Quick Summary
A painful, stiff big toe can alter how you walk. Treatment aims to make daily activity more comfortable through footwear advice, suitable exercise and individual support. Our physiotherapists in New Malden can assess your symptoms and help you choose appropriate next steps for your goals.
Understanding Hallux Rigidus

Hallux rigidus is arthritis affecting the joint at the base of the big toe. Reduced upward movement can make push-off painful, and a bony prominence may irritate footwear. It is different from a bunion, although the conditions can coexist.
Assessment at J&J Therapy
We review symptoms and any diagnosis, then examine toe movement, walking and footwear. We discuss whether podiatry advice, an insole or orthopaedic input is appropriate. The aim is useful function rather than forcing normal movement from an arthritic joint.
Do You Experience These Symptoms?
- Pain or stiffness at the base of the big toe.
- Difficulty pushing off, climbing hills or wearing flexible shoes.
- A tender bump on top of the joint or rubbing inside footwear.
An assessment helps guide your next step, based on your symptoms, health and goals.
Why symptoms may develop
Joint changes may develop over time or after an injury. Inflammatory conditions can also affect the big toe. A sudden hot, intensely painful joint needs medical assessment for causes such as gout or infection rather than assuming ordinary arthritis.
Treatment and rehabilitation options
Hands-On Manual Therapy
Gentle treatment may help surrounding stiffness when tolerated. Forceful mobilisation of a painful rigid joint is avoided, and manual therapy cannot remove a bony spur or reverse arthritis. We explain the purpose and check your comfort and response throughout treatment.
Is Shockwave Suitable?
Shockwave is not a routine treatment for hallux rigidus. Management centres on reducing painful joint demands, maintaining suitable function and considering specialist options if needed. Your physiotherapist can explain the more suitable options and how their effect will be reviewed during your ongoing rehabilitation.
Targeted Exercise Programme
A stiffer sole or rocker-style shoe may reduce painful toe bending after an individual footwear review. Exercises maintain comfortable movement and strength without repeated forced extension. We help adapt walking and fitness activities to the joint’s tolerance. Your home plan is adapted as your function and confidence improve.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
- Seek urgent GP or NHS 111 advice for severe pain after injury, inability to bear weight, or a hot swollen joint with fever.
- Go to A&E for an obvious deformity or a foot that becomes cold, pale or numb.
- If you have diabetes and a new foot wound, redness or swelling, contact your GP or diabetic foot team the same day; use NHS 111 if unavailable. Persistent altered sensation also needs medical review.
Your questions answered
Is it the same as a bunion?
No. Hallux rigidus mainly describes stiffness and arthritis at the big-toe joint; a bunion involves a change in toe alignment with a side prominence. Assessment can identify both.
Can physiotherapy make the joint normal again?
It cannot promise to reverse arthritis. It may help function and symptoms, while persistent limitations can be discussed with a podiatrist or foot and ankle specialist.
Which appointment should I book?
Start with a Physiotherapy Initial Assessment for new, persistent or recurring symptoms. We can assess the problem and agree a plan linked to your daily activities. If you have already had medical care or surgery, bring the relevant instructions.
Book a Physiotherapy Assessment or call our reception team on 07935 869938. Find J&J Therapy at CI Tower, Ground Floor, New Malden.
Related conditions
Bunions (Hallux Valgus) · Turf Toe
Sources and further reading
This page is for general information only and does not replace professional medical advice.
Information updated 15 October 2026. General information only; this page cannot diagnose your symptoms. Treatment is agreed after assessment. For urgent or severe symptoms, use the medical services described above.
