Hallux rigidus symptoms

introduction

As Hallux rigidus is called arthrosis of the metatarsophalangeal joint of the big toe. Literally translated means Hallux rigidus as much as "stiff big toe".

The symptom that the Hallux rigidus The focus is on pain. These are mostly permanent, but they become stronger when the joint is subjected to stress, i.e. ultimately with all movements. In addition, the joint is often swollen and / or reddened, which is triggered on the one hand by bony extensions and on the other hand by a subsequent inflammatory reaction. The swelling restricts mobility even further.
Those affected often feel the symptom of insufficient space in their shoes.

Because movements are often avoided as a consequence and the ossification narrows the joint space, the joint becomes more and more rigid over time and walking, especially rolling the foot, becomes more and more difficult. In many cases the Hallux Rigidus In addition, there are consequential complaints that can be traced back to incorrect loading of other joints, whereby the painful big toe joint should be relieved. Often this happens completely unconsciously.

For example, the metatarsophalangeal joint of the other 4 toes is exposed to increasing stress and the outer edge of the foot is overstrained, as patients tend to roll the foot over the outer edge due to the stiffness of the big toe. The resulting pain is often diffuse and difficult to localize. The knee or hip joint can also be affected by poor posture.

Hallux rigidus pain

Big toe joint pain is one of the most important symptoms of one Hallux rigidus.
The joint partners of the metatarsophalangeal joint as a real joint are covered with hyaline cartilage, which is part of the arthritic changes in Hallux rigidus is increasingly destroyed.

The articular cartilage performs important tasks by leveling the surface of the joint, thus preventing the build-up of excessive friction.
In addition, it absorbs pressure forces thanks to its elastic properties. A regeneration of the hyaline cartilage is not possible because cartilage belongs to the so-called bradytrophen (characterized by slow metabolism) Tissue matters. The breakdown of the cartilage mass increases the pressure in the underlying bone, resulting in tiny fractures.
Sometimes the rubbing of cartilage and bone tissue together is called crunching (Crepitation) audible.
Tiny pieces of bone or cartilage can become detached and get into the joint space, where they block it.

These degenerative changes result in a lack of resilience and lead to chronic inflammation, which causes great pain, especially when moving. The so-called start-up pain is characteristic of osteoarthritis pain, whereby the pain occurs more intensely when moving after a previous period of rest.
At the Hallux rigidus pain typically occurs after long periods of running, i.e. heavy stress on the joint. In advanced stages it also occurs at rest (i.e. independent of load) to pain, such as at night.
Many sufferers also describe their symptoms as weather-dependent.

The pain in the joint can mainly be caused by moving the big toe to the tip of the nose (Dorsiflexion) are provoked. Due to the inflammatory processes taking place, the area above the metatarsophalangeal joint of the big toe becomes painful on pressure and can swell. As a result, mobility is severely restricted.
Since touching the ball of the foot is perceived as particularly painful (please refer: Pain in the ball of the foot), there is a change in the rolling process of the foot when walking. The incorrect loads can in turn cause new pain and damage other joints.

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Redness / swelling

In so-called activated osteoarthritis there is an inflammatory reaction in the joint due to the arthrotic changes.
This inflammation manifests itself in the Hallux rigidus especially through redness, swelling and overheating over the affected joint.

This often results in a more or less pronounced restriction of movement, depending on the stage, and it also often leads to tenderness.
Redness (Rubor), Swelling (tumor), Overheat (Calor), Pain (Dolor) and functional / movement restrictions (Functio laesa) are considered cardinal symptoms of inflammation in medicine.
Signs of inflammation are characteristic of advanced stages of osteoarthritis and are less common in the early stages.

Activated osteoarthritis as a primarily degenerative disease with secondary inflammation must be distinguished from arthritis, a primarily inflammatory joint disease.

Restriction of movement

Due to the described signs of wear and tear and the subsequent inflammation in the joint, there is a painful restriction of movement in the metatarsophalangeal joint of the big toe.
In the metatarsophalangeal joint of the big toe, apart from a minimal splay (Abduction) especially a stretching (Dorsiflexion) and diffraction (Plantar flexion) possible.

At the Hallux rigidus especially the dorsiflexion is clearly restricted. Important stages of hallux rigidus are based on the degree of restricted movement of the diseased joint compared to the opposite side.
Due to the pain, movements in the affected joint are avoided, and the ossification narrows the joint space, so that the joint becomes increasingly stiff.

Classification

At the Hallux rigidus As with any type of osteoarthritis, 4 different stages can be distinguished.
One speaks of osteoarthritis grade 1 if the movement restriction of the affected joint is at most 50% compared to the other foot and the pain is not constant and only dependent on the load.
Grade 2 osteoarthritis is characterized by a movement restriction of 50 to 75%, the pain is more pronounced, and in some cases there is already a feeling of stiffness in the joint.
Arthrosis grade 3 describes a movement restriction of 75 to 100%. In particular, moving the joint upwards can usually no longer be carried out. Pain persists here and may worsen under stress.
Grade 4 osteoarthritis is only differentiated from grade 3 in that the x-ray no longer shows a joint gap at all, whereas grade 3 is only severely narrowed.

One is allowed to Hallux rigidus not to be confused with hallux valgus, which also leads to pain in the metatarsophalangeal joint of the big toe, but has other causes.