The Causes and Treatment Options for Hallux Valgus

Hallux valgus is a deformity of the metatarsal-phalangeal joint of the big toe and one of the most common toe pain causes to afflict humans. Commonly referred to as a “bunion” hallux valgus occurs when the phalangeal bone of the big toe develops an inward leaning aspect. This inward tilt creates unnatural pressure on the joint between the phalangeal and metatarsal bones. The result: a progressive deformity in the shape of a bump that develops on the medial side of the joint and is capable - because of its position within the load bearing structure of the foot - of causing severe toe pain when walking.

What Causes Hallux Valgus?

There is no hard and fast way to determine exactly who will develop bunions or why but there are several toe pain causes that are believed to put people at risk. They include:

  • Genetics - Genetics can play a part insofar as certain people will inherit physical abnormalities from their parents that can lead to the development of bunions.
  • Confining Shoes - Any shoe that forces your toes into confined areas in the front of the shoe (such as high heels) can create a joint deformity that may trigger hallux valgus. The same holds true for shoes that are too narrow for your foot.
  • Foot Injuries - Sports Injuries in particular often involve jamming or dislocation of the toe joints. These types of injuries are believed to be possible triggers for later development of bunions.
  • Arthritis - Particularly rheumatoid arthritis may cause changes to your natural gait or deformities in their own right that lead to big toe joint pain and eventually bunions.

Is Hallux Valgus Just Another Name for Gout?

No. Though people often confuse hallux valgus with gout and both can cause toe pain when walking, they are in fact separate conditions. Gout is caused by a build-up of uric acid in the blood which leads to the creation of tiny crystals in the joints that cause swelling, redness and a very sore big toe. Confusion arises due to the fact that both conditions primarily affect the metatarsal-phalangeal joint.

Diagnosing Hallux Valgus

Hallux valgus is not difficult to diagnose due to the prominent bony extrusion visible at the base of the big toe. Unlike the swelling associated with gout this bump will not go away over time but will in fact get worse and may require surgical treatment.

Treatment

A number of treatment options are available for the management of hallux valgus symptoms. The specifics of a treatment regimen will depend on the severity of those symptoms and may include:

  • Low-heel shoe styles that provide plenty of lateral space for the toes
  • NSAIDs to reduce pain and swelling
  • Steroid injections
  • Corrective orthotics
  • Surgery

There are two things you should keep in mind when contemplating treatment. First, if you are inclined toward non-surgical treatment you should be aware that this type of therapy may alleviate big toe pain in the short run, but will do nothing to stop progression of the condition. And second, surgery itself does not guarantee complete recovery and carries with it the small but real possibility of:

  • Nerve damage
  • Infection
  • Joint Stiffness
  • Deep Vein Thrombosis

Untreated Hallux Valgus - Risks and Complications

In some cases hallux valgus is not a serious health concern and results in little more than occasional big toe joint pain. Some people, however, choose to ignore the condition even as their symptoms become progressively worse. In these cases, failure to seek appropriate medical care can result in possibly serious complications including:

  • Hammer Toe - Not on the sore big toe itself but on the adjoining toes.
  • Bursitis - Joint abnormalities or crimping shoe styles can cause irritation of the bursa sac in the toe joint. When this occurs the entire joint area can become inflamed.
  • “Stone Bruise” or Metatarsalgia - Untreated hallux valgus can cause inflammation and pain in the metatarsal region of the foot at the base of the big toe.
  • Toe Arthritis - Perhaps the worst cascade effect from untreated hallux valgus is the potential development of arthritis in the toe joint or the foot in general.
  • Associated Deformity - The second toe of the foot can sometimes become deformed itself as the big toe pushes it out of the way to find accommodation for its misshapen self.

Prevention

A recurring theme when discussing possible causes of bunions are ill-fitting shoes or shoes intentionally designed to pinch the toes together. Common sense would then suggest that avoiding these types of footwear should lead to a reduced risk of developing big toe pain or hallux valgus. Also, if your natural gait displays a tendency toward excessive pronation your doctor may take the pro-active step of recommending orthotic inserts now in order to minimize your risk of developing hallux valgus later.