Hallux Rigidus

Foot Facts

  • Each foot has 26 bones
  • There are more than 100 ligaments in each foot
  • Diabetes is the #1 cause for lower extremety amputation
  • A toenail takes 4-9 months to completely grow out
  • Pain in the feet is NOT normal

Surgery: YES OR NO????

  • Deciding whether or not to have surgery is a big decision. 
  • Our foot and ankle surgeons are skilled in both surgical and conservative options. 
  • We will present the options most suitable for you and help you with your decision.

How much pain should I be in before I make an appointment?

  • Foot pain is not normal.
  • Foot pain is a signal that something is not right.
  • Any degree of foot pain warrants an evaluation to determine the source of the pain and possible treatment options.
  • Most foot pain left untreated will get worse and become more difficult to cure.
  • If you have foot or ankle  pain, make an appointment, do not wait.

Will soaking cure my ingrown toenail?

  • Soaking an ingrown toenail will often make it feel better, but it will not cure it. 
  • The symptoms of an ingrown toenail include pain, redness, and swelling.
  • An ingrown toenail is easily cured with a simple in office surgical procedure. 
  • The toe is anesthetized so that pain is not felt during the procedure.
  • The ingrown nail, or portion of the nail, is removed.
  • Most people feel no pain afterwards and return to normal activities the next day. 

What are orthotics?

  • Custom made foot arch supports designed to hold the foot in its optimum position
  • Can alleviate the discomfort caused by a number of foot conditions such as heel pain, bunions, and flat feet. 

Happy Feet...Happy Bride

happyComfortable footwear can help make the perfect day even better. Many times foot or ankle discomfort can be alleviated with appropriate shoes. It is not unusual for people to buy shoes that are too small for their feet. If your foot problem has an easy solution, our podiatrists will gladly provide you with that information. Sometimes the right shoe is not enough and custom-made orthotics is necessary to help the feet maintain the best position. Our podiatrists can utilize a three dimensional digital scan to have custom made inserts (orthotics) fabricated for your shoes, made from the scan of your feet to correct your specific foot abnormality and fit your feet only. If your foot or ankle problem can be resolved with conservative treatment, our podiatrists will advise you of the best treatment for you. There are times when the best solution for a foot or ankle problem is surgery. If you require foot or ankle surgery, our podiatrists can provide you with the latest state of the art surgical techniques. They will take the time to explain to you what to expect before, during and after surgery and will try to answer all your questions. Whatever your foot or ankle problem may be, our podiatrists will explain the various treatment options available to you. Everyone is happier when their feet are happy!

Thoughts on Celebrating 30+ Years

anniversarySome thoughts from Dr. Jacoby:
On April 30, 1984 I took over this podiatry practice. Elgin became my professional home as well as my personal home. I am forever grateful to Dr. Roger Hess who started this practice 50 years prior. Dr. Hess was a gentleman whom I admired and emulated both professionally and personally. I am forever honored to continue caring for the patients who initially trusted Dr. Hess.

My first office was at 860 Summit on the East Side of Elgin. I remember painting the office myself. I moved twice into larger space at 860 Summit. Eventually we outgrew the space there and moved to larger space at the Sherman Hospital Medical Building and then finally here to 750 Fletcher. I am grateful to the multitude of patients we have had the privilege of treating and that have kept us growing. I am also grateful to the multitude of other physicians in the area whom I am so privileged to work with.

Not only has this practice grown in physical space, but we have grown technologically as we offer many state of the art alternatives.  My staff has been and continues to be essential.  To all my staff, both past and present, I say a most sincere Thank You.

I look back on the years with much pride and sentimentality. I look forward to the future with the same enthusiasm and joy I felt on April 30, 1984. I love what I do and every day I realize how blessed I am to be in this wonderful profession!

What Is Hallux Rigidus?
Rigidus1Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe.  ‘Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis.

 

This disorder can be very troubling and even disabling, since we use the big toe whenever we walk, stoop down, climb up, or even stand. Many patients confuse hallux rigidus with a bunion, which affects the same joint, but they are very different conditions requiring different treatment.

Because hallux rigidus is a progressive condition, the toe’s motion decreases as time goes on. In its earlier stage, when motion of the big toe is only somewhat limited, the condition is called “hallux limitus.” But as the problem advances, the toe’s range of motion gradually decreases until it potentially reaches the end stage of “rigidus,” in which the big toe becomes stiff, or what is sometimes called a “frozen joint.”

Causes
Rigidus2Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis – the kind that results from “wear and tear” – often develops in people who have defects that change the way their foot and big toe functions. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus.

In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse – especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases such as rheumatoid arthritis or gout. Your foot and ankle surgeon can determine the cause of your hallux rigidus and recommend the best treatment.

Symptoms
Early signs and symptoms include:

  • Rigidus3Pain and stiffness in the big toe during use (walking, standing, bending, etc.)
  • Pain and stiffness aggravated by cold, damp weather
  • Difficulty with certain activities (running, squatting)
  • Swelling and inflammation around the joint

As the disorder gets more serious, additional symptoms may develop, including:

  • Pain, even during rest
  • Difficulty wearing shoes because bone spurs (overgrowths) develop
  • Dull pain in the hip, knee, or lower back due to changes in the way you walk
  • Limping (in severe cases)

Diagnosis
The sooner this condition is diagnosed, the easier it is to treat. Therefore, the best time to see a foot and ankle surgeon is when you first notice symptoms. If you wait until bone spurs develop, your condition is likely to be more difficult to manage.

In diagnosing hallux rigidus, the surgeon will examine your feet and move the toe to determine its range of motion. X-rays help determine how much arthritis is present as well as to evaluate any bone spurs or other abnormalities that may have formed.

Non-Surgical Treatment
In many cases, early treatment may prevent or postpone the need for surgery in the future. Treatment for mild or moderate cases of hallux rigidus may include

  • Shoe modifications. Shoes with a large toe box put less pressure on your toe. Stiff or rocker-bottom soles may also be recommended.
  • Orthotic devices. Custom orthotic devices may improve foot function.
  • Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
  • Injection therapy. Injections of corticosteroids may reduce inflammation and pain.
  • Physical therapy. Ultrasound therapy or other physical therapy modalities may be undertaken to provide temporary relief.

When Is Surgery Needed?
In some cases, surgery is the only way to eliminate or reduce pain. There are several types of surgery for treatment of hallux rigidus. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.