title: Hallux rigidus: A case report of successful chiropractic management and review of the literature.
abstract: OBJECTIVE
  To describe a common musculoskeletal disorder from a chiropractic management prospective, subsequently to stimulate further research into the chiropractic therapeutic effects on such cases and to contribute to chiropractic literature.
  
  
  METHODS
  A 27-year-old, 76" male student often involved in athletic activities, had a sudden onset of continuous localized pain in the medial aspect of the mid and forefoot on the right side for 1-and-a half months. The onset of pain was related to an accidental injury while playing basketball. The pain worsened every time during and after playing basketball and other weight-bearing activities such as walking upstairs and is palliated with physical rest. He tried Biofreeze and ice application for several times immediately after the injuries which help to some extent to relieve pain and swelling, but he did not seek any other professional care. The condition had been improving slowly even before he came to the clinic although the patient described the pain as 5/10 on the Borg pain scale when he came to the clinic for the first time. The characteristic local findings were a mildly hyper-pronated right foot, mildly asymmetric soft-tissue and bony contours, tenderness, stiffness and decreased range of motion (ROM) at the first metatarsophalangel and adjacent joints on the medial aspect of the midfoot decreased fluid motions in the concerned joints on the chiropractic evaluation and some abnormal wearing in the shoes.
  
  
  RESULTS
  He was managed with chiropractic manipulation combined with other conservative measures. Range of motion (ROM), Borg Pain Scale and an orthopedic test (Morton's Test) were used as the outcome measures. The subject showed a favorable response to the conservative (chiropractic) care.
  
  
  CONCLUSIONS
  Although hallux rigidus is one of the most common musculoskeletal degenerative conditions, our conservative management received a favorable response but there has been little discussion about it in chiropractic literature. It can be hypothesized that the progress of Hallux Rigidus (HR) can be reversed or halted by chiropractic management provided it is started at the early stage of the disease.
authors.affiliation: Resident in Chiropractic Family Practice, University Health Services Clinic, National University of Health Sciences, Lombard, IL.
authors.forename: Deepak B
authors.initials: DB
authors.lastname: Manral
references.citation: Foot Ankle Int. 1997 Apr;18(4):222-8
references.pmid: 9127112
references.citation: Foot Ankle Int. 1999 Apr;20(4):232-7
references.pmid: 10229279
references.citation: Foot Ankle Int. 2000 Nov;21(11):906-13
references.pmid: 11103761
references.citation: Foot Ankle Int. 2001 Jun;22(6):462-70
references.pmid: 11475452
references.citation: J Chiropr Med. 2003 Spring;2(2):55-9
references.pmid: 19674596