The Centre ASSAL
for Foot Care and Surgery
Avenue de Beau-Séjour 6
1206 Geneva - SWITZERLAND
Phone + 41 22 702 24 40
Fax + 41 22 702 24 49
contact@centre-assal.ch
One of the first symptoms of hallux rigidus is stiffness in the first joint of the big toe (hallux). Since this joint participates in extending the foot, walking can be uncomfortable or even painful. If mobility is reduced or lost, consultation is strongly recommended, particularly if the pain is accompanied by hard bone spurs at the phalanges of the big toe.
Hallux rigidus is caused by gradual wear of the cartilage between the metatarsal and phalanx of the big toe. Unfortunately, the consequences of this form of arthritis are irreversible. With the disappearance of the cartilage lining the joint, friction can contribute to the development of bone spurs (osteophytes) at the heads of the bones making up this joint.
If mobility is reduced or pain increases, initial conservative treatment will consist of taking oral anti-inflammatory medications or using a rigid support to provide some pain relief. To reduce the pain caused by movement, wearing shoes that allow good rolling of the foot joints can also be helpful. However, in cases of severe arthritis, surgery can offer a more lasting solution. Various options exist depending on the type of lesion present:
Treatment #1 : If bone spurs (osteophytes) have become too visible or bothersome, they can be removed by minimally invasive percutaneous surgery (cheilectomy). In rare cases, a surgery to shorten the first metatarsal (Weil) may be proposed in conjunction with this procedure.
Treatment #2 : Permanent fixation of the joint (fusion) is the last resort when all other treatments have failed to relieve the arthritis. This normally has a minimal impact on the patients’ quality of life, as they quickly regain their mobility and ability to walk. This surgery does not prevent patients from walking, running or even wearing high heels (3 to 5 cm). Neither does it result in limping.
