Have you noticed a lump on your big toe? Is your toe’s mobility getting worse?
If you’ve been researching foot conditions, you may be wondering if you have hallux rigidus vs hallux valgus.
Both of these foot conditions create a bony outgrowth on your big toe, although in different places. They also both get worse over time if left untreated.
But the two are quite different foot conditions and need to be treated differently.
Understanding if you have hallux rigidus vs hallux valgus is crucial to determine the best treatment.
Let’s have a look at the differences and similarities between these foot conditions to help you find the right treatment for your feet.
What Is Hallux Rigidus and What Is Hallux Valgus?
Hallux rigidus is a progressive and painful form of arthritis. It affects the first joint of your big toe, causing the toe joint to become stiff and inflexible.
The Latin name for this condition, hallux rigidus, means “stiff big toe” when translated. But this condition is also known as big toe arthritis or turf toe.
Your big toe joint supports up to 50 percent of your body’s weight every step you take. This makes your joint more prone to overuse and developing osteoarthritis.
As the articular cartilage between the first metatarsophalangeal joint breaks down, the end of the first metatarsal bone will begin to rub against the end of the first bone of the big toe.
This can lead to you developing a bone spur on top of the big toe joint, also known as a dorsal bunion or osteophyte.
As the condition progresses, your toe joint will lose flexibility, and you’ll find it difficult to move the joint.
This can make everyday tasks like walking, climbing stairs, or any form of weight-bearing exercise painful and challenging to do.
Hallux valgus is the medical terminology for what’s more commonly known as a bunion.
Both hallux valgus and hallux rigidus affect the same joint in the big toe. But it’s important to note that they are different conditions that require different treatments.
Hallux valgus is a progressive foot condition when the big toe joint is misaligned. This causes the tip of the toe to turn inwards towards the second and smaller toes.
At the same time, the end of the first metatarsal bone turns outwards, causing a noticeable bony bump at the base of your big toe joint on the side of your foot.
Bunions develop gradually and will often get bigger over time, with the bump becoming more prominent. Eventually, you’ll find it difficult to bend your big toe and find shoes that fit, and it can be painful to walk or move it.
What Are Common Symptoms?
Hallux Rigidus Symptoms
As hallux rigidus progresses, you’ll lose the flexibility in your big toe as the joint stiffens and eventually becomes frozen.
You will experience pain on the top of your big toe joint, which will feel worse when you’re standing, walking, bending, or when you try to bend the joint.
You may find that the pain in your big toe doesn’t subside, even when you’re resting your foot. The pain and stiffness can either worsen or increase when the weather is cold and damp.
There’ll be swelling and inflammation around the joint. As the condition progresses, you may notice a bony lump on top of your big toe joint.
With the decreased range of motion, you will walk differently to accommodate your big toe. This can cause you to experience pain in your lower back, hips, and knees.
Hallux Valgus Symptoms
One of the more noticeable differences between hallux valgus and hallux rigidus is the bump’s location.
If you have a bunion, you’ll notice the protruding bump that’s formed on the outside of the base of your big toe.
The bump will get bigger as a bunion progresses, with your big toe increasingly pointing inwards. You may find that your big toe crosses over your second toe and that you’re unable to bend your big toe.
The bump can be tender to the touch with swelling or redness around the big toe joint. You may experience an increase in pain or a burning sensation when you try to bend your toe.
The pain may come and go throughout the day, even if you’re resting your feet. Spending extended periods on your feet will aggravate the symptoms, and you may find that the pain increases.
You may notice the development of corns and calluses, where your toes rub against each other. And the soles of your feet for hardened skin by the big toe joint.
Your big toe will be stiff with a limited range of motion, making walking, standing, or climbing stairs challenging to do.
Hallux Rigidus Causes
There may not be a clear cause as to why you develop hallux rigidus, but several risk factors can increase your risk of developing the condition.
With that said, the most common cause for developing hallux rigidus is overuse of the big toe joint.
This can be caused by repetitive bending or squatting, which places a lot of stress on the big toe joint.
For example, hallux rigidus is a common condition with runners because of the stress placed on the joint with each step.
If you have a job or participate in sports where you’re bending or squatting frequently, this can increase your risk of developing this condition.
An injury to the big toe joint, such as spraining it or stubbing your toe, can increase your risk of developing the condition.
Faulty foot mechanics like having an elevated metatarsal bone, fallen arches, or how you walk—especially if you overpronate—can lead to the condition developing.
Inflammatory diseases like rheumatoid arthritis, gout, or osteoarthritis can increase your risk of developing hallux rigidus.
In some cases, it’s possible that it runs in your family and that you inherited a foot type that’s prone to developing the condition.
Hallux Valgus Causes
Bunions are most commonly caused by pressure placed on the forefoot, often by tight or narrow-fitting shoes. This pressure on the big toe joint forces it to bend towards your second toe.
There are a few other factors that can contribute to developing bunions.
These include the shape of your feet—especially flat feet—if you have an abnormal bone structure, very flexible ligaments, or the way you walk—overpronate—can cause you to develop a bunion.
