Hallux Rigidus

What is it?

Arthritis of the Big Toe. Arthritis is the loss of the cartilage lining the joint surface (articular cartilage). Normally this is a soft, glistening, smooth, white tissue that acts as a bearing surface to allow the joint to move freely. If the cartilage is damaged, the surface becomes rough and no longer glides. It may also result in extra bone growth producing painful lumps. This all combines to produce pain and stiffness within the joint.

What causes it?

Arthritis is a wear and tear process that may result from many years of playing active sport, or possibly from multiple episodes of stubbing the toe. But most commonly, no direct cause is identifiable.

What are the symptoms?

Pain and stiffness are the most common problems. Pain is frequently felt during activity, particularly if soft-soled shoes are worn. It will be aggravated by anything that causes the toe to be pushed upwards (i.e. going on tip toe).

How is the diagnosis made?

The doctor will listen to the description of the symptoms and will examine the foot and ankle. Plain x-rays are usually sufficient to make the diagnosis.

What is the initial treatment?

Wearing wider and stiffer shoes with a stiffer sole that protects the joint may be helpful along with avoiding higher heels.

If the initial treatment doesn't work, what's next?

  • An injection of steroid into the joint can dramatically improve the symptoms, but it does not always provide long-term relief
  • If stiffness is the major problem and there are big bits of extra bone, then an operation to remove these bits of bone (cheilectomy) can improve the movement and relieve some of the pain
  • If the arthritis is very extensive, a new implant (Cartiva) may be used to keep movement and relieve pain. This is a new procedure currently under trial by a few leading foot and ankle surgeons in the country including Mr Nielsen.
  • If the arthritis is too advanced and the toe is very stiff, fusing the joint (making it completely stiff) is very effective at relieving the pain and does not usually create any functional problems.

Our practice covers the following hospitals:

Parkside Hospital
For appointments phone : 0208 971 8026

St Anthony's Hospital
For appointments phone : 0208 335 4678

Ashtead Hospital
For appointments phone : 01372 221441

New Victoria Hospital
For appointments phone : 0208 9499000

Clock House Hospital
For appointments phone : 01372 840837