Does Your Big Toe Hurt? It Could Be Arthritis (Hallux Rigidus)

Maybe your big toe just hurts in certain shoes. Or maybe it just hurts when you exercise, or get up on your tiptoes to reach a higher shelf. In any case, you can feel a bump on the top of your toe, and the pain is slowly getting worse. 

There’s a good chance that your orthopedic surgeon will diagnose you with hallux rigidus.

What is hallux rigidus?

Because we like to keep things simple in orthopedics, hallux rigidus literally means “stiff toe.” Hallux rigidus is also one of many types of arthritis. Osteoarthritis is the wearing away of cartilage at the end of joints. 

In this case, osteoarthritis happens in the first metatarsal phalangeal joint (knuckle) of the big toe.  This is the most common site for arthritis in the foot. It can occur anytime in life, but most patients are over 30 years old, and 1 in 40 people over 50 develop big toe arthritis. It is more common in females. 

Why does big toe arthritis hurt?

Often, patients develop a large bone spur on the dorsal aspect (top) of their first metatarsal (foot bone). You can easily feel this bump. Also, if you are in a high-heeled shoe or doing exercise on your toes, the bone spur can pinch, making the pain worse. 

As arthritis progresses, it can cause pain with any movement. You can also have pain on the bottom of the knuckle of the first toe. 

What are symptoms of great toe arthritis?

Patients typically feel pain in the toe knuckle when being active, particularly when doing high impact activities on their toes. When pushing off, the pain can be worse. Sometimes, pain is accompanied by swelling. 

Why did I get arthritis of the great toe?

There are many causes for arthritis. Some patients with differences in foot anatomy have a higher risk of arthritis. Genetics play a role in foot arthritis, so you can blame your parents or grandparents. 

Your medical history matters, too. Prior injuries or fractures to the great toe can cause hallux rigidus, as can a history of gout or inflammatory arthritis (rheumatoid arthritis).

How do you diagnose big toe arthritis?

The orthopedic surgeons at Southwest Orthopedic Group can perform an exam and simple in-office radiographs to determine if you have big toe arthritis. 

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about hallux rigidus at FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD