How to treat hallux rigidus?
Posted: Jul 26, 2022
Pain in the big toe that hurts when walking is mostly common due to osteoarthritis and is often given the term more commonly known as hallux rigidus if the joint is really rigid or hallux limitus if its not so rigid. Hallux rigidus is painful when walking, so if its really painful at rest, then it might more likely be gout that a hallux rigidus. With the hallux rigidus, when we are walking and the heel starts to raise up off the ground, the big toe joint needs to move for that motion to happen. If that movement is limited or there is a painful osteoarthritis in the joint, then that it is not going to be as easy to walk. It makes sense that if that joint hurts when walking, then a logical way to deal the pain on movement is to restrict just how much the joint moves.
There are many ways to do this. One simple way that Podiatrists use is with felt padding that can be stuck on the foot under the big toe and ball of the foot or strapping could be used to tape the joint. Both of these are really good short term measures, but just not practical for the long term. If you need a foot orthotic for other reasons, there is an extension that a Podiatrist can add on the front of the foot orthotic that is called a Morton’s extension that can be used to stiffen up the joint by restricting bending or flexion of the foot. Another way is to use a carbon fibre insole plate that usually are less than 2mm thick so they can fit easily into the shoe and are very rigid. These carbon fibre plates are frequently used to treat hallux rigidus and other problems such as turf toe that need to restrict the motion of the joint. The research evidence is that they are pretty effective at dealing the symptoms in the joint with these conditions. Another way to treat the pain from the osteoarthritis and hallux rigidus is to simply use shoes that are more rigid across the ball of the foot. The more flexible the sole of a shoe is, the more that the big toe joint is going to flex and the more likely it is to be painful when walking. There are some shoes, especially the Hoka running shoes, that have a rocker and extra cushioning built into them that are particularly help at that. The effect of the rocker in these shoes is that the big toe does not need to move as much as the foot rocks forward over the rocker. A pedorthist or shoe technician can add a rocker to many different types of shoes to achieve the same thing.
If you have hallux rigidus or osteoarthritis of the big toe joint, then there are options in the short term to manage the pain and options in the longer term to control the movement of the joint so that it is not as painful.
Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.