Basically there is the conservative treatment, on the other hand there is the operative therapy of the hallux valgus.
Conservative therapy
Conservative therapy of the hallux valgus: These treatment contents of the hallux valgus can be carried out by the orthopedist as well as by the family doctor. Since many factors influence the deformity of the forefoot, the prospects of a conservative therapy of hallux valgus in terms of healing are very low, a progression of this “disease” can only be temporarily stopped or slowed down. In this respect, conservative treatment is only promising in early stages in mild cases and thus in younger patients.
However, it is also carried out in older patients who cannot or do not want to undergo surgery. 1) Footwear: Patients with a hallux valgus should wear shoes with sufficient toe room and flat heels, especially when walking or exercising, but also when standing or walking for long periods of time. High-heeled, pointed shoes that are tight in the forefoot area are contraindicated.
2. own activity:The toe gymnastics learned at the physiotherapist should also be carried out at home for longer-term therapy. Regular abduction exercises of the big toe can influence the muscular imbalance positively. Walking barefoot” with Hallux valgus can also be helpful if the floor is suitable and the changes are not too strong and painful.
3. shoe care:The Hallux valgus with flat splayfoot should be relieved of pressure on the ball of the big toe by e.g. lateral expansion of the shoe upper. Furthermore, insoles with retro-capital support (support behind the heads of the metatarsals) have proven to be effective. Pressure-relieving foam pads can also reduce the discomfort caused by hallux valgus at the ball of the foot.
If the advanced disease has already led to significant osteoarthritis in the metatarsophalangeal joint of the big toe, a Hallux rigidus insert, a bunion roll with a stiffened sole that takes over the rolling motion of the forefoot – an insert with a so-called rigidus spring – can relieve these complaints. If surgery or treatment with ready-made shoes is no longer possible, orthopedic shoes made to measure with all correction mechanisms can be prescribed for a hallux valgus. The Hallux valgus night splint, which is placed between the 1st and 2nd toe like a piece of foam or felt, can limit the progression of the malpositioning.
Otherwise, however, this treatment with night splint is more reserved for patients after the corresponding operation, where the effectiveness in terms of prophylaxis is considerably higher. Inflammations of the foot, e.g. bursitis above the protruding metatarsal head, can be treated with anti-inflammatory drugs such as Diclofenac etc. Envelopes can be treated locally with Rivanol or Polividon Iodine.