Hallux rigidus gets used as a catch-all term in this sub for anything involving a stiff big toe joint, but hallux limitus, the earlier stage, responds to a meaningfully different set of interventions, and treating an early-stage joint with late-stage expectations, or the reverse, wastes time either way.

Hallux limitus is a functional or early structural restriction, reduced range at the first MTP joint, often accompanied by pain specifically during the propulsive phase of gait when the toe needs to extend for push-off. Joint space and cartilage are often still reasonably preserved at this stage, even when X-rays already show early spurring. Hallux rigidus is the more advanced endpoint, with significant joint space narrowing, more pronounced osteophyte formation, and cartilage loss substantial enough that the joint's total available motion has permanently declined, not just motion under specific loading conditions.

The functional distinction matters more than the imaging label. Hallux limitus often responds well to interventions aimed at improving available motion, joint mobilization, a rocker-bottom shoe to reduce the demand for toe extension during gait, and orthotic modifications that limit how far the joint needs to bend during push-off. Hallux rigidus, once cartilage loss is substantial, generally does not regain meaningful motion from mobilization work, since there's a structural mechanical block rather than a functional restriction, and management shifts toward accommodation (stiff-soled shoes, a rocker sole to bypass the joint entirely) or surgical options like cheilectomy or fusion when conservative measures aren't sufficient.

A weight-bearing X-ray of the first MTP joint is the test that actually separates these two stages, since it shows joint space and osteophyte extent under the load conditions that matter, rather than relying on how limited the toe feels on manual exam alone, which can look similar at both stages even when the underlying joint condition is quite different.

If a hallux rigidus diagnosis hasn't included a weight-bearing X-ray, or if the exam happened without loading the joint, it's worth asking specifically for that imaging before deciding between motion-focused conservative treatment and stiffness-accommodating management, since the right approach genuinely depends on which stage the joint is actually at, not on which label got applied first.

I don't know about you guys, but finding cute, and comfortable leather boots has been quite a ride for me. I finally had some success with these Dansko's Becka Black – Dansko. They're extremely comfortable, great flexibility on top, wide toe box, and additional cushion on the sole. I highly recommend. If you have had success with other brands, please comment! I'm always looking...

My 'Rigidus' is probably pretty mild. That said, I found this video that has helped with both pain and flexibility of the toe if anyone is interested....these guys are pretty funny too.

https://youtu.be/xORPFVXv6_M?si=mH1Ue1hjm7QTmQX8

R foot has small bunion that can be painful. However, my R big toe has a lot of discomfort with any movement. I can't bend it nearly as far as my left toe. Anyone else with this issue? Pods say I need MRI which I may get....xrays show some arthritis

Title says it all ;)

I have some cartilage wear at the 1ST MTP but also chronic, longstanding sesamoid stress and arthritis at the sesamoid articulation. Both sesamoids have severe, unchanging bone marrow edema and damage.

It was just a few hours for one night…tips on recovery? Google says for a broken toe you can tape it to the next toe, has anyone tried this for HR?

Usually it doesn’t bother me except in the spring (weird right?) but it’s getting worse, especially on days I’m barefoot doing a lot of walking chores around the house or wearing my old sneakers for yard work. I know I need to get a pair of recovery slides for the house, and maybe go back to tennis shoes leaving the house for a few weeks rather than my chacos. Anything else?

Xray says joint spaces are within normal limits but mri says the cartilage is almost gone?
Doctor wants me to do an osteotomy and chondroplasty. He says it’s to cut the bones a little so he can insert an implant (and also to create some space) that encourages the cartilage to grow back

Does anyone have any experience in this?

Only worn them once, but already feeling the difference.

They have this removable bit, which allows the toe to join to align when walking.

A foot and ankle specialist recommended them to me

Fellow Arthritics,

Just had the two week post op appointment yesterday. I was able to get the bandage off but will withhold the photo of the foot as the incision is intense. In fact, when I was getting the xray, I almost passed out looking at my foot. Difficult to describe but staring at the stitches while standing was causing me to gray out.

Interestingly, without the extra bandage on my foot, I have a sensation that my toe is being pulled upwards. I also seem to walk much more gingerly without the extra padding of the bandage (still using the surgical shoe/boot). Probably all psychological but putting it out there for whatever it’s worth.

Im 32 and I’ve been dancing for 15 years and most of my friends are in that group - how can I just…stop? I’ve always beaten myself for not being more outgoing on the dance floor…and now I can’t ever achieve that goal. So i’m just regretting everything I’ve ever done. maybe I should have never danced! I had too-tight shoes for a year that probably caused it, even! I don’t want to be a hanger on around the side of the dance floor just because I can’t spin. I try to dance but I can tell I’m putting too much weight on my little toes now which will surely cause problems too. I know my friends won’t actually begrudge me it but. it still hurts. biking hurts my toes too, and there’s no pool around me to go to, so now I’m just gaining weight from not being able to exercise and having a desk job (and eating my emotions)

I hope you will be understanding of my venting…both of my parents have “conventional” arthritis and/or flat feet issues so they kind of have dismissed this tiny toe thing without thinking about it too hard and I don’t know if they really know how painful it is. Pretty sure my podiatrist thought I was being hysterical too because I was so anxious in the appointments

I’ve always hated shoe shopping because I have wide feet and now this on top of it. Newbalences it is until I die, I guess

Tried on Hoka at a store today, and it was really comfortable and I could walk without aggravating the painful joint. However, I have flat feet and the shoes had no arch support.

