Functional hallux limitus

If you are having problems with the movement of your big toe or experiencing pain between the large toe and foot, you could be dealing with a case of functional hallux limitus, which is often referred to as “stiff toe.”

Clinically, the condition affects motion at the first metatarsophalangeal joint and may lead to abnormal forefoot plantar pressures, pain, and difficulty with walking, or running, or basic mobility.

While pain in the toe may not seem too serious, for anyone feeling sharp pain, experiencing bone growths or seeing tightness in their joints that is impacting the way they walk, it’s important to have the foot examined by a healthcare professional as soon as possible.

Paul Betschart, DPM, has been helping people suffering from functional hallux limitus for years. He notes that most often, people complain of stiffness in the big toe and difficulty walking or playing sports.

Left untreated, it can lead to complete arthritis of the toe joint and restriction of motion; early treatment can prevent disability and keep a person moving.

Dr. Betschart recommends a custom-made foot orthotic, which would be designed to limit first metatarsophalangeal joint motion while providing cushioning and plantar pressure distribution, and improve the mechanical function of the big toe joint.

Other modalities that could help are cortisone injections, a laser treatment or physical therapy to remobilize the joint. In Dr. Betschart’s experience, long-term control with the custom orthotic device is going to most helpful.

Most often, hallux limitus impacts athletes as they are putting the most demand on their big toe joints. But it also effects women who like to wear high-heel shoes. And many people will get it as it does occur more often in aging.

“It tends to creep up on people and they tend to not come in for care until their joint is pretty damaged,” he says. “A lot of MDs don’t believe in orthotics and are just going to put the patient in a stiff-sole shoe and tell them to change their activity level and not try to fix the mechanical issues that are causing the damage in the first place.”

If caught in the early stages, Dr. Betschart says in an orthotic, it usually only takes a couple of weeks to be pain-free and as long as patients continue to wear the orthotic, it will keep things in check for life.