Hallux limitus/rigidus


  • Degenerative arthritis and stiffness affecting the 1stMTP joint at the base of the hallux.
  •  May be associated with poor function (biomechanics) and structural abnormalities of the foot e.g. fallen arches or excessive pronation.
  •  Hereditary is a factor for developing this condition.
  •  In the early stage, motion of big toe is only somewhat limited (hallux limitus) while on the end stage, toe becomes stiff and frozen (rigidus).

Diagnostic tips

  1. Presents with pain and stiffness in the great toe joint and swelling (top half of the joint usually) aggravated by activities that involve excessive repetitive dorsiflexion of the big toe joint such as prolonged walking.
  2. May cause pain in the forefoot (metatarsalgia) because patients compensate by putting more weight on the outside of the foot as they walk.
  3. Limited and painful motion in big toe joint.
  4. Prominent osteophyte on the dorsal aspect of joint is palpable and visible.

Tests and Imaging

  1. X-rays of weight-bearing foot will typically identify some loss of first MTP joint cartilage, and may reveal squaring of the metatarsal head. The lateral view will often show a prominent dorsal bone spur.

Immediate Treatment

  1. Analgesia.
  2. Possible guided injection into the first MTP joint for short-term relief.

Possible Referral

  1. Podiatry for help in limiting great toe motion by footwear modification (rocker toe, rigid shank extra depth/width), or an orthotic with a Morton’s extension (a.k.a. “Turf Toe Plate”).
  2. Orthopaedic foot surgeon for osteotomy.