Inflammatory diseases like gout, osteoarthritis, or rheumatoid arthritis can increase your risk of developing the condition.
If there’s a family history of bunions, this can be passed on, making it more likely for you to develop bunions.
What Are Treatments?
Hallux Rigidus Treatments
Hallux rigidus won’t go away by itself. Fortunately, treating hallux rigidus in the early stages may help postpone or even prevent surgery.
To start easing hallux rigidus pain, change your footwear and start wearing shoes with a wide toe box. This will reduce the amount of pressure placed on your forefoot.
The shoes should also have a rocker bottom sole, as this will allow smooth transitions from your heel-to-toe, without having to bend your toe.
The sole of the shoe should also be stiffer, as this will help limit the movement of your big toe joint while you go about your daily activities.
Avoid any activities that will aggravate your toe joint or place it under stress, such as running or jumping.
Rest your affected foot as much as possible throughout the day. Apply cold and heat treatments several times throughout the day.
You can do this by either applying ice to the affected foot or taking a contrast bath. You’ll want to place your feet in warm water for 30 seconds and then straight into ice-cold water for 30 seconds.
Continue to alternate between the cold and heat treatment for 5 minutes. This will help to alleviate pain and reduce swelling.
Your doctor may also recommend physical therapy to help improve flexibility and range of motion in your big toe.
These exercises will help relieve the amount of stress placed on the surrounding soft tissue and joints around the big toe, which will help provide you with temporary relief from the symptoms.
To help manage the pain and reduce inflammation, you can use anti-inflammatory medications.
In cases where the hallux rigidus is severe, your doctor may recommend cortisone injections or surgery to alleviate pain and reduce inflammation.
Hallux Valgus Treatments
Like hallux rigidus, bunions won’t go away by themselves. But you can slow the progression down and prevent the bunion from growing with some lifestyle changes.
The first step would be to start wearing footwear for bunions with a big and deep toe box.
Shoes with a wide toe box not only will this give you plenty of wiggle room, but it will prevent your toe from rubbing against the upper. This will prevent calluses and corns from developing on the top or the soles of your feet.
You can also use over-the-counter bunion pads to add an extra layer of cushioning and protection around the bunion.
This will also help reduce the amount of pressure placed on the bunion without constricting the big toe and alleviating pain.
You can also tape your big toe with medical tape to help keep the toe joint in its correct alignment.
Ensure that the shoes you wear provide adequate support for your foot shape, especially arch support. This will help distribute your body weight evenly and reduce the load placed on your big toe joint.
Your doctor may recommend physical therapy so that your toe joint remains flexible and provides temporary relief.
Apply ice to the bunion several times throughout the day for 20 minutes, as this will help reduce the inflammation and alleviate pain.
You can also use over-the-counter medications like acetaminophen or iBuprofen to alleviate pain and reduce swelling.
If you’re experiencing severe pain, your doctor may recommend a cortisone injection to help manage the pain.
If your bunion is interfering with everyday activities like walking, even if you’re wearing flat, comfortable shoes with a wide toe box, then your doctor may recommend bunion surgery.
Hallux Rigidus Prevention
Fortunately, you can take steps to prevent hallux rigidus from developing.
The first step would be to wear shoes that fit and support your feet while allowing your toes to splay naturally.
Rest your feet frequently to prevent an overuse injury of the joint. This may mean that you have to avoid or limit certain activities, like high-impact sports, that could aggravate the joint.
Incorporate foot strengthening exercises into your daily routine. This will help strengthen the foot muscles, correct muscle imbalances, and help keep your toe in its proper alignment.
Use supportive orthotic inserts or insoles in your shoes, as they can help to keep your foot in its natural alignment, reduce the amount of pressure that’s placed on the joint, and provide an extra layer of protection from shock.
Hallux Valgus Prevention
Hallux valgus develops gradually over time, but you can prevent a bunion from developing by taking care of your feet.
Similarly to preventing hallux rigidus, the footwear you choose can prevent a bunion from developing.
Wear shoes that have a wide, spacious toe box that allow your toes to splay naturally. This will prevent excessive pressure being placed on the forefoot that can force your big toe joint out of alignment.
Look for shoes with excellent arch support and a heel less than 1 to 2 inches high. This will help prevent your foot from sliding forward in the shoe, placing pressure on your big toe joint.
Avoid wearing high-heeled, narrow, or pointy shoes that will put pressure on your big toe joint.
You can also use over-the-counter orthotics in your shoes, as these will help distribute your weight more evenly on your foot and keep your foot correctly aligned.
In addition, there are specific toe spacers you can buy that will gently stretch your toes, keeping your big toe in its correct alignment.
Rest and massage your feet regularly throughout the day. If your feet feel tired and achy at the end of the day, then soak them in warm water with Epsom salt for 10 to 20 minutes. Then prop them up, gently massage them and let your feet rest.
Incorporate strength and stretching exercises for your toes and feet into your daily routine.
This will help with your foot mobility, maintain your toes flexibility, and strengthen the muscles that control your big toe.