Hallux Limitus & Hallux Rigidus

Description

As the name suggests, Hallux Limitus is a limitation of movement in the joint at the base of the big toe. This biomechanical disorder prevents the toe from rolling over the bone, and over time it becomes increasingly difficult to bend the articulation.

Without preventive measures, this condition leads to what is called Hallux Rigidus, where movement of the toe becomes impossible because the joint is too rigid. Both are actually forms of degenerative arthritis: the deterioration of cartilage with-in the joint.

Therefore, gait compensation will be present in the form of increased pressure being put on the outer side of the foot to avoid the big toe joint. Degenerative arthritis is not limited to the foot but is present in various joints of the body including the knee and hip.

As a result, the main metatarsal (the bone behind the big toe) begins to move towards the midline of your body, building a painful lump on the side of the foot, which often is an area under the foot submitted by much pressure and where friction is caused by wearing all types of shoes.

Symptoms of Hallux Limitus

• Pain and stiffness in the big toe, especially during physical activity or when walking
• Pain and numbness increases in cold, wet weather;
• Difficulty running, crouching and kneeling;
• The base of the big toe is often swollen and red.

Symptoms of Hallux Rigidus

• Pain is constant, even whilst at rest;
• Bone spines form around the bones of the joint, causing limitation for choice of shoe ware such as high heels;
• Pain may begin to appear in the lower back, knee and hip due to gait compensation;
• In some severe cases, the pain can cause a person to limp.

What are the causes of Hallux Limitus or Rigidus?

The development of Hallux Limitus is more often structural, with faulty or abnormal mechanics that lead to premature osteoarthritis. In some people, it is passed from generation to generation because the type of foot is genetically susceptible to developing this condition. Hallux Limitus can also appear from trauma such as hitting your toe.  It can also develop in a person who works so that they often strain their big toe whilst squatting or kneeling, or have an inflammatory bone disease, such as rheumatism, arthritis or gout.

Your podiatrist can determine the cause of Hallux Rigidus and suggest the best treatment for you.

Treatments

Depending on how advanced your hallux limitus is; you may respond well to conservative treatments. In fact, in many cases, early treatment can prevent or delay the need for surgery in the future. This is why it is important to see a foot specialist when you start to notice symptoms.

Here are some of the strategies offered:

• Wearing shoes with a deep upper allowing the full range movement of the toes without limitations. A rigid sole and possibly a cradle are recommended. Avoiding wearing high heel shoes is recommended.
• Plantar orthotics, custom-molded for your foot, are designed to distribute body pressure more evenly across the foot and realign joints. By controlling the movement of the big toe in this way, they prevent symptoms from worsening.
• Certain anti-inflammatory products may be prescribed to reduce pain. Taking vitamin and mineral supplements can help prevent bone deterioration.
• The podiatrist may also choose to inject corticosteroids or small amounts of a collagen derivative to temporarily relieve inflammation and delay surgery.
• Finally, along with physiotherapy, precise manipulations and ultrasound therapy may be considered for temporary relief of symptoms.

Hallux rigidus or limitus surgery may also be recommended.