Hallux Rigidus
NHS Tayside RefGuide
Warning
Who to refer
- Pain should be primary indication for referral - either due to pressure effects of the dorsal osteophytes or degenerate joint
- If patient wishes to be considered for surgery
- Surgical joint replacement/fusion may be necessary if conservative management is unsuccessful. Info on surgery
- Note that post op: unable to drive for 6 weeks, and will be off work 2 weeks for sedentary job.
Who not to refer
Pain controlled, do not wish surgery.
How to refer
SCI Gateway/Orthopaedics/Foot and Ankle Service.Referrals will be vetted by AHP and directed to most appropriate healthcare professional.
Information to include when referring
- Duration and any cause of symptoms
- Indicate site/spread of pain and if pain constant or intermittent, and/or waking at night
- Indicate ROM/functional limitation
- Include treatment to date (injections/ physiotherapy/podiatry/orthotics)
- XR results.
General information
Degenerative osteoarthritis of 1st MTP joint.
Symptoms and signs
- Swelling caused by dorsal exostosis/ osteophytes
- Local tenderness and pain during and following activities
- Restriction of movement in great toe
- Transfer metatarsalgia due to a stiff 1st MTP Joint.
Primary Care management
- Provide with NHS Tayside patient information leaflet to support self-management
- Footwear advice: wear shoe with rigid sole, wide toe, avoid high heels.
- Weight loss if appropriate.
- Analgesia & NSAIDs as appropriate.
- Rest feet (elevate) after periods of walking / standing
- If deciding to refer please request XR foot standing AP and oblique.