Hallux Limitus & Hallux Rigidus

Description

As its 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 toe.

Without preventive measures, this condition leads to what's known as Hallux Rigidus, where movement of the toe becomes impossible because the joint is too rigid. Both are in fact forms of degenerative arthritis: the cartilage in the joint deteriorates.

As a result, compensation for walking will be present in the form of increased pressure on the outer side of the foot to avoid the big toe joint. Degenerative arthritis is not confined to the foot, but is present in various joints throughout the body, including the knee and hip.

Consequently, the main metatarsal (the bone behind the big toe) starts to move towards the midline of your body, building a painful bump on the side of the foot, which is often a part of the foot subjected to

Symptoms of Hallux Limitus

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

Symptoms of Hallux Rigidus

• Pain is constant, even at rest.
• Bony spurs form around the bones of the joint, limiting the wearing of certain shoes such as high heels.
• Pain may begin to appear in the lower back, knee and hip due to gait compensation.
• In severe cases, the pain can lead to limping.

What are the causes of Hallux Limitus or Rigidus?

The development of Hallux Limitus is most often structural in origin, with faulty or abnormal mechanics leading to premature osteoarthritis. In some people, it is passed down from generation to generation, as the foot type is genetically susceptible to developing this condition. Hallux Limitus can also develop because of trauma, such as stubbing your toe. It can also develop if you're someone who works in such a way as to put frequent stress on the big toe when squatting or kneeling, or if you suffer from 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 postpone the need for surgery in the future. That's why it's important to consult a podiatrist experienced in foot surgery when you notice symptoms.

Here are some suggested strategies:

• 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.