Hallux Limitus: Big Toe Stiffness is a Big Deal

November 13, 2018

The human big toe is also called the Great Toe; the Latin word is hallux. It might be a relatively small body part, but stiffness of the big toe causes chronic pain, limits activity, and can make performing everyday tasks difficult. Hallux limitus, in which the big toe joint has limited motion, causes pain at the base of the big toe joint (the first metatarsophalangeal joint). It is the earlier stage of hallux rigidus, literally “stiff toe,” that develops over time as a result of the big toe’s limited range of motion.

 

Hallux rigidus is the most common degenerative arthritic condition of the foot and affects one in 40 people over the age of 50. It is often bilateral (involving both big toes). More women than men develop hallux rigidus; incidents of the disorder are increasing among our aging population.

 

The most common cause of developing hallux rigidus is trauma, such as a severely stubbed or fractured big toe. Excessive pronation (when the foot rotates inward) and collapsed arches also are linked to the disorder. Structural abnormalities of the foot – often inherited - impact function and can lead to osteoarthritis in the big toe joint, which increases the odds of developing the disorder. People with jobs that require squatting or stooping are more likely to suffer from hallux rigidus. Rheumatoid arthritis, gout and other inflammatory diseases can be factors.

 

Hallux rigidus is a common repetitive stress injury among athletes. Running, football, basketball, and soccer place additional stress on the big toe joint. Activities that require squatting, such as playing the catcher’s position in baseball, also exacerbate the metatarsophalangeal joint. Wearing soft shoes on a hard surface can be another factor in developing hallux rigidus.

 

Early signs that you could be suffering from hallux limitus include:

Stiffness and pain in the big toe joint

Stiffness and pain when bending the big toe

Damp, cold weather worsens pain

Difficulty stooping, squatting, running (especially when pushing off)

Swelling at the big toe joint
 

As the condition progresses to hallux rigidus, you might experience additional symptoms:

You cannot bend your big toe(s)

Pain when resting

A bunion-like bump (bone spur) is causing pain when wearing shoes

Limping and poor foot mechanics are causing pain in your ankles, legs, knees, hips, and possibly back

 

A physical exam and X-rays will confirm a diagnosis. If you have hallux rigidus, your podiatrist will recommend a course of treatment that may include:

Modifying your footwear; a larger toe box and stiff-soled shoes offload pressure from the big toe.  

Anti-inflammatory medications (NSAIDs) to manage pain

Corticosteroid injections to reduce inflammation

Physical therapy

Custom orthotic inserts

 

We use our big toe(s) to stand, walk, climb, and stoop; no wonder hallux rigidus is disabling. The condition is progressive; left untreated, bending and range of motion deteriorate until the big toe joint is frozen. Don’t wait until you are experiencing chronic pain and limited foot function. See your podiatrist and ask her/him how custom-made orthotics from Foot Doctors Orthotics can provide relief and support for your unique foot issues. We have more than 25 years of orthotic design experience. Email customerservice@footdoctorsorthotics.com or call 877-598-2471.