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Hyaluronic Acid Injection for Big Toe Osteoarthritis (Hallux Rigidus)

Osteoarthritis of the big toe, also known as Hallux rigidus, is a condition that affects 1 in 40 people over the age of 50. This degenerative joint disease can cause pain, stiffness, and reduced mobility in the big toe, making everyday activities like walking and wearing shoes uncomfortable. If you're struggling with big toe arthritis, this blog is for you. We will explore one promising solution: Hyaluronic acid injections.


big toe osteoarthritis (Hallux Rigidus)

What is Hallux Rigidus and What are The Symptoms?

Hallux Rigidus (or big toe osteoarthritis) is a degenerative process impacting the joint at the base of the big toe, known as the metatarsophalangeal (MTP) joint. This condition can result in joint pain, restricted movement, and challenges in walking, running or standing. As the cartilage within the joint deteriorates, the bones may come into contact with each other, leading to pain and inflammation.


big toe osteoarthritis (Hallux Rigidus)

The Role of X-rays in Diagnosis of Hallux Rigidus

X-rays play a crucial role in diagnosing and assessing the severity of big toe arthritis. They help healthcare providers visualize:


  • Joint Space Narrowing: This indicates cartilage loss in the affected joint.

  • Bone Spurs (Osteophytes): X-rays can reveal the presence of bony outgrowths around the joint.

  • Joint Alignment: Any changes in the joint's alignment can be observed through X-rays.

  • Disease Progression: Comparing X-rays over time helps track the progression of osteoarthritis


xray of big toe osteoarthritis (Hallux Rigidus)

Available Treatments for Big Toe Osteoarthritis

Several treatment options are available for managing big toe osteoarthritis, including:

  • Over-the-counter pain medications (Paracetamol, Ibuprofen)

  • Orthotic devices and shoe modifications

  • Physical therapy and exercises

  • Injection therapy (Corticosteroids and Hyaluronic Acid)

  • Surgical interventions (in severe cases)



Hyaluronic Acid Injections for Big Toe Osteoarthritis

Hyaluronic acid (HA) is a naturally occurring substance in our joints, including the big toe, that acts as a lubricant and shock absorber. As we get older or develop osteoarthritis, the amount of HA in our joints decreases. Hyaluronic acid injections, also known as visco-supplementation, aim to replenish this vital substance in the affected joint.


hyaluronic acid needle syringe AI generated

How Does Hyaluronic Acid Work?

When injected into the big toe joint, hyaluronic acid serves several purposes:


  • Joint Lubrication: HA improves the joint's natural lubrication, reducing friction and pain during movement

  • Shock Absorption: It acts as a cushion, absorbing impact and protecting the joint from further damage.

  • Anti-inflammatory Effects: HA has been shown to reduce inflammation in the joint, providing relief from pain and swelling

  • Cartilage Protection: Some studies suggest that HA may help slow down cartilage degradation and promote its regeneration


ostenil mini hyaluronic acid

Benefits of Hyaluronic Acid Injections


Hyaluronic acid injections offer several advantages for patients with big toe arthritis:


  • Pain Relief: Many patients experience significant reduction in pain after HA injections

  • Improved Mobility: By reducing pain and inflammation, HA injections can help restore joint function and mobility.

  • Delayed Need for Surgery: In some cases, HA injections may help postpone or even avoid the need for surgical intervention

  • Long-lasting Effects: Unlike corticosteroid, the benefits of HA injections can last for several months, with some patients reporting relief for more than a year

  • Minimal Side Effects: Compared to corticosteroid injections, HA injections have fewer side effects and can be repeated more frequently


woman standing on toes

Ultrasound-Guided Hyaluronic Acid Injections

While X-rays are essential for diagnosis, ultrasound guidance is utilised during the injection procedure itself. Ultrasound-guided injections offer several advantages:


Enhanced Accuracy: Ultrasound enables your doctor to visualise the joint live, ensuring accurate placement of the needle and injection flow, which results in maximum effect and pain relief.

Reduced Risk of Complications: By avoiding nearby blood vessels and nerves, ultrasound guidance minimises the risk of injury.

Patient Comfort: The combination of ultrasound guidance and local anesthesia ensures the most precise, tolerable, and comfortable experience for hyaluronic acid injection into the big toe joint.



The Hyaluronic Acid Injection Procedure


If you're considering hyaluronic acid injections for your big toe arthritis, here's what you can expect during the procedure:


  • Assessment and Consent:

    A thorough medical history, examination, and imaging confirm diagnosis and treatment suitability. Consent is obtained after discussing risks, benefits, and alternatives.

  • Preparation: The injection site will be cleaned and sterilised.

  • Local Anesthesia: A small amount of local anesthetic may be applied to minimise discomfort.

  • Ultrasound Guidance: Your doctor will use ultrasound to locate the precise injection site.

  • Injection: The hyaluronic acid will be carefully injected into the joint space.

  • Bandaging: A small bandage will be applied to the injection site.


The entire consultation and procedure typically takes about 15-30 minutes in a one stop clinic setting


female comfortable foot calm

What to Expect After Big Toe Hyaluronic Acid Injection

After receiving a hyaluronic acid injection for big toe arthritis, you can expect:


  • Minimal Downtime: Patients can stand and walk straightaway, avoiding running or jumping activities for 2-3 weeks.

  • Gradual Improvement: Pain relief and improved mobility may be noticed over a period of 4-6 weeks.

  • Potential Side Effects: Some patients may experience mild swelling or discomfort at the injection site, which usually resolves quickly.

  • Follow-up Appointments: Your doctor may recommend a series of injections for optimal results.


Take the Next Step

If you're struggling with big toe arthritis and are interested in exploring hyaluronic acid injections as a treatment option for big toe osteoarthritis, it's time to take action. ACTIVATE Musculoskeletal Clinic specialises in advanced treatments for joint pain, including ultrasound-guided hyaluronic acid injections.

Don't let big toe arthritis hold you back from enjoying life to the fullest. Book an appointment today and take the first step towards pain-free movement and improved quality of life. Don't wait – ACTIVATE your path to recovery now!


About the Author: Dr. Mustafa Alnaib MBChB, MRCS, MSc, FEBOT is an orthopaedic surgeon, musculoskeletal doctor and Clinic Director at ACTIVATE Musculoskeletal Clinic in Kent.

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