Hallux abducto-valgus (HAV) is a joint deformity where the first metatarsal moves away from the second metatarsal, causing the deviation of the big toe and a bump on the inner side of the foot. It’s a fairly common condition, often referred to as a bunion. It’s not necessarily related to any particular sport, but dances that require the wearing of high heels, pointy shoes or that involve a lot of pressure on the toes tend to increase the risk of deformity. Examples include the waltz, tango and ballet, to name but a few.
Causes and Symptoms of Foot Bunions
Although sometimes painless, if the shoe has stretched enough to fit the new shape of your foot or if you avoid putting weight on it, a hallux valgus is usually painful. At the very least, it can be uncomfortable and tiresome.
The most common symptoms are:
● A visible bump near the big toe.
● Redness and inflammation around the affected area.
● Difficulty walking.
● Osteoarthritis or bursitis.
● An ingrown toenail or subsequent deformity of the other toes.
What Actually Causes Bunions on your Feet?
Among the most common factors are genetic problems, including flat or hollow feet, a very long big toe (Egyptian foot), heredity and excessive elasticity of the ligaments.
There are also mechanical reasons for this podal deformity, such as a muscular imbalance involving the muscles attached to both sides of the big toe. In such a case, the adductor muscle is in a position of strength, stretching and atrophying the abductor muscle. In addition, excessive pronation causes the forefoot to flare, resulting in a more open footed gait, which will force the big toe outward.
The environment in which your feet dwell, mainly the type of shoes you wear, contributes greatly to the aggravation of the problem. Pointed or overly tight pumps and high-heeled shoes encourage the formation of bunions. On the other hand, a more stable and square shoe reduces the stress on the joint.
Finally, age, pregnancy, menopause, being overweight and some rheumatological diseases are also among the conditions that can lead to the formation of a hallux valgus.
How to Treat HAV
First of all, the diagnosis is clinical, visible to the naked eye. Nonetheless, X-rays are recommended to determine the degree of deviation of the toe and of the metatarsal, from mild to severe. A conservative protocol will first be recommended by your podiatrist. The primary goals are to reduce symptoms and increase mobility and comfort.
This non-invasive, non-surgical management consists of proper footwear, orthotics or toe separators, a targeted exercise program and therapeutic soft tissue manipulation. To manage pain, cortisone or hyaluronic acid infiltrations can be administered. Oral anti-inflammatory medications can be useful.
Surgery will be considered, but only as a last resort, mainly if the pathology becomes very symptomatic and greatly reduces the patient’s quality of life. Only this procedure can correct the aesthetic aspect of the hallux. The choice of surgical technique will depend on the severity of the joint deformity.
HAV probably concerns women much more than men. In fact, considering all factors, women undoubtedly check off the greatest number of the criteria conducive to the development of a hallux abducto-valgus. If you are suffering from this problem, do not delay in consulting your podiatrist. He or she will advise you to mind your bunions before they become a problem!