What It Is
Hallux rigidus is osteoarthritis of the first metatarsophalangeal (MTP) joint - the big-toe joint. It progresses from limited motion (hallux limitus) to a near-fused, painful, immobile joint with prominent dorsal osteophytes.
What It Feels Like
Pain at push-off - climbing stairs, jogging, getting up onto the toes - and increasing difficulty with shoes that pinch the prominent top of the joint. The dorsal bump can rub on shoe leather.
Conservative Care
Stiff-soled or rocker-bottom shoes, a Morton’s extension orthotic that limits painful motion at the joint, intermittent injection, and activity modification.
Surgical Options
For early-stage disease, cheilectomy (debridement of the dorsal osteophyte) preserves motion and relieves pain in selected patients. For advanced disease, first MTP fusion (arthrodesis) is the gold standard - durable, predictable, and compatible with a normal life including hiking, golf, and most exercise.