Every mile you walk puts 60 tons of stress on each foot. Your feet can handle a heavy load, but too much stress pushes them over their limits. When you pound your feet on hard surfaces while playing sports or wear shoes that irritate sensitive tissues, you may develop heel pain, the most common problem affecting the foot and ankle.
Hallux Valgus (Bunion)
A bunion is a one problem that can develop due to hallux valgus, a deformity of the foot. The Latin meaning of “hallux valgus” is turning outward (valgus) of the first toe (hallux). The bone that joins the first toe, the first metatarsal, becomes prominent on the inner border of the foot (a bunion). Shoe pressure on this prominence causes inflammation and pain.
Other problems can develop along with hallux valgus. The metatarsal bones can become prominent in the ball of the foot and the small toe joints can become contracted. With shoe pressure, corns and calluses can develop.
There is no single cause of hallux valgus. It may develop from muscle imbalance as in cerebral palsy or polio. It may develop from joint destruction as in arthritis. The most common problem is an imbalance of the forces of the toe, present from birth, which causes the hallux valgus to develop progressively with time.
High-heeled, pointed shoes are not the primary cause of the deformity, but they do cause it to be painful. They cause bunions, corns and calluses to develop where there is deformity.
Osteoarthritis, rheumatoid arthritis, infection and gout may all cause pain in the first toe. Therefore, before treatment of a painful bunion can begin, medical evaluation is needed.
Treatment may be surgical or non-surgical. The goal of the non-surgical treatment is to relieve pressure on the foot to prevent pressure sores and foot ulcers. This is accomplished by prescribing accommodative shoes – sandals or extra depth shoes with soft-moulded insoles.
The goal of surgery is different. Surgery attempts to realign and balance the first toe to restore normal function. Corns in the small toes may be treated by straightening and shortening the toes. Arthritis in the first toe can be treated by resurfacing the joint, or removing the joint and fusing the toe straight. The aim is to produce a foot which fits comfortably into an “off the shelf” shoe but it is not to restore the hallux valgus to a cosmetically normal looking foot.
Over 90% of patients are very happy with the result of the surgery. However, as with all procedures, there is always a small risk of complications.
Recognized complications include:
- Infection at the site of the wound.
- Over /Under correction.
- Nerve injury at the time of surgery.
- Toe joint stiffness.
- Transfer metatarsalgia.