Degenerative arthritis and stiffness due to bone spurs that affects the MTP joint at the base of the hallux (big toe) is called Hallux rigidus or stiff big toe.

Symptoms include:

• Pain and stiffness in the joint at the base of the big toe during use (walking, standing, bending, etc.
• Difficulty with certain activities (running, squatting)
• Swelling and inflammation around the joint

Diagnosis

Diagnosis is made following a history, physical examination and appropriate radiographs

Treatment

Non-surgical

Early treatment for mild cases of Hallux rigidus may include prescription foot orthotics, shoe modifications (to take the pressure of the toe and/or facilitate walking), medications (anti-inflammatory drugs), injection therapy and/or physical therapy.

Surgical

In some cases, surgery is the only way to eliminate or reduce pain. There are several types of surgery for treatment of Hallux rigidus. The type of surgery is based on the stage of hallux rigidus.

Stage 1 hallux rigidus involves some loss of range of motion of the big toe joint or first MTP joint and is often treated conservatively with prescription foot orthotics.Stage 2 hallux rigidus involves greater loss of range of motion and cartilage and may be treated via cheilectomy in which the metatarsal head is reshaped and bone spurs reduced.Stage 3 + Stage 4 hallux rigidus may be treated via fusion of the joint (arthrodesis).