Widespread foot pathology, in severe cases it can create pain and make normal walking difficult. The remedies and treatments are different, right up to surgery.
- Hallux valgus: what is it?
- What are the symptoms of hallux valgus?
- The causes
- Metatarsalgia and other complications
- Diagnosis
- Conservative approach
- The importance of posture
- Surgical intervention
- After surgery
- Hallux valgus: what to do and what to avoid
Ask for free advice from a doctor right away
Widespread foot pathology, in severe cases it can create pain and make normal walking difficult. The remedies and treatments are different, from surgery to some things you can do to protect the health of your feet. Let’s see how.
Hallux valgus: what is it?
L ‘ bunion is a protuberance that is formed at the base of the big toe. It is a bony protrusion that can be of variable size and is caused by the lateral deviation of the tip of this toe, which pushes towards the others.
The result is the increase in size of the joint at the base of the big toe , which can become a real deformity (the so-called “onion” in the foot).
More worrying than the aesthetic damage, however, is the pain that can occur as the disease progresses , also due to the alteration of the soft tissues. Pain that can worsen to cause problems with normal walking.
What are the symptoms of hallux valgus?
It is an easily identifiable disorder, characterized by symptoms that can vary from patient to patient, but which, in principle, include:
- redness and swelling of the big toe joint
- calluses, skin thickening and partridge eyes, located in most cases in the area where the big toe rubs with the second toe
- persistent or intermittent pain
- limitation of toe movement.
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The causes
Orthopedics experts and specialists do not have a definitive theory about what causes this disorder.
There are likely several factors that contribute to the development of valgus, including:
- genetic predisposition and hereditary factors , which can favor the development of this type of foot deformity
- injuries or traumatic injuries to the foot
- defects present at birth (congenital diseases)
- incorrect posture , in some cases due to muscle tone problems
- overweight
- the use of high heels , which shifts the load of the foot to the front of the foot, thus weighing on the toes
- shoes that are too small, with a narrow toe , which compress the foot making it more susceptible to the development of valgus
- rheumatoid arthritis .
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Metatarsalgia and other complications
If bunions go untreated, it can lead to several consequences . Including the appearance of associated pathologies. An example is metatarsalgia . It is a disease caused by an incorrect support of the foot on the ground. In particular, the weight of the body is not distributed evenly on the sole of the foot, but tends to concentrate mainly on the forefoot and metatarsus. This causes calluses to form which can cause discomfort or pain.
What to do with hallux valgus with metatarsalgia? The deviation of the big toe causes lateral thrust on the other toes. This situation, if not treated properly, can lead to the formation of so-called hammer toes, a deformity involving the proximal and intermediate phalanxes of the fingers. This unnatural position causes an overload at the metatarsal level corresponding to the formation of often painful calluses.
Another complication of valgus is bursitis , an inflammation that affects the sacs, fluid-filled blisters that have the role of protecting the joints from wear and tear due to continuous rubbing.
A separate discussion must be made if those suffering from hallux valgus are also suffering from diabetes . This pathology is associated with disorders of blood microcirculation, located in particular at the level of the foot. Suffering from valgus can aggravate vascular symptoms related to diabetic pathology.
Finally, leaving a hallux valgus without proper care can lead to the development of arthritis in the fingers or other joints of the foot, which, due to valgus, are subjected to constant rubbing.
Diagnosis: discover the hallux valgus
A physical examination by your doctor is enough to identify the characteristic symptoms of valgus or the complications associated with it.
For an even more precise diagnosis, the specialist may recommend an x-ray : with this examination it is possible to view the entire bone system of the foot and evaluate the severity of the disorder and hypothesize its cause.
In some cases, the presence of the characteristic “onion” in the big toe can be a sign of other diseases , such as gout , a metabolic disease that manifests itself in the presence of swelling and pain in the joints. The one at the base of the big toe is among the most affected and, to an inexperienced eye, the deformity caused by gout may appear similar to that caused by valgus.
In case your doctor suspects the presence of this metabolic disease, he may request other laboratory tests to investigate.
A misdiagnosis may also be due to the similarity between a condition associated with hallux valgus, namely metatarsalgia, and Norton’s neuroma . It is a particular type of metatarsalgia, which however is not due to the presence of valgus, but to a neuralgia localized in the anterior part of the foot (called forefoot). This pathology manifests itself with the presence of pain and swelling at the base of the big toe, but, unlike valgus, it presents with neuromuscular symptoms, such as tingling or loss of sensation.
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Conservative approach
Once the presence of valgus has been identified with certainty, there are several therapeutic strategies to be considered, based on the pain and severity of the hallux valgus.
The first is known as the conservative approach . It is a series of actions, which have both preventive and therapeutic functions, such as the use of wide and comfortable shoes, which allow the toes to have a lot of space available, avoiding an increase in pressure on them.
In some cases, the application of a bandage may be useful to avoid having the feet in an unnatural position . This is a procedure that must be performed carefully: it is better to avoid doing it yourself and always contact specialists.
To reduce swelling, pain, and inflammation, your doctor may suggest taking pain relieving medications . Rather widespread is the administration of cortisone , through local injections. There are also several anti-inflammatory ointments commercially available, which can be applied to sore skin.
In this sense, ice is also a good ally . Applying it to the affected area helps reduce symptoms related to inflammation.
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The importance of posture
As we have seen, if the weight of the body is not distributed evenly on the sole of the foot, there are areas subjected to excessive pressure, which can generate or aggravate the phenomenon of valgus.
Incorrect posture can lead to problems not only in the foot, but also in the ankle and knee and their respective tendons and ligaments.
It can therefore be very useful to use an insole to correct a bad posture or special pads to separate the fingers. The aim is precisely to make the load of the foot uniform during walking, distributing the weight not only on the forefoot, but also on the heel and hindfoot.
Orthotics and corrective pads are also useful for solving other foot pathologies related to hallux valgus.
Surgical intervention
In some cases, the conservative approach may not be sufficient to solve the problem of valgus. Your doctor may then decide to recommend surgery.
There are two types of surgery available:
- classical surgery , which aims to bring the big toe back into the correct position. We proceed by removing the protruding part of the bone (process known as osteotomy) and inserting specific supports
- percutaneous surgery , which allows you to restore the correct position of the big toe in a less invasive way. We proceed by making small holes in the skin and working on the bone through the guidance of radioscopic images. In this way, by reducing the invasiveness of the intervention, post-operative recovery times are also shortened.
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After surgery
Recovery after surgery can be quite long and requires special attention to your habits. The big toes may be weaker and will not necessarily be perfectly straight.
We recommend:
- avoid driving the car or other means for at least 2 weeks
- rest for about 6 to 12 weeks
- stop sports for up to 6 months
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Hallux valgus: what to do and what to avoid
To summarize, there are some behaviors to implement, and others to avoid, when it comes to hallux valgus. Here are which ones.
