Hallux rigidus refers to stiffness (rigidus) of the joint at the base of the great toe. This is the joint known as the metatarsophalangeal joint (MTPJ). The usual cause of hallux rigidus is arthritis or wear and tear of the cartilage that lines the joint. It may be caused by an injury or part of a generalised condition such as gout. Often there is no identifiable cause, it just develops particularly as patients get older. Clinically it presents as stiffness and pain in the great toe. If the symptoms are severe it can limit walking, compromise work and recreational activities. Bony spurs can develop around the joint and can cause pain by rubbing against shoes. In an attempt to offload this pain, patients will often try to walk on the outside part of their foot which may then cause some pain to the lesser toes, known as transfer metatarsalgia.
The main aim is to relieve pain, decrease loading and movement through the great toe. Often it may not need operative treatment, just simple lifestyle and activity modifications will help such as weight loss, walking aids and avoiding high impact activities. A patient may need to take some Panadol or anti-inflammatories. The type of shoe wear is important, avoiding high heels and shoes with a narrow toe box is important. Finally injections, either with cortisone or with platelet rich plasma, may help to relieve some of the inflammation but the treatment of this can obviously vary from patient to patient.
Meet Dr Rao
Dr Rao is a Newcastle Orthopaedic surgeon who specialises in all aspects of foot and ankle surgery. He graduated from medicine at the University of Sydney and trained as an orthopaedic surgeon in Newcastle and also in Queensland.
He also undertook further training by way of fellowship with world famous Dr Terry Saxby in Brisbane in 2008. He has also conducted further training by attending numerous courses overseas, in Thailand, the USA and right across Australia.