Stiff Big Toe-Hallux Rigidus

The most common site of arthritis is in the base of the big toe called metatarsophalangeal joint, also known as the MTP joint. It is one of the most important joints in the foot as it has to bend every time you take a step. With arthritis, the articular cartilage of the joint is damaged, and there is increased contact stress on loading the joint, resulting in a painful, stiff big toe, also referred to as hallux rigidus. 

a person holding his/her toe because of pain

Some common symptoms of a stiff big toe include:

  • Pain in the joint especially as you push on the toes when walking
  • Swelling around the joint
  • A bump, like a bunion or a callus, that develops on the top of the foot
  • Stiffness in the big toe and an inability to bend it up or down



Wear and tear or injury are common causes of big toe stiffness, as they damage the articular cartilage, causing the raw bone ends to rub together. A bone spur or overgrowth may also develop on the top of the bone, preventing the toe from bending as much as it needs to when you walk. 


Hallux rigidus usually develops in adults between the ages of 30 and 60 years. Differences in foot anatomy or old injury that increase stress on the joint could be a cause too. 


Your orthopaedic specialist will start off with a physical examination to check your foot and look for evidence of bone spurs and move the toe around to see how much motion is possible without pain. You may also be required to undergo an X-ray for an accurate diagnosis. 


Non-surgical treatments such as taking pain relievers and anti-inflammatory medications, applying ice packs, and wearing a stiff-soled shoe with a rocker or roller bottom design to support the foot and reduce the amount of bend in the big toe may help. 


Your orthopaedic specialist may recommend surgery if conservative measures fail. If the arthritis is mild to moderate, a cheilectomy is recommended; this involves removing the bone spurs and part of the metatarsal to allow more space for the big toe to bend. For severe arthritis, a fusion (arthrodesis) is recommended. This is a procedure to remove the damaged cartilage and bone of the metatarsophalangeal joint and fix the two bones together as one. Although this results in loss of motion of the joint, the pain can improve markedly.


Every case is different; hence it is best to consult an orthopaedic specialist for an accurate diagnosis so that you can obtain the best treatment option that is most suitable for you. Reach out to us today if you suspect you are suffering from hallux rigidus and let us help you enjoy a better quality of life.