Four Ways to Beat Big Toe Arthritis

Hallux Limitus SymptomsIf your big toe is achy or stiff, swelling, or spurring, you might be suffering from Big Toe Arthritis – a condition that can keep even the sprightliest souls in the old rocker.

Also known as “hallux rigidus,” big toe arthritis is one of the most common forms of arthritis in the foot. Why? Well, arthritis occurs when the cartilage between the two bones of a joint wears down so that the bones are scraping together. Because you bend your big toe every time you take a step, the cartilage here can wear thin as early as age 30 from overuse, or even earlier if you’ve sustained an injury.

If you do have big toe arthritis, you have several options for treatment available to you. Here are four of the most commonly prescribed methods.|

ONE: Conservative, Nonsurgical Solutions

Your foot and ankle specialist wants you to avoid going under the knife if at all possible. If you catch your big toe arthritis in its early stages, you may do best to treat the symptoms conservatively. Fortunately, there are lots of things you can do, both at home and with the help of your doctor!

  • Change your daily work and exercise activities
  • Trade in your old shoes for stiff-soled footwear
  • Get fitted for a custom orthotic
  • Nonsteroidal anti-inflammatory medication
  • Cortisone injections.

If conservative treatments don’t work for you, don’t worry! There are many other options that your foot and ankle specialist can explore with you.

TWO: Cheilectomy

It sounds like a procedure to cut some guy named Kyle out of your life, but a cheilectomy is one of the least invasive surgeries to treat big toe arthritis. And, bonus! It has the shortest recovery time!

It’s a very simple procedure wherein the surgeon cleans the big toe joint, ridding it of scar tissue and bone spurs, alleviating the stiffness and pain. It works best in the early stages of the disease, when most of the cartilage is still intact. After only a few short weeks, you should be able to wear your normal shoes again. The healing process is even faster with the help of physical therapy.

THREE: Osteotomy Cheilectomy

This procedure is a cheilectomy plus. Along with cleaning the joint, the surgeon will make a small cut in the first metatarsal (that’s the bone in your foot that leads to your big toe). The cut relieves pressure on the big toe joint, easing the pain and stiffness. It’ll take a little longer to heal, but most patients return to their normal activities in about two months.

FOUR: Fusion and Joint Replacement (aka Arthrodesis and Arthroplasty)

If your foot and ankle specialist recommends number three, your big toe arthritis must be a doozy, as these procedures are only for the most severe cases! The cartilage in your big toe has gone through some major trauma or over-wearing.

Here’s the gist of arthrodesis. You know that old joke?
“Doc, it hurts when I move it like this.”
“Then don’t move it like that!”

That is essentially what happens in an arthrodesis. It hurts to move your joint, so the doctor surgically immobilizes the bones around the painful joint so that they can no longer move freely. This might sound extreme, but we’re talking about your big toe here. The recovery period is rather long, and you may not bear weight on your joint for some time. The good news is, your big toe will never bother you again.

The surgeon might also decide to perform an arthroplasty, replacing the old joint with an artificial one. The implant will allow you to retain motion in the big toe joint. The recovery period for an arthroplasty is actually fairly short, and you may be able to put weight on the foot soon after the procedure. The downside? The implant might need replacement down the road.

If you would like more information on big toe arthritis,  please call us at (877) 989-9110 or visit us at

The UFAI Education Team

The UFAI Education Team

For almost fifteen years, University Foot and Ankle Institute and their nationally recognized physicians have been providing the most technologically advanced medical care for the foot and ankle with the highest success rates in the country.

As a teaching institution, University Foot and Ankle Institute’s Fellowship Program is among the most advanced in the nation.

We at UFAI are driven to get our patients back to their normal activities with the highest level of function, in the least amount of time, using the least invasive treatments possible. From start to finish, we are with you every step of the way.

The UFAI Education Team works to help empower our patients and website visitors with the most up-to-date information about foot and ankle conditions, treatment options, recovery and injury prevention. Our goal is to pass on truly useful information to our readers.

We hope you enjoy our work and find it of value. Please let us know!
The UFAI Education Team


  1. I didn’t realize there were so many surgical options to help treat big toe arthritis. If you get a cheilectomy will that stop the problem from getting worse? Is there still a chance that you would need arthrodesis or arthroplasty later in life? I’m trying to decide which treatment would be best for me and have the longest lasting results. Thanks for explaining these different procedures!

    • Thank you for visiting and asking your questions, we appreciate it.

      A cheilectomy does not mean there is no possibility for future problems. We at UFAI only do cheilectomy in very early cases. There is a new implant called Cartiva that has great potential. I hope this helps.

      Dr Bob Baravarian
      Assistant Clinical Professor
      UCLA School of Medicine
      Director and Fellowship Director
      University Foot and Ankle Institute

  2. I might require MTP fusion in the future. Can you describe the long term prognosis for someone who gets MTP fusion? Activity limitations? Any downsides?

    • Jeremy,

      Thank you for your excellent question. There are minimal long term issues with the procedure. A 1st MTP fusion is an excellent procedure that reduces pain and allows full activity.

      There are minimal activity limitations except for the height of heels that can be worn. They are usually limited to 2 inches or so but this can be compensated for somewhat by using a platform or wedge. Also getting into a traditional ski boot can be a problem so you will need to use a rear entry system because the angle of a regular ski boot entry can be hard once you have this procedure.

      Overall, there is minimal downside as the joint is usually very arthritic already. I hope this helps.

      Dr Bob Baravarian
      Assistant Clinical Professor
      UCLA School of Medicine
      Director and Fellowship Director
      University Foot and Ankle Institute

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