Hallux limitus/rigidus or great toe joint arthritis is arthritis of the 1st metatarsal-phalangeal joint. This condition can be caused either by direct trauma such as a old fracture or injury or by “wear and tear”. It is often misdiagnosed for a turf toe injury, gout or a fracture.
As the condition worsens, the motion of the great toe joint decreases and pain increases. The patient will change the way they walk which can lead to pain and injury in other parts of the foot, the hip, knee or back. The patient will typically either abduct, or turn their foot out, and roll over the inside part of their foot in order to lessen the motion and pressure on the great toe joint, or walk on the outside of that same foot. This can lead to other conditions such as posterior tibial tendon dysfunction or peroneal tendonitis.
The earlier it is diagnosed and treated the easier it is to treat. The biomechanical cause can be treated either non-surgically with custom molded orthotics or surgically preventing progression and pain. If the joint is very painful, a cortisone injection may be helpful, along with an oral anti- inflammatory, topical pain relievers, shoe modification, inserts, therapies or alternative exercise/activity.
For structural causes that cannot be managed biomechanically, surgery may be necessary. Joint sparing procedures can include “cleaning up” the joint and restoring range of motion. If there is a structural deformity causing jamming, an osteotomy or bone cut can be made correcting the bone angulation.
Surgical options are greatly varies and have to be tailored to your lifestlye, shoe choice and activity level.
If you have great toe joint pain, visit the Doctors at Advanced Foot and Ankle Center.