Definition
The splayfoot is the most common acquired foot deformity or malposition. It is almost always congenital and affects more women than men. The lowering of the transverse arch of the foot causes foot complaints with widening of the forefoot, which means that the entire forefoot is in contact with the ground.
Synonyms
- Splayfeet
- Splayfoot
- Pes transverso planus
- Hallux valgus
- Hallux rigidus
- Pain foot and sole of foot
Causes of splayfeet
A splayfoot can develop as an aging process without any external influence. With age, the fat pads under the 3 middle phalanges of the toes disappear. This increases the pressure on the underlying bones.
Splayfoot is further favored by wearing shoes with high heels for many years. These constrict the foot at the tip and increase the pressure on the tip of the foot fivefold due to the altered weight distribution. Women are often genetically predisposed to splayfoot because of the increased occurrence of connective tissue weakness.
Long-term wearers of high heels are therefore the largest risk group for the development of a splayfoot in old age. You can read more about the causes of this foot malposition here: The main symptom of splayfoot is load-dependent pain. This pain occurs particularly when walking and standing and subsides when the foot is at rest.
The widening of the foot causes discomfort in the shoe. Due to the changed positions of the metatarsophalangeal joints (hammer toes or claw toes), corns (ClaviClavus) develop over the toes. Another consequence is that the big toe pushes outwards (hallux valgus) while the small toe moves inwards (digitus quintus varus).
Due to the foot spreading further and further apart, the flexor tendons in particular become too short and the toes are pushed into a claw position. This results in the formation of hammer or claw toes. Splayfeet can lead to very severe pain.
The reason for this is a profound change in the structures of the foot and the adjacent tendons. The lowering of the arch of the foot causes the foot to widen. This widening requires – for example in the shoe – much more space than usual.
However, the anatomical broadening of the foot is not taken into account in standard footwear. Shoes that once fitted now cause pressure pain on the outside and even newly purchased shoes are too tight for the splayfeet. The constant pressure on the outside of the feet causes a so-called metatarsalgia in the long run.
This is the name given to the occurrence of pain under the heads of the metatarsals. The metatarsal bones form the connecting piece between the toes and the metatarsal bones of the foot. The middle three metatarsals are particularly affected.
Patients then express pain in the area of the front, middle third of the foot, as well as increased callus formation. The pain increases especially under stress, since the body weight exerts additional pressure on the arch of the foot. An additional problem is now posed by the tight shoes already mentioned: Since tendons can be displaced due to the lateral constriction, the toes can be displaced.
As extensions of the foot muscles, the tendons pull on the toes and over time bring them into an oblique position when they are displaced. After the toe bones have also been displaced, dislocations in the toe joints can occur. These are associated with extreme pain and must be treated orthopedically as soon as possible.
NSAIDs, i.e. painkillers that do not fall under the narcotics law, are usually prescribed for pain in splayfeet. These have relatively few side effects and can combat the pain well. However, in addition to symptomatic therapy, a causal therapy must also be carried out, since a permanent intake of painkillers cannot be a solution.
If taken over a longer period of time, they cause stomach damage, among other things, and must therefore always be combined with stomach protection (e.g. Pantoprazole®). In order to relieve the pain, it is also primarily recommended to avoid wearing tight shoes and to walk barefoot on a regular basis. This should at least be possible at home. In the end, however, freedom from pain can only be guaranteed by orthopedic treatment. You can find more information about pain with a splayfoot here: Pain caused by a splayfoot