1. What is Hallux rigidus?
The Hallux rigidus is a painful limitation of motion of the big toe as a result of joint wear (arthrosis). In the late stage, the toe joint may stiffen.
The Hallux rigidus is the most common osteoarthritic disease of the foot. It typically occurs in adults over 30 years. Women are more often affected than men.
2. What causes Hallux rigidus?
For Hallux rigidus responsible arthritis can have different causes – for example:
- hereditary factors
- minor injuries (so-called micro-trauma)
- Overload (e.g. through Sport)
- Violation in the area of the articular cartilage and bone
- Gout
- Psoriasis
The risk for the development of Hallux rigidus can also rise due to tight and/or high-heeled shoes. This is probably the reason that women are more often affected than men.
In most cases, the exact cause for Hallux rigidus, however, remains in the dark.
3. How do you recognize a Hallux rigidus?
Typical for Hallux rigidus have pain in the big toe, the Rolling of the foot to hinder. Also the Standing or walking on the tips of your toes is painful to impossible. In addition, the toe is often swollen. Shoes with heels or thin soles increase the problems.
Depending on the extent of the symptoms is different to Hallux rigidus different disease grade.
- Grade 0 (A): movements of the big toe solve only moderate pain. The mobility is not or at most slightly restricted. In the x-ray image osteoarthritis is undetectable.
- Grade 1 (B): The big toe hurts at the movements clearly and is only to a limited extent movable. From this stage, Arthro detect changes in the x-ray image.
- Grade 2 (C): When movements occur stronger pain. The mobility of the toe is significantly limited. At the top of the joint, a bony prominence is palpable.
- Grade 3 (D): The big toe is in its agility is severely limited and the joint may stiffen. This hinders the rolling movement of the foot while walking and thus leads to an impaired gait.
4. What helps with Hallux rigidus?
The treatment of Hallux rigidus depends on how the changes to the affected toe advanced. In addition, individual factors are also crucial – for example, how old and how active it is. In the early stages of the Disease rich conservative measures:
- Pain relievers (NSAIDs) can be of acute relieve discomfort.
- The doctor may also an analgesic or anti-inflammatory drug into the joint injection (agents for local anesthesia, corticosteroids, or hyaluronic acid).
- The big toe joint Hallux rigidus to relieve, are orthopedic custom shoes (e.g., with special insoles, Shoe unwind and Shoe expander).
- In the early stages of the Hallux rigidus is a form of manual therapy is useful to the mobility of the big toe joint to maintain or even to improve. Who is the appropriate Exercises show, can you make then yourself at home.
- Support can also be physical measures are used – such as cold therapy, application of a weak direct current (iontophoresis) or electrical stimulation.
These measures can help to reduce the symptoms, but the progression of osteoarthritis progress, not stop it. If, then, in the middle and late stages of Hallux rigidus the joint changed significantly, and with each movement hurts, a OP of the question.
5. How is the Hallux-rigidus-SURGERY?
Also it depends on the degree of toe change. With only mild arthrosis of the metatarsophalangeal joint, is a joint-preserving Operation is possible. In the case of the so-called Cheilektomie wearing the surgeon, the damaged bone and cartilage areas of the big toe joint, the mobility of the joint, the discomfort to improve.
A severely worn joint can not be obtained. Then helps in the case of Hallux rigidus, only a total joint replacement (prosthesis) or a stiffening (arthrodesis).
Sources:
Hallux Rigidus. Online information from the American Orthopaedic Foot & Ankle Society: www.aofas.org (retrieval date: 18.2.2019)
Hallux rigidus. Online information of the Pschyrembel: www.pschyrembel.de (status: may 2017)
Wirth, C. J., et al. (EDS.): Practice of Orthopaedics and trauma surgery. Thieme, Stuttgart, 2014
Imhoff, A. B., et al.: Check List Orthopedics. Thieme, Stuttgart, 2014
Rivet hard, F. U., et al.: Dual row of Orthopaedics and accident surgery. Thieme, Stuttgart, 2014
*The contribution of “Big toe swollen? Behind it is a chronic disease can put” comes from Onmeda. There is no editorial review by FOCUS Online. Contact with the executives here.