- Hallux non extense
- Hallux limitus
- Arthrosis of the metatarsophalangeal joint of the big toe
- Stiffening base joint of big toe
Definition
Hallux rigidus is a wear-related disease of the base joint of the big toe (arthrosis). The consequences are restricted movement and pain. If left untreated, this leads to stiffening of the metatarsophalangeal joint of the big toe. Preliminary stages of this disease are also known as hallux limitus.
Gender distribution and frequency
Hallux rigidus predominantly affects men. The primary hallux rigidus is often unilateral. The disease occurs in all age groups and often begins in adolescence.
Cause
The arthrosis of the metatarsophalangeal joint of the big toe and thus the development of the hallux rigidus develops slowly over years. Normal physical exertion does not usually favour the development of arthrosis. However, injuries can lead to cartilage damage and thus to arthrosis. Most people probably suffer from hallux rigidus because of congenital bad cartilage. Other possible causes are deformations of the metatarsophalangeal joint of the big toe, e.g. due to a hallux valgus – malpositioning of the big toe and metabolic disorders such as gout.
Symptoms of hallux rigidus
The wear and tear caused by wear and tear results in a painful restriction of movement of the metatarsophalangeal joint of the big toe. The rolling motion is painfully restricted, and the load-bearing capacity is considerably reduced when walking for long distances. In the initial phase of the disease, the big toe (towards the sole) usually retains sufficient bending capacity, but the considerably more important stretching capacity (towards the back of the foot) for the rolling motion is reduced more and more until, in the worst case, the big toe stiffens in the base joint in a bending position.
Overstretching in the end joint still maintains a low rolling capacity. Due to the painful rolling motion as the disease progresses, the gait pattern also changes. This results in a gentle gait, sometimes also in a gentle limping on the affected side.
Frequently, a rolling motion over the outer edge of the foot is also observed, sometimes with a tendency for the entire foot to rotate inside. The toe position can no longer be demonstrated without pain, climbing stairs and uphill are very painful. When looking at the foot, a thickened metatarsophalangeal joint of the big toe is often noticeable.
The joint is painful under pressure, sometimes reddened and overheated. Mobility is painfully limited, and rubbing is noticeable when moving through the joint. You can also find more information on this topic under Symptoms of Hallux RigidusThe pain associated with hallux rigidus is a sign of overloading and destruction of the joint.
They usually manifest themselves typically in the form of a stabbing pain in the area of the ball of the big toe. Especially for runners, it is possible that the pain initially only occurs after the strain or, for example, during a run. If swelling, overstimulation and malpositioning of the entire forefoot area then occurs in the course of the disease, the pain usually occurs continuously.
It is important to always check other joints as well. For example, pain in the big toe can also be caused by a defective position in the knee or hip. Especially when all these joints are painful, it is important to find out exactly where the cause and effect lies.
The pain of Hallux Rigidus can be intensified by several factors. Besides the strain, cold weather or shoes that are too tight can also increase the pain. In advanced stages of the disease, any strain on the foot, including standing or normal walking, is perceived as painful.
As the pain can become more frequent in the course of the disease, it is also important to take action against the pain as early as possible. In addition to conservative and surgical therapies, painkillers can be used to reduce the pain but also the inflammation. Devil’s claw and hyaluron injections into the affected joint should also relieve the pain.
Often the pain causes a vicious circle. This means that the pain causes the joint to move even less. Although this relieves the pain, it also leads to further stiffening and worsens bad posture.
So if the pain prevents normal movement, a better pain therapy or operation should be considered urgently. Over a longer period of time, the incorrect posture can otherwise lead to consequential damage to other joints or, for example, to the outside of the foot, since this area is usually subjected to more stress in order to reduce the pressure on the big toe.If the pain is ignored for too long, a whole series of problems can arise. However, the various forms of therapy, at the latest surgery, are usually a good way to reduce the pain in the long term.
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