"Is It a Bunion?" - Part 1 - Hallux Rigidus

"My bunion is playing up".

 The big toe joint causes a lot of trouble for some people, but it isn't always a bunion, even if the joint is swollen, red and painful.                                

Quite often it is a condition called Hallux Rigidus. The 'Hallux' refers to the big toe and 'Rigidus' means that the toe is rigid, or does not move easily. It requires very different treatment to a bunion.

 It is actually  a form of degenerative arthritis which is a progressive condition  and with time, stiffness develops in the toe.  In the early stages when movement is only slightly limited it is referred to as 'Hallux Limitus', but eventually the motion deceases and when the joint is very stiff, it becomes Hallux Rigidus.

We use the big toe joint for many activities, walking, climbing, kneeling, stooping or even standing and so, any inflammatory condition affecting the joint is very painful.

This type of arthritis is often referred to as 'wear and tear' and may be  attributed to the internal 

architecture of the foot, the way in which the joint moves in relation to the other joints in the foot.  There are many biomechanical discrepancies that can lead to this problem including excessive 'pronation' of the foot. Some people have occupations  that require putting excessive strain on the joint, for example climbing ladders or squatting for long periods of time. This may be the sole cause or it may be adding to the inherited problems. There is often a family history of Hallux Rigidus which may be due to the inherited predisposition and the bony alignment or even that career paths may also 'run in families'.

Hallus Rigidus may be caused by injury or trauma, such as stubbing the toe(common in athletes); or through suffering other inflammatory conditions such as gout or rheumatoid arthritis.

As Hallux Rigidus develops, the symptoms progress. Pain and stiffness are the first signs which are aggravated by cold, damp weather and made worse during certain activities (squatting, running). There may be inflammation around the joint combined with swelling. All of these may cause a limp and, as a result of the altered gait, knee, hip and back pain are often evident.

Your podiatrist can usually diagnose this condition by manipulating the toe, but an x ray would determine it.

Treatment involves reducing the inflammation and pain.

 Keeping the joint straight is very helpful and so thick stiff soled shoes are advised. For once, flexible trainers are not advised by the professionals! Well placed pads inside the shoe can reduce the movement in the joint and high heels are definitely not recommended. Avoid all activities which include repeated trauma on the joint, such as jogging. Once the inflammation has reduced, the pain will subside.  Ultimately the toe may become completely inflexible. This may not necessarily cause any problems, as  instinct is to hinge off the second toe joint if the first one is not functioning.