Causes and risk factors
The exact cause is still not clear, however. Multiple theories have been put forth. Hallux rigidus is seen hereditary in some cases. Overuse of the joint can also lead to its rigidity, hence it is more commonly seen in people who are engaged in activity where continuous stooping or squatting is required. Any injury (fall, arches, etc.), to the toe can also lead to hallux rigidity. Structural abnormality and improper functioning of the joint can also lead to rigidity of the hallux. It is often associated with other disorders of the bone like rheumatoid arthritis, gout, etc. Turf toe in its long run can lead to rigidity of the hallux. It is commonly seen in athletes, especially who are engaged in running.
Clinical presentation:
Unlike any other fracture, pain is the predominant feature seen. The pain is especially at the top of the great toe. It is aggravated by movement. Activities like walking or even pressure of shoes also initiates pain. The pressure of the shoes causes abnormal sensation. Restricted movement is seen. Swelling occurs. There is formation of osteophyte at the level of the joint. The complaints go on aggravating as the time passes. The patient is unable to move the toe. Gradually, the entire movement of the toe is restricted, the toe becomes frozen. All the complaints are worse on exposure to damp, cold weather. Abnormality in gait is also seen. The patient starts limping.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and the physical examination carried out by the orthopedic doctor. Investigations which are done are x-ray of the affected foot. Routine x-rays, usually, or specialized digital x-rays can be advised. In case of advance pathology, CT scan of the bone or MRI can also be done.
Treatment:
The treatment plan consists of administration of medications to allay the pain. It consists of administration of pain relieving medications or nonsteroidal anti-inflammatory drugs. Corticosteroid injections can also be administered. The motion of the joint should be restricted, especially kneeling and squatting should be avoided. Modification of shoes is necessary. Still-soled shoes or shoes with wide toe box are advised. In severe cases, surgical repair is advised. Osteophyte formation needs to be excised. Cheilectomy method of surgery is adopted. Other surgical methods includes osteotomy, joint arthroplasty, or arthrodesis.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Certain yoga exercises can also be helpful in strengthening the muscles.
