Stiff Big Toe (Hallux Rigidus) Symptoms and Causes

Stiff big toe, also known as hallux rigidus, is an arthritic condition in the big toe that causes the joint to stiffen. Because the big toe is so involved in movement of the feet, hallux rigidus can make walking painful and difficult. The big toe is the most common site of arthritis in the foot. The joint in the big toe is referred to as the first metatarsophalangeal or MTP joint. Every time you take a step, the MTP joint bends to help maintain proper balance and weight displacement in the foot. Like any other joint, the MTP joint is protected by smooth cartilage. This prevents the  connecting bones from rubbing together painfully. When injury, disease or normal wear and tear damage the cartilage, painful and debilitating symptoms can result.

Stiff Big Toe Symptoms

The symptoms of stiff big toe or hallux rigidus include:

  • Pain – This occurs in the affected joint usually when you are more active. Pain can especially occur when you use your toes to push your feet off of the ground, such as in running or other active sports.
  • Swelling – This symptom of stiff big toe occurs in the joint as well as the surrounding tissue. Swelling can aid in stiffness in the toe and prevent the joint from functioning properly.
  • Bunions or calluses – A bunion is a painful, abnormal growth in the joint at the base of the big toe that causes pain and sometimes misalignment. If the bunion becomes severe enough, it will force the big toe to move sideways and cross over the adjacent toe. Calluses are thickenings of the skin that result from abnormal stresses on the bones and often occur on the bottom of the foot.
  • Stiffness – This occurs throughout the toe and makes it very difficult to bend or extend the toe.

Stiff Big Toe Causes

There are many theories about what causes hallux rigidus. Risk factors and possible causes of stiff big toe include:

  • Age – Stiff big toe usually occurs in adults between the ages of 30 and 60.
  • Heredity – It is possible that people with a family history of stiff big toe are more susceptible to the condition.
  • Injury – Accidents such as jamming your toe can possibly damage or inflame the cartilage covering the joint in the big toe. Fractures can increase stress on the joint as well and make the toe more susceptible to hallux rigidus.
  • Imbalance – If you have imbalance in your foot structure or foot function, it could possible cause a stiff big toe.
  • Other conditions – People who suffer from flat feet or low arches seem to be more susceptible to developing stiff big toe.
  • Increased activity – A sudden increase in activity, especially combined with injury or other conditions affecting the foot, can lead to hallux rigidus.

Stiff Big Toe Diagnosis

After your doctor gathers your full medical history, a physical exam is performed. During the exam your doctor will inquire about your concerns and the severity, location and frequency of your symptoms. Diagnostic procedures such as x-rays and MRIs will most likely be used to diagnose and determine the extent of the disease.

Treatments for stiff big toe depend upon the severity of the condition and range from nonsurgical treatment such as anti-inflammatory medication  and shoe modification to joint reconstruction surgery.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Foot and Ankle Services in New York treats stiff big toe, or hallux rigidus as well as a broad range of foot and ankle conditions that can occur at any stage of life.

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