Foot & Ankle · Arthritis

Hallux Rigidus

Cared for across all 6 OSI locations

Overview

what it is and why it matters
Clinical photograph of a great-toe MTP joint with hallux rigidus
Hallux rigidus, clinical appearance. Mehlauge 2002 CC BY-SA 3.0.

Hallux rigidus is osteoarthritis of the first metatarsophalangeal (MTP) joint — the big toe joint — causing pain, stiffness, and loss of dorsiflexion (the critical motion for push-off in walking and running). Dorsal osteophytes (bone spurs) form at the metatarsal head and the base of the proximal phalanx, impinging with toe extension.

It is the most common arthritic condition of the foot. Most patients cope well with footwear modification; a minority require surgery.

Diagnosis

exam first, imaging second

Reduced dorsiflexion (normally >60°), dorsal tenderness and osteophyte, pain at end range. Weight-bearing lateral X-ray shows osteophytes, joint space narrowing, and flattening of the metatarsal head. The Coughlin-Shurnas grading system (0–4) correlates with treatment options.

Treatment Path

how care progresses at OSI
1

Stiff-soled rocker-bottom shoe

Reduces dorsiflexion demand on the first MTP joint during push-off — the single most effective conservative intervention.

2

Carbon-fiber foot plate insole

Semi-rigid insole worn inside any shoe.

3

Corticosteroid injection

Provides months of relief in lower-grade disease.

  1. NSAIDs

    For acute flares.

Surgical Options at OSI

if non-operative care isn't enough

Surgery is offered for grade 2–4 disease failing conservative management with significant activity limitation.

Further Reading

authoritative sources

External patient-education references and related OSI pages for additional background:

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