Anthony Babigian, D.P.M. [January 30 2014]
Everyone probably knows someone who has had a foot ailment – maybe even you. A more common and uncomfortable condition, known as hallux rigidus, affects the big toe joint and causes pain and stiffness in or on top of the big toe joint, which absorbs most of the pressure when walking and is affected by most movements we make. This particular condition is a progressive disorder that has mild, moderate and severe stages. An effort should be made to get early treatment before it progresses.
There are structural and functional causes of hallux rigidus. Structural causes are due to an elevated or long bone behind the big toe. Functional causes are due to a tendon not pulling correctly. Trauma to the big toe joint can also cause symptoms as well as some systemic diseases like rheumatoid, psoriatric and reactive arthritis or gout that would need to be ruled out.
Early signs and symptoms include pain, stiffness, difficulty with certain activities, swelling and inflammation. End-stage symptoms are pronounced pain even when resting, pain in the lateral knee and low back as well as limping. Diagnosis is made with a foot exam and the help of weight-bearing X-rays.
If the condition is in the early stages, conservative treatment including orthotics (molded supportive orthosis that fit within the shoe), supportive shoes, physical therapy, anti-inflammatory medications and injection therapy are helpful in relieving symptoms and stopping the progression. If the condition is in the middle stages corrective surgery can relieve symptoms and reposition bones so it does not advance to the severe stages. If the joint is destroyed surgery can fuse it or another option is to surgically place an implant within the joint. It is recommended that those who suffer from hallux rigidus seek help early on.
Anthony Babigian, D.P.M., is a member of The Hospital of Central Connecticut (HOCC) medical staff and practices at Grove Hill Medical Center, One Lake St., New Britain, 860-832-4666. For referrals to HOCC physicians, please contact our free Need-A-Physician referral service by phone at 1-800-321-6244 or online, www.thocc.org.