What is hallux valgus?

Behind a "Hallux valgus" is a misalignment of the big toe. It is one of the most common deformations in the foot area and mainly affects women. About 90 percent of the patients are female. Colloquially, a hallux is also called ball toe, ball of the foot or over leg. The metatarsal bone of the big toes and the metatarsophalangeal joint of the big toe gradually bend outwards in the direction of the other foot. This kink formation is called medically "Hallux valgus interphalangeus". The other, smaller toes can be moved along with it.

The term hallux valgus comes from Latin and means crooked toe. The misalignment can trigger painful inflammation in the tissue and joints. If this inflammation marketingmediaweb   spreads to the cartilage, there is a risk of arthrosis of the big toe (hallux rigidus). Hallux valgus has a tendency to get worse over time. Obesity or high heels increase the stress and lead to the fact that freedom of movement suffers.

Causes of Hallux Valgus

Whether hallux valgus develops depends on various factors. The tendency to this deformity is often inherited. In this cases there is a genetic predisposition to weak connective tissue. This susceptibility of the supporting tissue also affects the ligaments divinebeautytips   that stabilize the longitudinal and transverse arches of the foot. If they cannot give the foot sufficient support, a so-called splay or buckle foot can easily develop. Hallux valgus can develop from these misalignments.

Persistent and heavy loads on the forefoot joints nanobiztech  promote hallux valgus. With pumps and similar shoes, the body weight no longer rests mainly on the heel and the longitudinal arch of the foot due to the high heels. Rather, the forefoot carries the weight without being designed for it. Over time, the muscles, ligaments and tendons change their direction of pull as a result of the load, and the deformity increases. In the long run, incorrect footwear leads to splayfoot, even in women who are not hereditary, - the starting point for hallux valgus. You can recognize a splayfoot by the fact that the front part of the foot widens.

The reason that 90 percent of hallux valgus affects techcrunchblog   women is therefore a double burden: On the one hand, Eva's daughters have weaker connective tissue due to hormonal factors, and they also wear high or very tight shoes more often. In addition, malpositions of the feet, inflammatory changes in joints ( arthritis ), neurological diseases or broken bones also promote hallux valgus. Obesity and prolonged standing are other risk factors. These globalmarketingbusiness   circumstances are responsible for the fact that the bunion also occurs in men and in cultures where people mainly walk barefoot.

At a glance: causes and risk factors for hallux valgus

• hereditary predisposition (genetic weakness of connective tissue)
• wrong footwear, especially high heels and tight, "pointed" shapes
• Malpositions of the feet
• inflamed joints (arthritis)
• neurological diseases
• Injuries, especially broken bones on the foot
• permanent loads such as B. Standing for long periods of time and being very overweight

Hallux valgus symptoms

Hallux valgus is one of the most common foot diseases. Depending on the stage and patient, it causes more or less severe discomfort, pain and walking difficulties. Most of those affected suffer from load-dependent foot pain. They find it difficult to stand or walk for long periods of time. In narrow shoes or in high-heeled kicks, every step can be torture. 

Visible symptoms of hallux valgus are the protrusion of the ball of the toe (exostosis) as well as swelling and redness in the tissue. In addition, toes can overlap or twist if they come under the pressure of the inwardly displaced big toe in hallux valgus. This appearance is particularly annoying to women. However, this is a cosmetic problem that is not critical to therapy from a medical point of view.

Hallux valgus itself is usually not painful. The stress in the foot and the changed position of the bones, however, affect the surrounding tissues and impair their function. As a result of hallux valgus, the bursa in the big toe joint is often inflamed (bursitis). A arthrosis may arise threaten to stiffen joints and metatarsal is often overloaded (metatarsalgia).

Due to the misalignments of the big toe in hallux valgus, the neighboring toes can be displaced from their normal position and deformed. Hammer and claw toes emerge. Pressure and friction points with the shoe often swell and cause additional pain and calluses. The gait pattern also changes in many patients. The stiffened joints in the foot and the pain prevent it from rolling properly. Some hallux valgus patients become unsteady when walking.

Whether and to what extent hallux valgus causes pain or other impairments does not depend solely on the degree of the foot deformity. Everyone perceives their body and the symptoms of illnesses differently.  

Diagnosis of the halluxx valgus

Hallux valgus can be recognized at first glance in many cases , even for laypeople. The big toe is tilted and a ball forms on the inside. The protruding metatarsal head is responsible for the ball of the foot. The big toe itself turns inwards when the tendon is pulled. Further information for the doctor is the patient's complaints and the diagnosis of “hallux valgus” in family members. Because the tendency to bunion can be inherited. Often the arch of the foot of patients with hallux valgus shows further misalignments.

An x-ray of the foot confirms the diagnosis and shows the degree of hallux valgus deformity. The doctor determines the inner edge of the foot or hallux valgus angle while standing. A big toe deviation of up to ten degrees is considered normal.

A slight hallux valgus deformity is present if the deviation is between 16 and 20 degrees. A medium hallux valgus points outwards at an angle of 21 to 40 degrees. If the angle is even larger, there is a severe hallux valgus deformity. Possible cartilage and bone damage as well as soft tissue crushing can be detected by magnetic resonance imaging ( MRI ).

Treatment of Hallux Valgus

The earlier hallux valgus is detected, the easier it is to treat the deformity. The patient and doctor can choose between different therapies. In the early stages, especially with young people affected, conservative treatments usually work well. Under certain circumstances, however, an operation can make sense even for mild forms of hallux valgus. The primary goal is always to achieve permanent freedom from pain and freedom of movement and to prevent consequential damage to the metatarsophalangeal joint.

