Hallux Rigidus (Big Toe Arthritis): Symptoms and Treatment Options
What Is Hallux Rigidus?
Hallux rigidus is a form of arthritis affecting the big toe joint, also known as the first metatarsophalangeal (1st MTP) joint. This condition causes stiffness, joint pain, and limited motion, especially during walking or bending activities.
Commonly referred to as big toe arthritis or a stiff big toe, hallux rigidus is typically a result of cartilage degeneration in the joint, which may lead to the formation of painful bone spurs over time.
What Are the Symptoms of Arthritis in the Big Toe?
Patients with hallux rigidus often experience:
- Pain in the big toe while walking, running, or standing
- Difficulty bending the toe or pushing off during activity
- Swelling or inflammation around the joint
- A visible bump on top of the toe joint (bone spur)
- Joint stiffness, especially in the morning or after rest
These symptoms tend to progress over time. If left untreated, the condition may limit mobility and impact overall foot function.
What Are the Treatment Options for Hallux Rigidus?
Non-Operative (Conservative) Treatments
For early-stage hallux rigidus, many patients can find relief without surgery. Our foot and ankle specialists often recommend:
- Activity modification to reduce joint stress
- Anti-inflammatory medications for pain management
- Custom orthotics or stiff-soled shoes to limit joint motion
- Physical therapy to improve flexibility and reduce stiffness
- Corticosteroid injections for temporary inflammation relief
While non-operative care cannot reverse joint damage, it can significantly improve daily comfort and delay the need for surgery.
Operative (Surgical) Treatments
When non-surgical options no longer provide relief, we may recommend surgical intervention. The most common procedures for advanced big toe arthritis include:
- Minimally Invasive Dorsal Cheilectomy: Ideal for mild to moderate arthritis. This procedure removes bone spurs and reshapes the joint to restore motion and reduce pain.
- 1st MTP Fusion (Arthrodesis): Recommended for severe cases. Fusion permanently joins the bones of the joint, eliminating movement and pain.
The best surgical option depends on the severity of your arthritis, your activity level, and your personal goals. Our orthopedic foot and ankle specialists will work with you to determine the most effective and personalized treatment plan.
What Is a Minimally Invasive Dorsal Cheilectomy?
A minimally invasive cheilectomy is an outpatient surgical procedure designed for patients with mild to moderate hallux rigidus. Using small incisions, your surgeon removes bone spurs and reshapes the top (dorsal) portion of the 1st MTP joint.
Benefits include:
- Less post-operative pain
- Faster recovery time
- Smaller incisions and minimal scarring
- Preservation of joint movement
This approach helps relieve pain and restore mobility while avoiding more invasive procedures.
What Is 1st MTP Joint Fusion (Arthrodesis)?
For patients with advanced arthritis in the big toe, a 1st MTP joint fusion (also called arthrodesis) may be recommended. This procedure involves surgically fusing the bones of the big toe joint, eliminating painful motion while preserving alignment and function.
Though the joint will no longer bend, most patients are able to walk, cycle, hike, and even return to low-impact sports after recovery. MTP fusion remains the gold standard treatment for severe hallux rigidus.
Cheilectomy vs. Fusion: Which Is Right for You?
| Treatment Option | Ideal For | Preserves Joint Motion | Recovery Time | Pain Relief |
|---|---|---|---|---|
| Minimally Invasive Cheilectomy | Mild to moderate arthritis | Yes | Shorter | Yes |
| 1st MTP Fusion (Arthrodesis) | Severe arthritis | No | Longer | High |
Our specialists will guide you through your options and help you choose the most effective treatment based on your condition, lifestyle, and long-term goals.
What Happens After Big Toe Arthritis Surgery?
Recovery will vary based on the procedure:
- After a cheilectomy, many patients can bear weight within days and return to regular shoes within a few weeks.
- After a 1st MTP fusion, patients typically wear a boot or cast for 6–8 weeks, followed by gradual return to activity.
We provide detailed post-op care instructions and support every step of the way to ensure a smooth and successful recovery.
Ready to Find Relief from Big Toe Pain?
If you’re experiencing chronic pain or stiffness in your big toe, don’t wait to seek expert care. Our board-certified orthopedic foot and ankle surgeons offer advanced treatment for hallux rigidus, from minimally invasive options to long-term surgical solutions.
Schedule an appointment today to learn which treatment is right for you.