HALLUX RIGIDUS

Hallux rigidus is a medical condition that affects the big toe joint, also known as the metatarsophalangeal (MTP) joint of the hallux (big toe). It is a type of degenerative arthritis that primarily affects the joint at the base of the big toe, causing pain, stiffness, and limited movement.

WHAT IS HALLUX RIGIDUS?

Hallux rigidus is a medical condition that affects the big toe joint, also known as the metatarsophalangeal (MTP) joint of the hallux (big toe). It is a type of degenerative arthritis that primarily affects the joint at the base of the big toe, causing pain, stiffness, and limited movement.

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The condition is characterised by the progressive loss of cartilage within the joint, leading to the bones rubbing against each other and causing pain, swelling, and difficulty in moving the toe. As the cartilage wears away, bone spurs (osteophytes) can also develop around the joint, further contributing to pain and limited motion.

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Hallux rigidus often develops gradually over time and is more commonly seen in individuals over the age of 30. It can be caused by various factors, including genetics, abnormal foot mechanics, prior injuries to the toe, or certain inflammatory conditions.

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What are the symptoms of Hallux Rigidus?

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Characterised by a range of symptoms, Hallux Rigidus primarily affects the big toe joint. These following symptoms can vary in severity and may worsen over time.

Common symptoms of hallux rigidus include:

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1. Pain: The most common symptom of hallux rigidus is pain in the big toe joint, especially during movement or when pressure is applied to the joint. The pain may be described as a dull ache or a sharp discomfort.

2. Stiffness: Stiffness in the big toe joint is another hallmark symptom. The joint may become progressively stiffer over time, making it difficult to bend the toe upward (dorsiflexion) or perform activities that involve toe movement, such as walking, running, or squatting.

3. Limited Range of Motion: As the condition progresses, the range of motion in the big toe joint becomes restricted. This limitation can affect activities that require toe flexibility, such as pushing off during walking or running.

4. Swelling: The affected area around the big toe joint might become swollen and tender, especially after prolonged activity or pressure on the joint.

5. Difficulty with Footwear: Due to pain, swelling, and limited motion, individuals with hallux rigidus might find it challenging to wear certain types of shoes, particularly those with a narrow toe box that puts pressure on the joint.

6. Bone Spurs: As the cartilage in the joint deteriorates, bone spurs (bony growths) can form around the joint. These bone spurs can contribute to pain, inflammation, and reduced joint mobility.

7. Changes in Gait: People with hallux rigidus might alter their gait (walking pattern) to minimize pressure on the affected joint, leading to changes in the way they walk.

8. Bump on the Joint: A visible bump or prominence might develop on the top of the big toe joint, caused by the growth of bone spurs.

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It's important to note that the severity of these symptoms can vary from person to person. Some individuals might experience mild discomfort and limited mobility, while others might have more significant pain and impairment in daily activities.

If you suspect you have hallux rigidus or are experiencing any of these symptoms, it's advisable to seek medical attention from a podiatrist with expertise in foot and ankle conditions. An accurate diagnosis is essential to determine the appropriate treatment plan based on the severity of your symptoms and your overall health.

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How can you treat Hallux Rigidus?​

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The appropriate treatment plan for hallux rigidus depends on the severity of the condition, the individual's symptoms, overall health, and preferences. Treatment options can range from conservative measures to surgical interventions. It's important to consult with a medical professional, such as a podiatrist or orthopedic surgeon, to determine the best course of action for your specific case.

Here are some treatment options:

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1. Footwear Modification: Wearing shoes with a wider toe box and adequate cushioning can help reduce pressure on the affected joint.

2. Orthotic Inserts: Custom-made or over-the-counter orthotic inserts can improve foot mechanics and reduce stress on the joint.
3. Medications: Nonsteroidal anti-inflammatory drugs or pain relievers may help alleviate pain and inflammation.
4. Physical Therapy: A physical therapist can provide exercises and stretches to improve joint mobility, strengthen surrounding muscles, and promote better foot mechanics.
5. Activity Modification: Avoiding high-impact activities that exacerbate pain and stiffness can help manage symptoms.
6. Injection Therapies: Corticosteroid Injections: Injections of corticosteroids into the affected joint can provide temporary pain relief and reduce inflammation. However, the effects are not usually long-lasting.

7. Surgical Options:

   • Cheilectomy: This procedure involves removing bone spurs and reshaping the joint to improve movement and relieve pain.

   • Arthrodesis (Joint Fusion): In cases of severe pain and joint damage, the big toe joint can be surgically fused, which eliminates movement in the joint but can significantly reduce pain.

   • Arthroplasty (Joint Replacement): In cases where joint damage is extensive, joint replacement surgery may be considered. This involves replacing the damaged joint surfaces with artificial components.

   • Osteotomy: This procedure involves cutting and repositioning the bones around the joint to improve alignment and function.

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The choice of treatment depends on factors such as the degree of joint damage, the patient's age and activity level, and their preferences regarding surgery. Conservative treatments are usually tried first, and if they don't provide sufficient relief, more invasive options may be considered.

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It's important to note that the goal of treatment is to reduce pain, improve joint function, and enhance the patient's quality of life.