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Big Toe Arthritis (hallux rigidus)

Big toe arthritis, which can affect one or both feet, is when there is arthritis in the metatarsophalangeal (MTP) joint of the big toe. The Latin name comes from ‘Hallux’ meaning the big toe and ‘rigidus’ meaning rigid or stiff.

What causes big toe arthritis?

Big toe arthritis, which is more common in people aged 30-50, can be caused by damage to the joint from wear and tear or by repetitive strain, but in some cases there may be no obvious reason. However, people who have big toe arthritis often have arthritis in other joints as well.

What are the signs of big toe arthritis?

Signs include:

  • Pain and stiffness in the joint, especially where the toe bends upwards
  • A lump on top of the joint that can cause your shoes to feel uncomfortable
  • Pain when you walk or take part in sporting activities

How is big toe arthritis diagnosed?

During your first appointment, you’ll have an opportunity to discuss your symptoms with Mr Heidari who will usually carry out a number of diagnostic tests. These may include an X-ray or an MRI scan to identify any damage to the joint.

What does treatment involve?

Earlier treatment can mean the joint is preserved, while later treatment may involve big toe fusion surgery.

Not everyone with big toe arthritis needs to have surgery and Mr Heidari will be able to advise you about the type of treatment that’s best for you. In some cases, it may be possible for you to wear specially designed insoles to take pressure away from the big toe joint, or shoes that support the toe while allowing enough space inside your shoe. Along with being prescribed anti-inflammatory painkillers (if advised by your doctor), this may be enough to manage the pain.

However, if the lump that’s formed on the joint stops the toe being able to bend upwards, it can be removed to relieve pain and improve movement. This procedure (usually carried out as day case surgery) is known as cheilectomy. In some cases, Mr Heidari may suggest you have big toe fusion surgery, which stiffens the joint permanently but can help relieve pain and enable you to wear your normal shoes.

This information is written as a guide to your treatment but it is not intended to replace the advice of your doctor. Please contact us for advice if you are worried about any aspect of your health or recovery.