Treatment methods

We tailor treatment to your symptoms

In general, in the early stages of the disorder, we can greatly alleviate your symptoms through conservative measures and eliminate the need for Hallux rigidus surgery. The right shoe is great at providing significant relief. There are a wide variety of Hallux rigidus shoes available which will let you walk again with ease.

Conservative treatment methods

Hallux rigidus: treatment without surgery

The goal of conservative treatment is to reduce the stress on your joint, the pressure on the bony outgrowths, and joint inflammation and swelling.

An insert with a stiff sole serves to transfer the rolling movement of your foot to the sole of your shoe. Your big toe then bends upwards less when you roll your foot, stopping pain.

Adjusting the sole of your shoe using a so-called rocker sole can also help. This is a rounded piece of rubber that is glued to the outside of the sole of your shoe. It reduces the flexibility of the sole around the big toe joint, making rolling movements in the shoe easier.

One proven method, particularly with sports shoes, is to hollow out the sole underneath the big toe and fill the cavity with very soft material. During rolling movements, your big toe is immersed in the soft material and pressed less in the instep direction.

Shoes with soft top material and lots of toe room provide your big toe joint with enough space. These shoes often significantly reduce your symptoms, but aren’t very fashionable.

Our physiotherapists will be happy to demonstrate different exercise techniques that you can use to improve the movement of your big toe joint, as well as reduce inflammation. Osteoarthritis cannot be remedied through physiotherapy alone.

Anti-inflammatory medications such as Diclofenac and Ibuprofen can also have a positive impact on severe inflammations in the big toe joint. However, these medications should not be taken over long periods of time.

Surgical treatment methods

Hallux rigidus: treatment with surgery

Various surgeries are available to preserve your joint. These include arthroscopy of your joint, removing painful bony outgrowths (cheilectomy) and correcting displacements (corrective osteotomy). We can preserve the mobility of your joint using these procedures, but we cannot remedy arthritis. Therefore, even with surgery, it may be necessary to replace the surface of the joint with artificial tissue, perform ankylosis (arthrodesis) or artificially replace the joint (arthroplasty) at some point. With corrective osteotomy and cheilectomy, your joint may be fused or artificially replaced at any point in the future.

Additional surgical options as required

We offer even more surgical procedures at Schön Klinik, according to your individual requirements. Our foot surgery specialists can advise you on which ones are best for you in a personal consultation.

Ankylosis (arthrodesis)

If your joint has completely deteriorated, we can fuse the big toe joint. This decreases your pain and increases the stress tolerance. In this operation, we remove the deteriorated cartilage from your joint and screw both joint surfaces together. Once the bones have been unified, you’ll be able to put your full weight on your foot without limitation, even while playing sports. The rolling movement is largely taken over by the big toe end joint.

Implantation of artificial tissue as a placeholder

If your arthritis is already advanced and you want to preserve mobility in your joint, we can insert artificial tissue as a placeholder. Partially elastic materials have been proven to prevent bones rubbing against one another. However, there is still no conclusive evidence of whether ankylosis can be permanently prevented in any patient. The placeholder will still function well over the first five years. Furthermore, no new joint is implanted through this procedure. Typically, there will still be reduced mobility, and the joint will often be somewhat thicker than the healthy joint on the other side.

Correction of additional displacements

If, alongside osteoarthritis, your first metatarsal bone has shifted to your inner foot, this displacement can be corrected through surgery (displacement osteotomy). In some cases, we can rearrange your joint so that regions with good cartilage are moved into the principal stress zone to relieve strain on regions with poor cartilage.

Removal of painful bony outgrowths (cheilectomy)

We can improve your movement if it is reduced by under 75% and alleviate your symptoms. To do so, we extract the bony outgrowths and remove the joint area affected by the wear. Just a small cut above the ball of your big toe joint is needed for this procedure. We can also remove the bone edges using minimally invasive methods: through a small “keyhole” made with a bone cutter. After this procedure, it is important that you complete intensive exercises.

Arthroscopy

In the very early stages, arthroscopy of your big toe joint may alleviate your symptoms. The inflamed inner lining of your joint is stripped away through surgery, and bony outgrowths are removed. However, because we can’t rectify the causes of your arthritis, it will progress in spite of surgery.