Hallux Rigidus (Stiff Big Toe)

Understanding Causes, Symptoms, and Treatments

If you think your big toe is giving you trouble, it may be more than just a little discomfort. You may have something called hallux rigidus, or stiff big toe—a condition that causes pain and limited mobility in the joint at the base of your great (or first) toe.

Hallux rigidus can make everyday activities difficult and uncomfortable for sufferers, so if you’re experiencing any limitation of movement or chronic stiffness in your big toe, understanding what this disorder entails is important to help manage your symptoms and improve your quality of life.

Read on to learn more about this condition, including how it develops, the types of treatment available to treat it, and tips for managing its effects. Contact OrthoNeuro for expert diagnosis and treatment. Our orthopedic surgeons are fully equipped to treat many foot conditions. You can find us in Columbus, Ohio.

What Does it Mean to Have a Stiff Big Toe?

A stiff big toe (medically known as hallux rigidus) occurs when the joint at the base of the big toe stiffens. It is the most common form of arthritis that occurs in the foot. Those with this foot condition usually have pain and stiffness in the toe, making it difficult to walk. Hallux rigidus is most commonly found in adults between the ages of 30 and 60.

What Causes a Stiff Big Toe?

A stiff big toe joint is usually the result of damage to the smooth articular cartilage between the joints. There could be one of several possible causes. For example:

Common causes of stiff big toe

  • Wear and tear: Over time, degenerative arthritis can wear cartilage down
  • Trauma: An injury to the toe can damage the cartilage
  • Poor foot alignment: A bunion or flatfoot can cause stress on the MTP joint
  • Genetics: Hereditary factors may also play a part in hallux rigidus

Signs and Symptoms of Hallux Rigidus

You may experience any of the following signs and symptoms if you have hallux rigidus:

  • Big toe joint pain: It’s usually felt at the top and deep inside the joint.
  • Joint swelling: You may need to wear modified shoes. 
  • Bunion or callus on the top of your foot.
  • Big toe stiffness. 

How is Hallux Rigidus Diagnosed?

If you have pain in your big toe that’s making it difficult to walk, or you are finding it difficult to bend your toe up and down, it’s essential to see your doctor. If you wait till a bump appears on your toe, you will likely have developed bone spurs already. This may require more treatment.

Your doctor will begin with a physical examination. They will look for bone spurs and see how much motion is possible through your toe joint. Your doctor may also order imaging tests. X-rays can show the extent of the arthritis and any bone spurs that have developed.

How a Stiff Big Toe is Treated

Treatments of stiff big toes are best implemented early on after diagnosis. You will likely be recommended for non-surgical treatments first before surgical treatments.

Non-Surgical Treatment

Non-surgical treatments are usually the first-line treatment for a stiff big toe. They are designed to ease the symptoms of the condition. Non-surgical treatments may include the following:

  • Medications: Non-steroidal anti-inflammatory medicines (NSAIDs) and other pain relievers may be taken to ease pain and reduce swelling.
  • Ice: An ice pack can be used to temporarily reduce swelling. The ice should not be placed directly on your skin.
  • Footwear: Modified footwear can help reduce the bending of the toe joint, relieving pressure. The recommended shoe may have a stiff sole or rocker bottom design. You may also use shoe inserts.
  • Injections: Corticosteroid injections can help relieve symptoms for a few months. They are usually given after trying other non-surgical treatments but before surgery is considered. 
  • Orthotics/Inserts: These can be used to try and limit motion through the painful joint. If most of the pain you experience is with motion of the joint, this can help by limiting the painful motion.

Surgical Treatment

Surgery may be considered if non-surgical treatments are unsuccessful. The following are some surgical procedures that are used to treat hallux rigidus:


Cheilectomy or bone spur removal may be recommended if you have mild to moderate hallux rigidus. The surgeon will remove the bone spurs together with a piece of the big toe bone. This will allow the toe more room to bend.


Joint fusion (arthrodesis) is usually recommended when there is severe damage to the big toe’s cartilage. The surgeon will remove the damaged cartilage and fix the bones together using screws, pins or plates.

Over time, the bones will fuse together in a permanent position. Although you will lose this movement, it is the most effective way to reduce pain for those with severe hallux rigidus. 


If you are an older patient with limited functional demands on your feet, you may be recommended for joint replacement surgery (arthroplasty). Your surgeon will remove the MTP joint surfaces and place an artificial joint in its place. This procedure is designed to relieve pain and preserve joint motion.

Book a Consultation Today

If you would like to know how the orthopedic surgeons at OrthNeuro can help, book a consultation today! Our physicians are well qualified to diagnose a range of foot conditions. Our tailored approach to treatment will ensure that you get the best outcome possible. We have offices conveniently located throughout Greater Columbus, OH.

Foot, Ankle, and Podiatry Specialists


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