How to Deal with Big Stiff Toe or Hallux Rigidus

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By dorigillman
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You big toe joint

Hallux Rigidus is a condition when you develop pain in your big toe joint and it becomes very stiff, thus the name “Big Stiff Toe”! The reason it becomes a big stiff toe is that the cartilage between the joint and the big toe begins to deteriorate. Eventually, if it is not treated or it deteriorates continuously even with some treatment, the cartilage disappears and the bone scrapes the joint.

This condition is characterized by swelling, a grinding feeling in your toe, and of course, pain. If you are a woman, who wears heels, you will experience immense pain. That was when I first realized that I had a problem. The pain can transfer to the rest of your body, hip, or knee because you will begin to walk to compensate for your discomfort.

Genetics, wear and tear, repetitive stress injuries—all these things can contribute to Hallux Rigidus. My brother and I both suffer from this condition. He ran marathons and played tennis; I played squash and tap danced obsessively. We both developed Hallux Rigidis. I had mine successfully treated surgically many years ago. He didn’t. Here is how to deal with it.

Difficulty: Moderately Challenging

Instructions

Step 1

See a podiatrist when you realize there is a problem. I went when I began limping in my heels. He/she will spell out your options and tell you where you are in the progression of the problem.
Step 2

You can still wear low heal cute shoes!

Do not wear heels higher than ½ inch anymore!!!!! Wear supportive shoes with a wide shoe box to minimize pain when walking. This doesn’t mean you have to wear oxford style clunkers. Go the comfort shoe store and get some cute and stylish shoes!
Step 3

Orthotics

Have your podiatrist fit you for orthotics. Orthotics will correct your walking and help manage any pain you feel from the toe.
Step 4

Get a shot

Get a cortisone shot in your toe to reduce inflammation if your doctor recommends it. This is only if the problem isn’t too bad. You will develop arthritis with this, too, but that can be easily managed with steroids or simple over-the-counter anti-inflammatory medications. There are also creams that numb the area temporarily available by prescription.
Step 5

You might still be able to play squash or whatever you like

Consider surgical option one if the problem is not manageable with palliative methods. A Cheilectomy or shaving of the bone is the first thing to try. The surgical podiatrist or foot and ankle orthopedist will clean out the big toe joint, removing part of the bone to make more room in the area. It is not a difficult surgery and you will still be able to do all your sports and regular activities. I have had this one.
Step 6

You may be able to perform normal activities

Consider surgical option two if the problem has become a crisis. An Arthodesis or fusion of the bone is when the bone is actually fused to the joint. They will attach is further by placing steel plates or pins in the joint to hold it together. There is no cartilage left between the two body parts to cushion and hold it together.

This option is more radical than option one. Your toe joint will really be “stiff” after this procedure and you may or may not be able to do your sports and regular activities.
Step 7

You will wear a surgical boot for awhile

Consider surgical option three. An arthroplasty or removal of the bone from the joint (joint replacement) is the most radical of the three options listed so far. You will not have range of motion at all but you will recover and be able to perform regular activities. It is like a hip replacement but on your toe.
Step 8

Skin from a different part of the foot

Consider surgical option four. This fourth procedure is not as well documented or even on the radar screen of some doctors. The surgical podiatrist will take a piece of skin from elsewhere on your foot and place it in-between the joint and the bone of your big toe, cushioning it. When you recover from this surgery, you will weight- bear immediately after the procedure. And the recovery is relatively quick. You will have range of motion and be able to perform normal activities. I had this one, too!