Big toe arthritis (hallux rigidus) is one of the most common forms of foot arthritis. It causes pain and progressive stiffness at the base of the big toe, affecting every step you take.
Reviewed byProf Paul Lee MBBch, FRCS (Tr & Orth), PhDLast reviewed 1 May 2026
The first MTP joint bears up to 60% of body weight during the push-off phase of walking. When cartilage wears and bone spurs form, this essential movement becomes painful.
The goal is to maintain the joint for as long as possible. Every month of preserved movement is a month of normal walking mechanics.
You may have more options than you think
At London Cartilage Clinic we follow a structured clinical framework across four areas of treatment. Before recommending a single procedure, we assess which combination of approaches gives you the best outcome.
Protect what you have. Slow degeneration and manage symptoms.
Fix specific damage. Torn tissue, unstable joints, structural problems.
Rebuild lost tissue. Biological treatments that stimulate new growth.
When other options are exhausted. Joint replacement as a last resort.
Explore the full range of treatments available for your joint. Each hub page shows every option we offer, organised by clinical approach.
Hallux rigidus is arthritis of the first metatarsophalangeal (MTP) joint at the base of the big toe. It causes the joint to stiffen and lose its normal range of motion, making push-off during walking painful and difficult.
The big toe joint is critical for the toe-off phase of gait. When it stiffens, the foot compensates by altering walking mechanics, which can lead to pain in other parts of the foot, knee, or lower back.
Options include stiff-soled footwear or carbon fibre insoles to reduce joint stress, steroid or hyaluronic acid injections, PRP, mFat therapy, and physiotherapy. These can provide meaningful relief and delay the need for surgery.
Surgery is considered when pain and stiffness significantly limit walking despite non-surgical treatment. Options include cheilectomy (removing bone spurs to improve movement) and fusion (arthrodesis) for advanced cases. Your specialist will discuss which approach suits your stage of arthritis.
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