Hallux rigidus (great toe arthritis)
Although most bunions are caused by malalignment of the first metatarsal bone, they can also be caused by arthritis of the first metatarsophalangeal joint (hallux rigidus). This is a “wear and tear” process in which there is pain and swelling at the base of the great toe. Initially the pain may just be felt at the extremes of movement, but as the joint gradually wears out it becomes more constant and the joint stiffens up. Bone spurs (osteophytes) form around the joint and can create pressure on shoes.
There are several possible treatment strategies for hallux rigidus and which is best depends on the individual and extent of the arthritis. Options include footwear modification, orthotics (insoles), steroid injection, surgery to remove the bone spurs but preserve the joint, or surgery to fuse the joint.