Big Toe Arthritis (Hallux Rigidus)

Big toe arthritis - which usually refers to osteoarthritis (the most common form of arthritis) of the big toe - is a condition which involves the wearing down of the cartilage in the big toe joint. This leads to bones rubbing against each other, and in turn, can cause inflammation and pain, affecting range of movement. A typical site for big toe arthritis is the first metatarsophalangeal joint, located at the base of the big toe.


The risk of developing big toe arthritis increases as you get older. This is because your body has been subjected to more wear and tear as you age, and it loses the ability to heal cartilage which becomes damaged. If you have a family history of arthritis or are obese, you can also be more likely to develop big toe arthritis.


Big toe arthritis can cause pain, tenderness and inhibited movement in the big toe itself, as well as other toes and other parts of the foot.

Walking difficulty arises when big toe arthritis leads to a lack of flexibility in the big toe. Because this can lead to an imbalance when walking, it can cause bunions to develop, and the big toe to become squashed against the other toes. Bunions themselves can lead to calluses, corns, and the hammertoe condition.

Big toe arthritis can also lead to a change in the appearance of the foot, due to inflammation around the big toe joint. Bone spurs can develop due to the growth of more bone, as the wearing away of the cartilage causes bones to rub together. Symptoms of bone spurs include a callus or bump on the toe.


In many cases, home treatments can help to alleviate the symptoms of big toe arthritis. These include wearing the right footwear, with plenty of room for the big toe, and inserts such as arch supports and pads; medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and painkillers; and ice treatments. Making lifestyle changes - such as exercising more and adopting a healthier diet - can help to address the extra weight which can increase symptoms of big toe arthritis.

Physical exercises can be recommended by your doctor or physiotherapist. These include exercises and stretches designed to improve your big toe's range of movement and strength. Walking aids such as a walking stick can improve balance when walking, and wearing a brace or splint can also be recommended.

In some cases, steroid injections can be administered into the big toe joint, helping to alleviate symptoms. Severe cases may necessitate surgery, which is typically focused on the removal of damaged cartilage, and the fixing of the big toe joint in place. This procedure is known as an arthrodesis or fusion, and usually uses a plate and screws to fix the joint in position. There is also the option of an arthroplasty (joint replacement surgery).

Ankle pain can be distressing, especially if you're not sure what options are open to you. If you're wondering if surgery could help you, book an appointment.

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Patient stories

Mr Ajis is a great surgeon, he listens to any concern you may have and explains what is going to happen also gives great care... He suggested a fairly new procedure that wasn't available on the NHS but he pushed me through and he and his team have worked wonders, I am now healing very well and pain-free in my ankle after 6 years!

Written by a patient at BMI Goring Hall Hospital

Mr Ajis was very informative and reassuring about my surgery. He was professional at all times and allowed time for me to have all my questions answered without feeling rushed.

Written by a patient at BMI Goring Hall Hospital

I saw Mr Ajis after sustaining a fracture of my 5th metatarsal which had not healed after a year. The pain was unbearable. He saw me promptly and took the time to explain my condition with the help of x-ray images with assurances that he could fix the problem. I was advised by other clinicians to be patient and wait for the fracture to heal on its own. Mr Ajis said that healing would be highly unlikely without intervention. After numerous emails and 'phone calls to him he constantly...

...spent the time reassuring me and patiently going over the intended procedure. To date after seeking advice and guidance from Mr Ajis, his secretary and the Physio Team and the insertion of a plate my fracture has united I walk well, without pain and I have joined a walking group. In summary, he is the best foot consultant the South of England can provide. In fact, I travelled from both the IoM and the IW to West Sussex to see him.