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Where do hallux valgus arthritis come from?
Hallux valgus is most often the result of a disorder in the biomechanics of the foot - abnormal forces cause the formation of deformities. There are many causes of hallux valgus, the main ones are: flat feet, diseases of the Achilles tendon, rheumatic diseases, damage to the posterior tibialis muscle. A major role in the development of hallux valgus toes is played by genetic susceptibility to the condition. This is evidenced by the fact that in a significant percentage of cases it occurs familially in the female line: grandmother, daughter, granddaughter. Although this deformity most often affects women over 40, the problem of hallux valgus can also affect younger ladies and even men.
Factors that can affect the formation of hallux valgus also include obesity, a standing lifestyle, as well as playing sports or classical dance (ballet). The most common cause of hallux valgus, however, is prolonged wearing of ill-fitting shoes or orthotics. This largely refers to shoes with narrow and pointed toes, which put pressure on the toes in an unnatural position. Sometimes, seemingly comfortable sneakers or ballerinas that do not have adequate cushioning in the sole can also contribute to the weakening of the muscles and joints of the foot, and thus lead to the formation of a clubfoot. Scientific studies show that hallux valgus toe in populations that wear shoes is about 15 times more common than in people who go barefoot.
It's not just stiletto shoes that can cause hallux valgus. |
Symptoms of hallux valgus
- Pain - the primary symptom of hallux valgus is pain located in the area of the joint of the big toe, giving great discomfort especially when walking or wearing tight shoes. Particularly narrow high-heeled shoes aggravate hallux valgus discomfort.
- Deformity - the most characteristic symptom is a change in the shape of the foot. There is a bending of the big toe towards the other toes, which can lead to problems with walking and foot function. A misaligned toe does not properly stabilize the foot. In addition to displacement of the big toe, there may be a characteristic bump on the outside of the foot.
- Limited mobility - in advanced cases of hallux valgus, mobility in the joint of the big toe may be limited, making walking difficult.
- Inflammation - inflammation may develop around the joint of the big toe, manifesting as increased local warming, redness and burning. There may also be thickening of the skin, and the epidermis may become painful due to friction and pressure from footwear.
- Calluses - in advanced stages of "hallux valgus" there are often concomitant deformities, such as clawed toes, hammer toes, skin calluses, bunionette or metatarsalgia, adding to the discomfort.
Hallux valgus - discomfort when walking
Patients who are bothered by hallux valgus toe often wonder whether it is possible to treat hallux without surgery. Under the influence of deformation of the first metatarsal bone, the biomechanics of the foot changes, as the weight of the body is distributed unevenly on it. The toe ceases to be a strong enough point of support during gait. The strength of the tendons stabilizing the foot deteriorates, the muscles weaken, and joint limpness occurs. Occasionally there is inflammation of the joint capsule, swelling and soreness. Such symptoms should not be underestimated and we should go to an orthopedist, who will choose the appropriate method of treatment.
How to treat hallux valgus?
Most hallux valgus, especially those that do not cause pain, can be treated conservatively. With proper prevention, we are able to stop further development of the toe deformity. One course of action may be to change the shoes to ones that fit properly and do not put pressure on the toes. Barefoot walking on soft ground and, above all, proper corrective exercises for hallux valgus can also bring relief.
If the problem occurs, for example, between the ages of 30 and 40, should one react?
Yes, using preventive measures such as:
- proper footwear,
- insoles,
- rehabilitation.
It is also important to answer the question of whether hallux valgus surgery is necessary and when to undergo it? - This is a very individual question. There are people with severe valgus and yet no pain. The decision on surgical treatment is made after a thorough examination and discussion with the patient. Hallux valgus treatment is best started as soon as possible after noticing the condition. Preventing the defect from worsening, including by giving up narrow high-heeled shoes and using appropriate exercises, will help avoid a procedure such as hallux surgery.
Patients with hallux valgus come to the clinic for several reasons:
- persistent pain,
- problems with shoe selection
- aesthetic reasons.
Medicine has not yet found an effective non-surgical treatment for hallux valgus. One can encounter a number of insoles and braces for hallux valgus, the use of which brings temporary relief from pain, but in the long term they are not effective. Prevention in small deformities, using exercises for hallux valgus at home, makes it possible to slow the progression of the disease. However, only hallux valgus surgery is an effective solution.
What does hallux valgus surgery involve?
If conservative treatment proves insufficient, then only hallux surgery can correct the foot deformity and relieve the patient of pain. The extent of the surgery depends on the severity of the deformity. There are many surgical techniques, and the choice is made by the doctor after a clinical examination and evaluation of an X-ray showing the degree of damage to the toe joint.
Effectiveness of hallux valgus treatment
A correctly selected surgical method can give an effective elimination of the hallux problem forever. In some cases, however, the toe deformity may recur, and the underlying cause is a genetic tendency to joint limpness.
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Bibliography:
- Fizjioplaner - "HALUKSY - PALUCH KOŚLAWY - OBJAWY, PRZYCZYNY, LECZENIE" - mgr Michał Angerman -2019
- Harvard Health Publishing - "What to do about bunions" - Dr. James P. Ioli - 2020
- Healthline - "Bunions" - Elaine K. Luo, M.D. - 2017
- Medical News Today - "What you need to know about bunions" - William Morrison, M.D. — By Lori Smith, MSN, BSN, WHNP-BC on February 18, 2019
