Hallux valgus is ugly, should it be treated?

Author: Tang Qin, Deputy Secretary-General of the Science Popularization Expert Committee of the Chinese Medical Association

Reviewer: Zhang Jianzhong, Chief Physician, Beijing Tongren Hospital, Capital Medical University

Hallux valgus, also known as big foot disease, is the deviation and displacement of the big toe at the first metatarsophalangeal joint. The main manifestations of hallux valgus are that the big toe joint bulges outward, the big toe severely squeezes the second toe, and the big toe joint becomes red, swollen and effused; at the same time, calluses (commonly known as "calluses") will grow under the second and third metatarsal bones. In severe cases, the inside of the big toe will become red, swollen and inflamed, forming bursitis.

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1. Why does the big toe turn outward?

At present, the specific cause of hallux valgus is still unclear. Medically, more than 50% of hallux valgus cases are related to genetic factors. These patients often have a family history of the disease, and most of them develop hallux valgus in adolescence. Some hallux valgus may also be caused by inflammation, especially rheumatoid arthritis, which destroys the joints and forms an outward subluxation.

Eighty percent of people with hallux valgus are women. This is because women's estrogen levels drop after entering menopause, and the muscles and ligaments of the whole body will relax, which may cause hallux valgus; in addition, some women wear pointed shoes and high heels for a long time, which squeezes the front of the foot into a narrow triangular area, and the big toe joint will be in a state of "survival in the cracks", and has to bulge outward, causing the big toe to severely squeeze the second toe, resulting in hallux valgus.

Therefore, in daily life, it is important to choose a pair of shoes that are comfortable and have a non-tight toe box.

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2. Diagnosis and treatment of hallux valgus

Whether or not to treat hallux valgus depends on the symptoms. Some people have no symptoms of hallux valgus, so they can be observed and followed up. But if the bone on the inside of the big toe is protruding, and there is pain in the inner bone protrusion, which makes it impossible to wear shoes, you should pay attention. But the pain also depends on the situation: one situation is that it hurts when wearing shoes, and the local skin is red and swollen, which is hallux valgus; another situation is that it hurts even when barefoot, not near the big toe, but under the foot, not where the shoe touches, but where the ground touches, suggesting that the patient may have arthritis.

Patients with mild hallux valgus can use some corrective devices, such as toe clips, traction straps, etc. This group of people can place a silicone toe pad between the hallux valgus and the second toe to reduce hallux valgus and relieve pain. However, some corrective devices are difficult to wear shoes after wearing, so you can choose to use them at night. But for silicone toe pads, patients generally tolerate them well. Patients with hallux valgus can also put foot pads or orthopedic aids on the painful callus to protect the callus and prevent it from rubbing against the shoes. If the correction effect is not obvious, surgical treatment should be taken in time. For more serious deformities, orthopedic aids can only delay the development of the deformity and relieve pain. If the symptoms cannot be relieved, surgical treatment can be taken.

3. Self-care for hallux valgus

If hallux valgus is not taken seriously and allowed to develop, it may gradually worsen and even cause other toe deformities. Once the hallux valgus deformity is caused, the inner side will be repeatedly squeezed and rubbed, causing bursitis, which will cause unbearable pain to the patient and even affect walking.

Clinically, doctors will advise patients with hallux valgus to pay attention to the daily care of their toes. The precautions and methods are as follows:

(1) Wear shoes with appropriate tightness: Do not wear pointed shoes or high heels. Instead, wear square-toed shoes or oblique square-toed shoes to reduce the pressure on the forefoot, especially the big toe. In addition, you can also wear shoes or insoles with scientific arch design to reduce the reaction force of the ground on the human body.

(2) Practice grabbing glass balls with your feet: Use your toes to grab 20 glass balls one by one and put them into a small basin. Practice twice a day. This can help train your feet's grasping function and the ability of your foot muscles to stretch and contract.

(3) Stretching exercise: Use a self-adhesive elastic bandage to bind the area below the toes, stick it to the big toe, and stretch it to the position of the self-adhesive bandage below the toes, bending the bones that are pointing outward inward and pulling the toes that are curled inward outward; note that the bandage should be tightened, but not so tight that blood circulation is blocked. Tie it for 2 hours a day, it is not only effective for hallux valgus, but also for inversion of the little toe.

In short, hallux valgus not only affects the appearance, but also causes pain and difficulty in walking. The early stage of the disease is a reversible stage, and patients can take conservative treatment and self-care. In addition, rehabilitation training of foot-related muscles can also stabilize the arch of the foot and correct hallux valgus to a certain extent.