Which therapy is the best depends not only on the severity of the hallux valgus but also on the level of suffering, the age and the wishes of the patient. As a first measure, those affected should only wear flat, well-fitting shoes. These give the toes free space and reduce the pressure on the forefoot. If you continue to wears high heels despite the bunion, you lose the chance to heal the deformation.

Strengthen the foot

Foot and toe gymnastics , walking barefoot on a soft surface and taking good care of the feet are helpful for hallux valgus . Pressure, friction points, swellings and redness should be creamed, padded and - depending on the cause and pain - cooled or warmed.

Also important: keep nails short. It is bests to consult a doctor or a medical podiatrist (podiatrist) about the various options and home remedies for the pain associated with hallux valgus.

The best way to do the right gymnastics for hallux valgus symptoms is shown by a physiotherapist. There are various exercises and massages to strengthen the foot muscles, to grip with balls and toes and to relax ("foot school"). The so-called taping of a hallux valgus has a supportive effect on the arch of the foot. When taping, stable, highly elastic plaster strips (kinesiology tapes / kinesio tape) are stuck around the foot in a special way with tension. Taping is offered by some doctors and physiotherapists.

Support the foot

There are also various insoles, splints (orthoses) and bandages on the market for the treatment of hallux valgus. The aids are intended to support the foot, correct misalignments, avoid friction or pressure points and prevent the splayfoot from developing further. Corrective socks made of elastic material are a special form of bandage for hallux valgus. They look like stockings with the big toe separated. Like a bandage, the hallux valgus socks exert tension on the arch of the foot, stabilize and correct it.

Doctors often prescribe a so-called orthosis for their patients. This hallux valgus splint is intended to move the big toe back into its limb. Orthoses are not only available as a rigid version for the night, but also in a dynamic version that can also be worn during the day. With a built-in joint at ball height, the rail allows the foot to roll off. That stabilizes the gait.

Toe pads, toe separators, support inserts and the ball roll are used as additional aids. A ball roll is a rolling aid that is specially adapted to the shoe. It relieves the metatarsal and forefoot joints and helps with splayfoot and more advanced malpositions such as hallux valgus and hallux rigidus. Some of these orthopedic hallux valgus assistants are freely available in stores. Even so, they shouldn't be used lightly on their own as they can be harmful if used improperly. Before treatment, a doctor should examine the alleged hallux valgus.

Special hallux valgus shoes with a lot of space for balls and toes can relieve the foot and relieve pain. The treating orthopedic surgeon clarifies whether these are actually sensible or even necessary - ideally in cooperation with an orthopedic shoemaker. He also advises on possible shoe insoles and, if necessary, makes the aids individually.

At a glance: aids and therapies for hallux valgus

• flat, well-fitting shoes
• Insoles, pads, roll-off aids
• Splints (orthoses), bandages, tape
• Gymnastics, foot school, massages
• good care of the feet
• Special shoes, corrective socks
• Operations

Hallux valgus without pain

Not all hallux valgus causes pain. In the early stages, the deformation is primarily a cosmetic problem: visible through a slowly growing bump on the inside of the foot. As a rule, however, the protruding pad quickly causes pressure and chafing points when wearing shoes. And since hallux valgus progresses by itself (the doctor speaks of a progressive course of the disease), the deformity should be treated by a specialist even if it is not yet causing pain.

Anyone who already suffers from restricted mobility and severe pain due to their hallux valgus can have their doctor prescribe non-steroidal anti-inflammatory drugs (NSAIDs) for pain relievers. These not only relieve pain, they also have anti-inflammatory effects. In this way, the drugs can protect joint structures, ligaments, tendons and soft tissues and reduce swelling.

Regardless of the degree of the deformity, the chances of curing hallux valgus are good. Depending on the stage of the disease, the age and the requirements of the patient, the right therapy must be found. With consistently implemented conservative measures, hallux valgus can heal just as much as with an operation. The doctor and patient should joint decide on the path to freedom from symptoms.

 

Operation for hallux valgus

The operation of a hallux valgus is relatively complicated because the correction should preserve the joint and, if possible, the complete function of the foot.

Surgery - even a minor one - is a procedure that can lead to complications and leaves a scar. The advantage and disadvantage of this therapy should be weighed carefully. The aim of the surgical correction of hallux valgus is to ensure the patient's freedom of movement and pain in the future. It is usually not enough to just straighten the crooked big toe and remove the protruding bone on the ball of the foot.

In order to normalize the tension of the tendons, ligaments and muscles in the foot, the metatarsal bones usually also have to be corrected during hallux valgus surgery. The doctor speaks of an osteotomy. There are different surgical methods for hallux valgus. In addition to moving the bones during an osteotomy, the tendons or joint capsules can also be operated on or arthroscopy can be performed to preserve the joints. In the case of severe complications from the hallux valgus, a stiffening of the joint brings back mobility.

Hallux valgus surgery can be performed on an outpatient basis under general or partial anesthesia. After the procedure, the patient remains under observation for some time until he is fully responsive and fit enough to return home. On the day of the operation, however, a patient cannot take part in traffic independently and should be picked up from the clinic by an attendant. He may temporarily need a walking aid.

Hallux valgus after surgery

Healing after hallux valgus surgery takes several weeks, regardless of the method. During the follow-up treatment, the foot can usually be put under pressure, but special shoes must be worn for the first four to eight weeks. If the hallux valgus was very pronounced and a stiffening was necessary, only a partial load on the foot may temporarily be possible. As a rule, the foot and ankle are then immobilized with a special boot or plaster cast.

Such large foot operations can take up to twelve weeks before the bones are healed and fully resilient again. If the right surgical method is chosen and the procedure proceeds without complications, surgical correction of hallux valgus usually delivers very good results in all stages. If necessary, physiotherapy can stabilize or improve the results of the operation.