Hallux Rigidus (Arthritis big toe)

What is Hallux Rigidus?

This is the medical term for arthritis of the joint at the base of the big toe. It is often caused by “wear and tear” to the joint. In this condition, the joint becomes stiff and may be painful to move. In severe cases the pain may be severe even at rest. There may also be a “bump” over the joint. This bump is known as a bunion.

What are the non-surgical treatments for Hallux Rigidus?

In mild cases, modifying your activity may help. Some people find it helpful to avoid high heel shoes. Painkilling tablets or gels may help to relieve the pain. If these do not work, your surgeon may try an injection of steroid into the painful joint.

What are the surgical treatments for Hallux Rigidus?

There are two main surgical treatments for Hallux Rigidus: Cheilectomy and Fusion surgery.

What is a Cheilectomy?

A cheilectomy is an operation to remove extra bone from around the toe joint that may be blocking movement and causing pain. It is often tried first in less advanced arthritis.

It is successful in over 70% of patients but it is important to note that not everyone is completely pain free after this operation. If your surgeon feels the arthritis is more advanced or you have had a previous cheilectomy and are still in pain, a fusion procedure may be performed instead.

The recovery from a cheilectomy is often quicker than a fusion. Most people will be able to walk on the operated foot straight away while wearing a stiff soled surgical show. It is important to keep your foot elevated and not overdo things as this will help with the post operative swelling and pain.

What is a fusion?

A fusion is an operation in which the bone at the base of the toe (the metatarsal bone) is fused to the top toe bone (the phalanx) to create a stiff joint that does not move. Any bunion is usually removed at the same time. When the bones have fully healed together the toe should be strong and not painful, but will not bend at the joint at all. As it takes time for the bones to fully heal together, your surgeon will fix the bones with either metal plates or screws. This will keep the ends of the bones together while your body heals. Sometimes the screws or plates may need to be removed at a later date if they cause irritation beneath the skin.

Most people will be able to walk on the operated foot straight away while wearing a stiff soled surgical show. It is important to keep your foot elevated and not overdo things as this will help with the post operative swelling and pain.