Hallux rigidus is osteoarthritis of the joint at the base of the big toe. The joint becomes stiff and painful, particularly when the toe bends upwards as you push off in walking, and a bony ridge often forms on top. It is the most common site of arthritis in the foot. Stiff-soled or rocker-soled footwear and insoles help many people, and surgery is an option when pain remains severe.
Also known as hallux limitus, big toe osteoarthritis, stiff big toe
Anatomy: where the problem is
Top view of the foot. Highlighted in the diagram: big toe joint.
Symptoms
- Pain in the big toe joint when walking, especially as you push off
- Stiffness and loss of upward bend in the big toe
- A bony bump on top of the joint that can rub in shoes
- Swelling around the joint
- Pain in the outer side of the foot from walking on it to avoid the toe
- Difficulty with heels, squatting, running or going up on tiptoe
Causes and risk factors
- Wear of the joint with age
- A previous injury, such as a stubbed toe or a sprain of the big toe joint
- The shape or length of the bones in the foot
- A family history of the condition
- Gout or inflammatory arthritis in some people
What the evidence says helps
- NICE recommends exercise, clear information and, where relevant, weight management as core treatments for osteoarthritis in any joint.2
- In a randomised trial, shoe-stiffening insoles and rocker-soled shoes were similarly effective at reducing pain from big toe arthritis. People found the insoles easier to keep using.3
- A steroid injection can be considered for short-term relief of a flare.2
- A Cochrane review found too few good trials to judge most conservative treatments for this joint, so choices are guided by what eases the load on the toe.4
- Surgery is considered when pain persists. Removing the bony ridge suits milder arthritis, and fusing the joint is the most reliable option for severe arthritis.5
Things you can try at home
- Choose shoes with a stiff sole or a rocker sole, and plenty of depth and width at the toes
- Avoid high heels and very flexible, thin-soled shoes
- Try a stiff insole that limits bending under the big toe
- Use ice after activity if the joint is swollen
- Keep active with lower-impact exercise such as cycling or swimming during flares
- Ask a pharmacist about anti-inflammatory gel
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A foot or ankle that is badly swollen, looks deformed or cannot take weight after an injury: go to A&E or a minor injuries unit
- A hot, red, swollen foot or joint with a fever or feeling unwell: get same-day medical help
- Any foot wound, sore or infection if you have diabetes or poor circulation: contact your GP or foot protection service urgently
- A foot that suddenly becomes cold, pale or numb: call 999
- Sudden, severe pain with redness and swelling in the big toe joint, especially at night: see your GP, as this can be gout
How Apollo can help
Our podiatrist assesses the joint, your foot posture and the way you walk, and looks at your footwear. Treatment usually centres on reducing the bending load on the toe with footwear advice, padding and insoles, and we can make custom orthoses from pressure analysis where they are likely to help. Gentle joint mobilisation and exercises for the foot and calf can help maintain movement. If the joint is not settling, we write to your GP about an injection or a surgical opinion.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Is hallux rigidus the same as a bunion?
No. A bunion is a sideways drift of the big toe with a bump on the inner side of the foot. Hallux rigidus is arthritis of the joint, with stiffness and a bump on top. They can occur together.
What are the best shoes for big toe arthritis?
Shoes with a stiff or curved rocker sole reduce how much the toe has to bend, and a deep, wide toe box avoids pressure on the bony bump. Avoid high heels and very flexible soles.
Will I need surgery for hallux rigidus?
Many people manage with footwear changes and insoles. Surgery is considered when pain continues to limit walking. The options range from removing the bony ridge to fusing the joint, depending on how advanced the arthritis is.
References
- Roddy E, et al. (2015). The population prevalence of symptomatic radiographic foot osteoarthritis in community-dwelling older adults: cross-sectional findings from the Clinical Assessment Study of the Foot. Annals of the Rheumatic Diseases 74:156-163. View source
- National Institute for Health and Care Excellence (2022). Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226. View source
- Menz HB, Auhl M, Tan JM, Levinger P, Roddy E, Munteanu SE (2016). Effectiveness of Foot Orthoses Versus Rocker‐Sole Footwear for First Metatarsophalangeal Joint Osteoarthritis: Randomized Trial. Arthritis Care & Research 68:581-589. View source
- Zammit GV, Menz HB, Munteanu SE, Landorf KB, Gilheany MF (2010). Interventions for treating osteoarthritis of the big toe joint. Cochrane Database of Systematic Reviews. View source
- Lam A, Chan JJ, Surace MF, Vulcano E (2017). Hallux rigidus: How do I approach it?. World Journal of Orthopedics 8:364. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
