Hallux valgus is a common painful condition in pedorthic in which the big toe deviates laterally (i.e. the lesser toes), usually with a bunion, a protrusion of the bone on the medial aspect of the big toe joint with redness and swelling. Hallux valgus may get worse with age, the bunion may become more prominent and the big toe may overlap with the second toe with a obvious change in shape of the entire forefoot. The consequences are far-reaching.
Hallux valgus is not exclusive to women and is not necessarily associated with the wearing of high heels. In fact, the condition is hereditary and there are several risk factors that can make it progress.
- The main causes and aggravating factors of hallux valgus include genetics, improper shoe wear and foot malalignment.
- Heredity: Loose ligaments of foot and lack of muscle tone are hereditary which increase the risk of hallux valgus formation.
- Improper shoe wear: Wearing high heels or pointed shoes frequently increases the pressure on the big toe, which can lead to a progression of hallux valgus.
- Flat feet or excessive foot pronation: Over-pronated feet cause instability in the metatarsal joints during push-off and muscle imbalance can pull the hallux towards lateral side.
- Deviation and rotation of the hallux to the lateral side.
- Protrusion of the big toe joint, causing redness and swelling, resulting in a bunion.
- Stinging pain in the bunion area after walking or exercising, especially when wearing high heeled, narrow or pointed toe shoes.
- Wear shoes with wide toe box: This provides enough space to avoid excessive rubbing on the bunion, reducing swelling and pain. High heeled or pointed shoes should also be avoided.
- Hallufix: Help reduce the speed of progression of hallux valgus.
- Toe separator: Separate the big toe from the second toe to reduce friction when walking.
- Custom-made foot orthoses/ corrective sandals: Correct foot malalignment, stabilise the first ray and prevent worsening of hallus valgus.
- Surgery: If hallux valgus is severe, medical advice should be sought and surgical treatment may be required to improve the shape and disposition of hallux.