Hallus rigidus or stiff big toe is when arthritis affects the big toe. It can cause stiffness, pain, numbness, and changes in gait. Treatment options include pain relief medication and surgery.

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Big toe arthritis affects the first metatarsophalangeal (MTP) joint. With each step, this joint bears around 119% of the body’s weight. For this reason, a stiffening of this joint due to arthritis can severely impact a person’s mobility.

This article discusses big toe arthritis. After defining this condition, it will detail the symptoms, causes, diagnosis, and treatments. It will also discuss the preventions and briefly discuss some other causes of big toe pain.

Research from 2022 defines arthritis as an inflammation of the joints. Big toe arthritis is when someone’s arthritis affects the joints of at least one big toe.

When big toe arthritis occurs, the inflammation typically affects a specific part of the toe — the first MTP joint. Research has shown that having a healthy MTP joint is crucial for efficient walking.

Big toe arthritis has several symptoms. A 2021 review lists these as follows:

Some other signs of big toe arthritis may become more apparent during a physical exam. These signs include a swollen or tender first MTP joint and a reduced range of motion in the big toe. Additionally, toe pain can be worse when bending the foot backward.

Osteoarthritis is a kind of arthritis that arises from joint wear and tear. Big toe arthritis is a form of osteoarthritis, and the big toe is one of the most common places that osteoarthritis occurs.

Researchers remain uncertain about the exact causes of big toe arthritis. However, experts have discovered that several risk factors may increase the risk of this condition. These include:

Additionally, certain conditions, such as gout and rheumatoid arthritis, can also worsen big toe arthritis.

The above 2021 review explains that doctors will use several methods to diagnose big toe arthritis.

One important diagnostic tool is radiographic imaging, such as X-rays. These allow doctors to determine the amount of spacing between the joints of the big toe. Less spacing will lead to more severe arthritis.

Doctors can use further techniques to gauge the severity of someone’s big toe arthritis, such as asking about the amount of pain or stiffness the individual feels. They can also test the individual’s ability to move their big toe.

Doctors can treat big toe arthritis in various ways.

Some interventions are nonsurgical, such as using nonsteroidal anti-inflammatory drugs to reduce pain and swelling.

Medical professionals may also recommend special types of shoes and other devices to help take pressure off the big toe.

Many treatment options are surgical and may include the following:

Cheilectomy

This procedure involves removing some of the bone within the big toe. It is most helpful for people with milder forms of big toe arthritis.

This surgery has a success rate of approximately 80%.

Arthrodesis

This surgery is when surgeons fuse some bones in the big toe, removing the damaged joint between them. This procedure is most helpful for people with severe forms of big toe arthritis.

It is also possible for surgeons to replace damaged toe joints with artificial ones. Some research suggests this can be helpful in the short term. However, it is not certain whether this procedure yields optimal long-term effects, as more research is necessary.

There is limited research on the specific prevention of big toe arthritis. However, scientists consider that some people can lower their risk of developing this condition.

For instance, avoiding injuries may help, but this is not always easy. There is also evidence that some individuals could avoid osteoarthritis by reducing frequent heavy lifting.

Other interventions relate more to specific lifestyle changes. For example, not maintaining moderate weight and having low muscle strength are risk factors for osteoarthritis. Therefore, some people may minimize these risk factors with appropriate diets and exercise routines.

However, there is no scientific evidence that such interventions lower the risk of osteoarthritis.

Big toe arthritis is not the only cause of pain in the big toe. Several other conditions can feature big toe pain as a symptom. These include the following:

  • Turf toe: Turf toe is a toe injury that often occurs during sport or exercise. It occurs when someone hyperextends the first MTP joint and can cause significant levels of big toe pain. Additionally, turf toe may itself cause or worsen big toe arthritis.
  • Ingrown toenails: Experts define ingrown nails as nails that have begun to grow into a person’s skin. Ingrown nails can cause inflammation and infections, which may lead to pain that can affect the big toe.
  • Gout: This common cause of arthritis can affect the MTP joint. It occurs when a person has a buildup of certain crystals in their tissues, which may cause severe pain.

Doctors will consider such conditions before diagnosing big toe arthritis. However, someone can also have several of these conditions at once.

Big toe arthritis is arthritis that affects a person’s big toe.

This condition can cause significant pain and discomfort. However, it may be preventable in some cases, and doctors can treat big toe arthritis in several ways.

Healthcare professionals will prescribe nonsurgical options, such as pain-relieving medication, or recommend surgical procedures that remove or fuse certain parts of the bone. Certain lifestyle changes may also help a person with big toe joint pain.