Hallux valgus is a malpositioning of the big toe, it is also called bunion toe. The bunion deviates inwardly in the metatarsophalangeal joint of the big toe, so that the pull of the muscles pulls the big toe outwardly in the direction of the other toes. This causes the metatarsophalangeal joint of the big toe to deviate prominently inwards and is now exposed to pressure.
Callus formation as well as bursitis can occur. The malalignment can cause considerable pain when walking and standing, as well as in tight shoes. Wearing footwear that puts pressure on the forefoot (e.g. heels) or foot malpositions such as fallen arches can lead to hallux valgus.
A genetic disposition is probable, since there is often a familial occurrence of hallux valgus. Women are more frequently affected than men. The diagnosis is usually made by a simple examination, the therapy can be conservative, such as physiotherapy, splints or bandages. In cases of severe pain resistant to therapy, a simple surgical intervention is indicated.
Therapy
If an oblique position of the big toe in valgus position is detected, the therapy should be adjusted according to the extent of the problem. If the big toe is slightly inclined, it is essential to select the correct footwear to prevent further training. Girls in particular should avoid heels, shoes that are too short or too tight, as they compress the toes.
The position of the big toe can also be corrected with tapes or bandages. Shoes that are adapted to provide relief can provide relief especially for pressure-sensitive big toe joints. If the tendon of the abductor hallucis muscle has not yet slipped over the joint, this muscle should definitely be exercised, as this muscle can pull the big toe inwards into the physiological position.
In advanced hallux valgus, vision may already be displaced over the joint and paradoxical muscle traction then favors the valgus position of the big toe. Training the arch of the foot also counteracts hallux valgus. In case of severe pain, which also has an unfavorable effect on the gait pattern, surgery should be considered.
There are a variety of surgical techniques that aim to correct the position of the hallux valgus. The soft tissues around the joint are also mobilized during the operation, so that the possibly stiffened joint can be moved again after the operation. Since hallux valgus is often accompanied by arthritis of the basic joint (hallux rigidus), this should also be considered during the operation. After the operation, the joint must be protected for a certain period of time and can then be gradually exercised and loaded.
