint can help relieve symptoms and improve function.
• Corticosteroid Injections: Joint injections can help reduce inflammation and pain, especially in acute cases.
• Surgery: In more severe cases or when conservative treatments are not effective, surgery may be necessary. Surgical procedures may include removal of bone spurs, arthroplasty (joint replacement), or arthrodesis (joint fusion).

Some preventive measures include:

• Use of Appropriate Footwear: Choosing shoes that offer support, cushioning, and sufficient toe space can help reduce pressure on the joint.
• Weight Control: Maintaining a healthy weight can help reduce stress on joints and prevent condition progression.
• Biomechanics Correction: Correcting foot mechanics anomalies and making gait pattern adjustments can help avoid injuries and discomfort.