Hallux Limitus and Rigidus

A pain in the big toe is often excruciating, because it hurts every time you take a step. But we can help. One of the primary sources of big toe pain is Hallux Limitus, which can turn into a very painful and degenerative condition if it’s not treated.

When we humans walk, our big toe joint bends up to an impressive 75 degrees just before the foot leaves the ground. But sometimes, due to unusual wearing and tearing of the cartilage in the toe joint, the toe becomes stiff and starts to hurt. It’s a condition known as Hallux Limitus, in which the toe’s movement is limited.

When that happens, instead of bending at that angle, the toe is pushed toward the ground each time you take a step.  This just causes even more wear and tear on the joint, leading to more pain, more damage and eventually arthritis. If left untreated, Hallux Limitus can turn into Hallux Rigidus, which is a stiff big toe joint that won’t move. We need to make sure it never gets that far.

There are several issues that can contribute to Hallux Limitus, including:

• Repetitive injuries caused by running on your toes, dropping heavy things on your big toe joint, wearing stilettos or shoes that don’t fit, and squatting for long periods of time
• Pronation, which is when the feet roll outward when walking, which places excessive pressure on the big toe
• Genetic defects in the toe and joint
• Overly high arches
• Osteoarthritis, a type of arthritis that usually just comes with age

How will you know if you have Hallux Limitus? You need to schedule an appointment for an evaluation so it can be properly diagnosed, because this isn’t a condition you want to mess around with. But the symptoms include pain or stiffness in the big toe, especially when it’s in use; swelling or a tight feeling around the big toe joint; and aches in the joint that are brought on by cold, damp weather.

If the condition progresses into Hallux Rigidus, these symptoms become more serious. You might feel a constant pain in the big toe joint, whether or not it’s in motion. The toe will become very stiff and unable to bend, making it extremely painful to walk. Some patients say they can literally feel the bones grinding against each other as they walk.

Another sure sign is getting bone spurs, which happen when the worn bone tries to regenerate and small bumps of bone pop up around the big toe and on top of the joint. Sometimes you can even see these from the outside.

If an elderly relative complains that it hurts to wear shoes, hurts to walk, or they start to limp or show signs of bone spurs, bring them in for a check-up. These can all be signs of Hallux Limitus and Hallux Rigidus.

So you’ve seen the signs and come in for an appointment, now what? As with most conditions, how we treat it varies by your foot type, how bad the pain is, and how much it has limited your mobility. The good news is, we can usually relieve the pain and avoid surgery if we catch it early enough.

First, we’ll take steps to correct any issues with the foot that might be contributing to the condition, such as supporting high arches, preventing pronation, and stabilizing the toe. This is usually done with a custom foot orthotic that will offer support and immobilize the toe to prevent further damage.  We’ll also take a look at the type of shoes you wear and the type of activities and exercise you frequently do to see if any adjustments need to be made.

In advanced cases of Hallux Rigidus, surgery might be necessary to correct the problem and relieve the pain. But this is only when the other treatments aren’t effective.

The important thing is to make sure you come in right away if you are experiencing big toe pain. It’s much better to catch this condition early before things get worse. Call our office to make an appointment.