Hallux Valgus – Oblique Big Toe

Hallux valgus means that the big toe is oblique and points towards the other toes. Sometimes the toe joint is also pressed, which causes a lump on the side of the foot. It can make it difficult to find shoes that fit and do not pinch the foot.

Nine out of ten who get hallux valgus are women. The most common thing is that the problems start in middle age, although you can already have problems as a teenager.

Symptoms of hallux valgus

Wider foot and sore toes

If you get the hallux valgus, it starts with flattening the foot arch between the big toe and the small toe. The front of the foot is a little wider and you may need bigger shoes than before.

When the front foot is flattened, the big toe is angled and pulled towards the other toes. It can cause pressure and scuffs on other toes. Sometimes you can also get wounds.

The toe joint is pushed out

If you have hallux valgus, the toe joint can sometimes be pushed out from the foot. Then it may look like a lump has been formed where the joint access the shoe. This is because there is a small mucus bag under the skin that easily swells when exposed to pressure. The skin often becomes red and irritated. The expressed joint can make it difficult to find shoes that fit and do not pinch the foot.

Hammertoe

Hallux valgus can cause the toes closest to the big toe to losing space. It can cause the toes next to the big toe, but sometimes also several toes, to curl. Due to the fall of the forefoot, tears can pull against what is called a hammertoe, since the small joints in the toe are bent so that the toe resembles a hammer. The toe that is above or below the hammertoe is called over the toe or under toe.

When should I seek care?

You usually do not need care if you get hallux valgus, but if you need help to alleviate your complaints, you can contact a health care center. 

What happens in the body?

The slanted big toe and the flat front foot

Hallux valgus is Latin and means oblique big toe. As the hallux valgus develops, it begins with the front of the foot becoming flatter and wider. Then the big toe starts to angle towards the other toes.

Hereditary factors affect the toes

Big leap years are much more common in women than in men. It is most common for the problems to start in middle age, although you can get hallux valgus as a teenager. If oblique big years develop when you are young, the problems often have hereditary causes. The risk is greater than you will get hallux valgus if the toe closest to the big toe is long. In the western world, hallux valgus is very common, while the disease does not occur as often in countries where shoes are not used as often. There is no safe evidence that cramped and pointed shoes are speeding up the hallux valgus, however, the trouble can be exacerbated.

How can I prevent it?

Relieve the hassle of oblique tears

You can prevent and alleviate your inconvenience of oblique big years by using a sturdy shoe with plenty of room for the foot.

It can also be good to think about how your day will look and choose shoes accordingly. A shoe suitable for the party may be less suitable for the walk home. You may need to bring an extra pair of shoes.

Investigation

A doctor can usually determine that you have hallux valgus by looking and feeling your feet. No special investigations beyond that are needed.

Treatment of hallux valgus

Good shoes and posts

In most cases, you do not need to seek help from a doctor for hallux valgus, as it is usually enough to use good shoes with plenty of room for the foot.

It can be good to supplement with a post that lifts the foot arch between the big toe and the small toe if you have a hammertoe. Such a post is sometimes called a front peloton. There are also so-called pressure-relieving rings, soft rings of foam rubber, which you can apply over sore hardening. You can buy the rings at pharmacies or in stores that specialize in foot-friendly shoes.

You can also try out different special bandages and aids. You can buy this from, for example, an orthopedic technical department at the hospital, at a pharmacy or in medical stores.

Take care of hardens

If you have hallux valgus, continued pain can relieve any pain. You can soften the hardness by taking a foot bath in body-warm water for about 20 minutes. Then gently file down the hard skin with a foot file and finish by lubricating your feet with a softening cream.

If you find it difficult to take care of your feet yourself, a foot care specialist can help.

Assessment for surgery

Sometimes oblique tears can lead to such serious problems that you need surgery. If you have such problems, you can contact the health care center where the doctor makes an assessment. If you are in need of surgery, you will receive a referral to an orthopedic clinic.

You may undergo an X-ray examination to find out which orthopedic procedure is best for you. There are various surgical methods for hallux valgus, but all are aimed at reducing the width of the forefoot.

Narrow foot after surgery

The most common method of operating the hallux valgus is called Chevron osteotomy. The purpose of the operation is to make the forefoot narrower and straighten the big toe.

First, the middle foot leg is operated so that the big toe can be moved towards the little toe side. This reduces the width of the forefoot. Then the leg is fixed by means of a screw. During the procedure, you will receive local anesthesia or be anesthetized with anesthesia. After surgery, the doctor fixes the big toe with tape or a soft bandage.

You can usually go home the same day. After two weeks the stitches are removed. Then you get a new dressing that you have for another four weeks.

You often have sore toes on both feet, but usually one foot at a time when the big toe is to be straightened. It can be difficult to get around if you have both feet operating at the same time and are hurting them.

Good to quit smoking

If you smoke, the winnings are many to stop before an operation. The wounds heal faster, blood circulation and fitness improve so you recover faster. The best thing is to stop smoking altogether, but if it does not succeed then it is good if you can refrain from smoking before the operation and even the first weeks afterward. If you need help to quit smoking, your doctor can tell you what support is available.

After the surgery

You usually need to rest for the first few days after surgery. The first few days after the operation the foot swells and it is, therefore, good to put the foot high when sitting or lying down.

After the surgery, you can get a special shoe that you can wear for six weeks. With these shoes, you can gently load the foot and go shorter stretches the first day after the procedure. If you need crutches you can borrow them.

You may be in pain for the first 24 hours after surgery but then the pain will decrease. The pain can be relieved with different pain tablets. In the first place, prescription pain tablets should be used in the type of acetaminophen, for example, Alvedon. Paracetamol used at the right dose produces few or no side effects.

Since the foot swells when operated, it may be difficult to use regular shoes two to three months after surgery. Sometimes the swelling can last up to six months.

How long you need to be on sick leave depends on how physically heavy work you have and how much you need to move at work. If you work at a desk and sit a lot, it may be enough for a week’s sick leave, but if you stand or do a lot of work you may need up to eight weeks.

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