Description of complaints
Early symptoms of all arthroses are initial pains in the affected joint, which occur especially after previous resting phases and subsequent movement. In addition, complaints after strong and prolonged stress, in the case of hallux rigidus after long walking, are typical. Advanced stages are characterized by stress-independent movement pain and also pain at rest and at night.
Pain can also increase or decrease due to weather conditions. Above all, moving the big toe upwards towards the back of the foot (dorsal extension) can cause pain. Increasingly, inflammatory processes also occur, which are characterized by swelling, pressure pain in the joint and reddening and warming of the surrounding skin.
Furthermore, there is a progressive stiffening of the metatarsophalangeal joint of the big toe until movement is hardly possible. Typically, one foot is mainly affected by all these complaints. Since especially the occurrence with the ball of the foot is painful, the foot is no longer rolled off properly when walking and instead occurs with the outer edge of the foot. Due to this incorrect static load, pain ultimately occurs here as well and neighboring joints can be affected.
Treatment of pain
Depending on which stage of the disease the hallux rigidus has reached, different treatment options are available. The primary goal is always freedom from pain and the best possible functionality of the foot. Pain therapy with medication is always a cornerstone of the treatment.
In particular, pain medication, which is not only analgesic but also anti-inflammatory (antiphlogistic), plays an important role. These include ibuprofen and diclofenac. The latter is suitable both as a tablet and in the form of an ointment for pain therapy.
If this pain medication is not sufficient, an infiltration therapy is possible, in which a local anaesthetic is injected into the affected area together with a cortisone preparation.The former provides effective pain relief, whereas cortisol has an anti-inflammatory effect. Efficient pain treatment is also important because it is the only way to perform physiotherapeutic exercises to treat hallux rigidus. Another way to treat hallux rigidus and relieve pain is to immobilize the joint.
This can be done either with a plaster cast or a splint. However, this treatment is only used until the inflammation has subsided and other orthopedic aids can be used. These include hallux-rigidus insoles.
These are reinforced under the big toe and thus relieve the strain on the base joint of the big toe. Special orthopedic shoes, which are stiffened and partially thickened under the forefoot, are based on a similar principle. This means that the foot no longer rolls over the metatarsophalangeal joints when walking, but over the shoe itself.
This leads to a significant relief of the arthrotic joint and thus ultimately to a reduction of pain and a normalization of the gait pattern. Special physical measures are also suitable for pain relief. This term includes procedures such as electro- and hydrotherapy.
In electrotherapy, direct or alternating current is used to improve the blood circulation in the inflamed region and to achieve muscle relaxation. Hydrotherapy, on the other hand, relies on the use of water to relieve symptoms, for example in the form of foot baths, wraps and alternating baths. If there is no other way to relieve the pain, the last option is surgery for hallux valgus. Depending on the patient’s age and exact symptoms, various procedures are available, ranging from simple stiffening to metal endoprostheses.
