Hallux rigidus (stiff big toe)

A common problem which affects the big toe is called hallux rigidus or stiff big toe. ‘Hallux’ is the Greek word for big toe and ‘rigidus’ indicates the joint is stiff and inflexible. Hallux rigidus is a form of osteoarthritis which occurs when the cartilage within the joint wears out.

Your big toes bear a great deal of pressure as you walk. With every step, a force equal to about twice your body weight passes through this very small joint. The big toe is used every time we walk, bend down, climb up and even stand still.


The condition varies in terms of stiffness, pain and loss of mobility. Some people will develop what is known as hallux limitus, where mobility is restricted rather than lost. Symptoms of hallux limitus include:

  • Pain and stiffness during movement
  • Problems with some activities such as running
  • Swelling and inflammation around the joint
  • Symptoms are worse during cold and damp weather

At a more advanced stage, symptoms include:

  • Pain when resting
  • Development of bony bumps (osteophyte) may develop on the top of the joint which can rub on shoes

People may walk on the outer side of the foot to avoid pain from the big toe. This can produce pain in the ball or outside of the foot.

The big toe can become what is known as a “frozen joint” when all movement is lost. At this end stage of hallux rigidus, other related problems are likely to have developed in the foot.

Hallux rigidus can start early in life, even during teenage years or the twenties. However, in the majority of cases, it does not get progressively worse. About 20 to 25 per cent of patients experience increasing stiffness and loss of mobility and are likely to require treatment.


Hallux rigidus can occur spontaneously, without any obvious cause. In other patients, there can be one or a combination of factors which trigger the development of this condition. People with flat feet and other structural deformities such as fallen arches and excessive pronation (rolling in) of the ankles are particularly susceptible to hallux rigidus because of the stress placed on their big toe joints.

Some people may have a family history of the condition and inherit a foot type which is more prone to developing problems within the big toe joint. Hallux rigidus can also be triggered by injury, inflammation and infection.


The condition is simpler to treat in its early stages. Therefore it is recommended that you see a foot and ankle specialist when your big toe feels stiff or when you experience pain as you walk, bend or stand. Once the condition becomes more advanced and bone spurs develop, it is more complex to manage.

Our clinician will examine your feet and assess your range of movement. X-rays may be used to evaluate the extent of arthritis and any abnormalities which may have developed.


Non-surgical treatment

If the condition is caught early, non-surgical treatment is more likely to be effective.

Shoe Modifications

The joint is usually most painful when it is bent upwards during walking. Therefore it can be helpful to stiffen the sole of the shoe so it does not bend during walking. A small ‘rocker bar’ can be fitted so you can rock over while walking, rather than bending your toes. Shoes with a large toe box should be worn, because they put less pressure on the toes. High heels and shoes with pointed toes should not be worn.

Custom-made orthotics

These can be helpful, particularly if your condition is caused by abnormal foot biomechanics. Orthotics are designed to alter the function of your foot. Custom made orthotics have been a specialty for over 15 years our experts have been field leaders. We have prescribed and dispensed thousands of orthotics in the Niagara region are recognized within the medical community as the regional experts.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These include ibuprofen, and may be prescribed to help reduce pain and inflammation.

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