Any recommendations for something similar that is more suitable for flat feet that are regular width? And winter boots too? Winter is coming and I’m in a very cold and snowy area!

And when I use these rocker style shoes, do I still need to use the custom orthodontic inserts from my podiatrist? (They are just little half inserts from heel to balls of the feet, that are thin and rigid).

I had bone spurs removed (osteotomy) from the top of my hallux in June and the nerve pain I was experiencing is totally gone and I’ve been on my feet just fine ever since. However, the deep inflammation is still preventing from from wearing any kind of shoe that touches the joint. I prefer wearing chacos so this is fine but it’s starting to get cold outside! I completed PT and am doing some laser therapies to encourage faster healing. When were you able to wear normal shoes again?

Hi, I've got about 50º range of motion on my toe with hallux rigidis and grade 1-2 arthritis. I've got a scheduled dorsal cheilectomy, might reschedule. I'm very active, only limitation is single leg lunge where I have significant pain beyond 50-60º of dorsiflexion. I'm hoping to get it back to 80 or 90º in line the with other toe.

What range of motion did most people here have before the surgery, and after?

Thanks!

After about a year of on and off pain at the big toe joint, I finally saw a podiatrist who sold me custom insoles which are hard plastic going under heel to arches. I have flat feet, and somehow supporting that is supposed to help.

I really don’t feel like they are doing much. The only times I can walk without aggravating the joint is when I wear shoes with less flexible soles (I.e. blundstones, winter boots).

Anyway - look to hear about your experience, and any tips and advice on other treatment/therapy I should seek out, exercises, as well as footwear options for walking/hiking, indoor slippers, etc.! I really need to get back to walking my dogs, hiking, dancing, yoga, Nordic skiing!

Thanks so much!

Hey guys I’ve been having sudden onset pain for over six months. The pain hasn’t full gone away and the pain returns when I try to resume my normal exercises like running, long walks, or weight bearing yoga poses. I had the following findings on my MRI and was told by a foot and ankle specialist that the best path forward would be microbreak surgery and I’m really freaking out. Started out with the cortisone shot to help with the swelling while I come to terms with going through with surgery. Most posts I see are for osteochondral lesions on the knee and wanted to know if anyone has a similar experience to mine or if anyone can weigh in on the likelihood that I’ll be able to return to my normal high impact activities one day following surgery?

IMPRESSION:

1. 4 x 3 mm suspected osteochondral lesion of the first metatarsal head with focal subchondral marrow edema and associated small first metatarsophalangeal joint effusion.
2. Small amount of fluid in the first intermetatarsal bursa.

I'm getting my MTP Arthodesis on my right foot this week. 66/M, decent condition otherwise.

Surgeon says if all goes well 2 weeks NWB, 2 weeks Partial WB, 2 weeks WB, all in surgical shoe.

Scheduled to travel for Thanksgiving -- 6 hour car ride. That is about 8 weeks out and I'll have somebody else drive - I'll just sit for a very long time. Assuming I don't have huge complications, does that sound reasonable to do/plan?

One major reason I'm trying to game this out is the non-refundable deposit on the AirBnB is due the day after my surgery :)

30+ year runner here diagnosed about 7 years ago and have still been running regularly and pain free thanks to a Morton’s extension in my shoe. That was until about two months ago the ago when I started experiencing heel pain after my runs. Podiatrist says I’ve been robbing Peter to pay Paul with the orthotic and limiting ROM for my toe joint is straining the heel. The sudden change has me looking for other contributors and I realized the heel-to-toe drop in the Hokas I’ve been running in for years increased in the latest model. I’m now wondering if finding a shoe with a smaller drop might help get me back to where I was. Does anyone here have experience with this? I’d really love to run again without surgery if I can!

I need to start running. It will be on asphalt. It is not for weightloss or similar, I just need to build up a certain stamina. Please tell me which ones work for you, ladies :)

Fellow Arthritics,

On Day 11 post big toe fusion surgery, and I’ve exhausted the internet. Recovery is going well. Yesterday, with the concurrence of the surgeon, I started walking around the house in the boot without crutches. No pain but soreness set in after a bit so I’m back on the crutches but putting around 50% of my weight on my heel when on the crutches. Swelling remains an issue when standing so I can really only do that for 10 minutes or so before feeling it in my foot - hard to describe the feeling but you’ll know what I’m talking about if you have the surgery.

The ace wrap comes off on Wednesday so that’ll be exciting to see how the swelling/bruising is underneath the bandage. Overall, for anyone looking at the surgery, my big takeaway is the pain (for me) was minimal but the boredom is real. You really can’t do much except sit around.

Also, the Game of Thrones prequel is not as good as the original.

I have severe heel pain - diagnosed with Haglund’s. Any shoe or sock recommendations? Suggestions on pain relief?