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Hallux valgus – bunion toe

Treatment of pain by widening the forefoot

A forefoot deformity – also called hallux valgus – leads not only to an aesthetic impairment, but also to movement restrictions of the feet. The disease is mostly caused by years of wearing the wrong footwear. If the feet and especially the toes are squeezed in too tight and uncomfortable shoes for a long time, the foot base position at the forefoot deforms and leads to the development of a hallux valgus as a toe malposition of the big toe.

At the Orthopaedic Center Munich East (OZMO), our experienced orthopaedic specialists such as Dr. med. Meinhard Balensiefen are happy to assist you as hand and foot specialists. From diagnosis to the best possible treatment, we care for and accompany you on your way to freedom from symptoms of hallux valgus and other conditions. Find out about the clinical picture in advance on our website and make an appointment in our practice in a timely manner.

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Table of Contents:

What is hallux valgus?

Symptoms of hallux valgus
Causes of hallux valgus as forefoot deformity

Diagnostics for suspected hallux valgus
Treatment for hallux valgus
If you suspect you have hallux valgus, make your appointment at OZMO

What is hallux valgus?

Hallux valgus is the name given to a particular deformity of the big toe, also known as a bunion. The position of the toe bones shifts in such a way that the ball of the foot pointing inward becomes pronounced, while the tip of the toe leans toward the adjacent toe. In this case, the ball of the toe often thickens due to the increasing irritation as part of the malposition.

Depending on the degree, the malpositioning of a hallux valgus causes pain and movement restrictions, for example when rolling the foot in the stepping motion. The most common cause of hallux valgus is the combination of incorrect footwear, usually too tight, and weakened tissue.

Symptoms of hallux valgus

If the first metatarsal shifts outward, the front part of the toe moves inward over the metatarsophalangeal joint. This creates a forefoot widening where the ball of the foot protrudes. The deformity provides variable pressure due to the altered load on the foot, which leads to nerve stress and nerve damage. Accordingly, the symptoms of hallux valgus present themselves with pain, but also with numbness. Thickened areas of skin (callus) appear on the sole of the foot and the ball of the foot, while the ball of the foot becomes red and shows with swelling, indicating possible inflammation. At the same time, the big toe stiffens more and more, as the deformation deprives it of its natural freedom of movement.

Parallel to hallux valgus, other problems with the feet sometimes develop if no treatment is initiated. For example, the deformities can promote the development of osteoarthritis in the big toe (hallux rigidus), other toes can deform into hammertoes or claw toes, and the risk of corns (clavus) is increased.

Causes of hallux valgus as forefoot deformity

The main cause of hallux valgus is usually misuse and overuse of the foot, which is associated with incorrect footwear. Especially shoes with high heels and too narrow fit can promote the development of hallux valgus when worn for a long time during permanent standing and walking. Accordingly, women from middle age onwards who wore high shoes for long periods of time are often affected.

If there is also a preload due to weak connective tissue, insufficiently developed foot muscles or a congenital malposition of the foot bones, the risk of developing hallux valgus is increased. Regular compensation to relieve the feet and the abandonment of weight-bearing footwear should therefore take place even before the development of the widening of the forefoot.

Diagnostics for suspected hallux valgus

Hallus valgus is easy to diagnose because of the symptoms so typical of the condition. Usually, a look at the deformity by a specialist in orthopedics is sufficient, who can distinguish the particular signs of a hallux valgus from other diseases through his experience.

Nevertheless, careful diagnostics are indispensable. Imaging techniques such as X-ray clearly identify the location in the toe joint. X-rays allow precise assessment of the foot malposition and of any joint wear that may already have occurred, which in addition to hallux valgus may indicate hallux ridigus as arthrosis in the metatarsophalangeal joint of the big toe. If further damage is suspected, a magnetic resonance imaging (MRI) scan can also be performed as a supplement.

At the Orthopaedic Center Munich East (OZMO), our specialists with the experienced team on site perform all examinations and also arrange for necessary blood tests (to differentiate rheumatism, arthritis, etc.) as well as imaging procedures directly in our well-equipped center for orthopaedics and initiate the individually appropriate treatment for hallux valgus and other diseases.

Treatment for hallux valgus

Not every hallux valgus needs to be treated. It is advisable to undergo therapy in cases of foot pain, severe aesthetic impairment or inflammatory or painful changes in the area of the foot. The earlier treatment is initiated, the more promising the results for alleviating symptoms and preventing more complex sequelae.

Mild forms can be treated well with conservative therapy. Physiotherapy and toe gymnastics can be used to strengthen muscles and tendons, but also to improve curved foot structures. More advanced stages can be supported with a hallux valgus splint, which helps to fundamentally correct the foot situation by wearing it at night or in everyday life with suitable footwear. Bandages, orthopedic footwear and insoles are other options, along with toe spreaders, pads or taping. Pain and inflammation caused by hallux valgus can be accompanied by medication if necessary.

Only as a last option, surgical treatment is used, which, however, should not be undertaken solely for aesthetic reasons, but primarily to promote health. There are various methods to choose from, such as an osteotomy, a pseudoexostosis and other variants, which are individually adapted to your foot situation with hallux valgus.

If you suspect you have hallux valgus, make your appointment at OZMO

If you have discomfort in your feet and at the base joint of the big toe, you should see an experienced orthopedist promptly. If you suspect the development of hallux valgus, please feel free to make an appointment with our specialists such as our hand and foot specialist Dr. Meinhard Balensiefen, who will be happy to assist you as a specialist in orthopedics. Call us or write us a message so that our practice team can reserve an appointment for you at the Orthopädie Zentrum München Ost (OZMO) as soon as possible.

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